Coverage
Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
Endpoints
alpha
https://api.dev.ovok.com/fhir/R4/Coverage| Interaction | Method | Path |
|---|---|---|
| Read | GET | /fhir/R4/Coverage/[id] |
| Vread | GET | /fhir/R4/Coverage/[id]/_history/[vid] |
| Update | PUT | /fhir/R4/Coverage/[id] |
| Patch | PATCH | /fhir/R4/Coverage/[id] |
| Delete | DELETE | /fhir/R4/Coverage/[id] |
| Create | POST | /fhir/R4/Coverage |
| Search | GET | /fhir/R4/Coverage |
| History | GET | /fhir/R4/Coverage/[id]/_history |
Top-level elements
| Element | Type(s) | Cardinality | Description |
|---|---|---|---|
identifier | Identifier | 0..* | Business Identifier for the coverage |
status | code | 1..1 | active | cancelled | draft | entered-in-error modifier |
type | CodeableConcept | 0..1 | Coverage category such as medical or accident |
policyHolder | Reference | 0..1 | Owner of the policy |
subscriber | Reference | 0..1 | Subscriber to the policy |
subscriberId | string | 0..1 | ID assigned to the subscriber |
beneficiary | Reference | 1..1 | Plan beneficiary |
dependent | string | 0..1 | Dependent number |
relationship | CodeableConcept | 0..1 | Beneficiary relationship to the subscriber |
period | Period | 0..1 | Coverage start and end dates |
payor | Reference | 1..* | Issuer of the policy |
class | BackboneElement | 0..* | Additional coverage classifications |
order | positiveInt | 0..1 | Relative order of the coverage |
network | string | 0..1 | Insurer network |
costToBeneficiary | BackboneElement | 0..* | Patient payments for services/products |
subrogation | boolean | 0..1 | Reimbursement to insurer |
contract | Reference | 0..* | Contract details |
Resource-specific search parameters
Reference
- Official FHIR R4 spec:
Coverage - Maturity: Trial Use 2 (FMM 2).