Guia de Implementação do Projeto de Padronização e Qualificação dos Dados Assistenciais da Saúde Suplementar (PQDAS)
202309 - CI Build Brazil flag

A caixa de publicação vai aqui

Resource Profile: PlanoSaude - Descrições detalhadas

Active as of 2023-08-03

Definitions for the plano-saude resource profile.

Guidance on how to interpret the contents of this table can be found here

0. InsurancePlan
Definition

Plano de Saúde

ShortPlano de Saúde
2. InsurancePlan.id
Definition

Identificador lógico e único deste recurso

ShortIdentificador lógico do plano
4. InsurancePlan.meta
Definition

Metadados sobre o recurso

ShortMetadados do plano
6. InsurancePlan.implicitRules
Definition

Regras de negócio que se aplicam a este recurso

ShortRegras implícitas de negócio
8. InsurancePlan.language
Definition

Idioma do plano

ShortIdioma do plano
BindingThe codes SHOULD be taken from CommonLanguages

Uma linguagem humana.

10. InsurancePlan.text
Definition

Elemento narrativo do plano. Descreve em texto livre e compreensível por humanos o conteúdo deste recurso.

ShortElemento narrativo do plano
12. InsurancePlan.contained
Definition

Recursos contidos neste recurso

ShortRecursos contidos
14. InsurancePlan.extension
Definition

Extensões do plano

ShortExtensões do plano
SlicingThis element introduces a set of slices on InsurancePlan.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. InsurancePlan.modifierExtension
Definition

Extensões modificadores do plano

ShortExtensões modificadores do plano
18. InsurancePlan.identifier
Definition

Identificadores externos do plano

ShortIdentificadores externos do plano
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
SlicingThis element introduces a set of slices on InsurancePlan.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
20. InsurancePlan.identifier.id
Definition

Identificador do plano

ShortIdentificador do plano
22. InsurancePlan.identifier.extension
Definition

Extensões do identificador do plano

ShortExtensões do identificador do plano
24. InsurancePlan.identifier.use
Definition

Uso do identificador do plano

ShortUso do identificador do plano
Fixed Valueofficial
26. InsurancePlan.identifier.type
Definition

Tipo do identificador do plano

ShortTipo do identificador do plano
28. InsurancePlan.identifier.system
Definition

Sistema de identificação do plano

ShortSistema de identificação do plano
Control1..?
30. InsurancePlan.identifier.value
Definition

Valor do identificador do plano

ShortValor do identificador do plano
32. InsurancePlan.identifier.period
Definition

Período de validade do identificador do plano

ShortPeríodo de validade do identificador do plano
34. InsurancePlan.identifier.assigner
Definition

Entidade que atribuiu o identificador do plano

ShortEntidade que atribuiu o identificador do plano
36. InsurancePlan.identifier:rpsScpa
Slice NamerpsScpa
Definition

RPS SCPA

ShortRPS SCPA
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..?
38. InsurancePlan.identifier:rpsScpa.id
Definition

Identificador do plano

ShortIdentificador do plano
40. InsurancePlan.identifier:rpsScpa.extension
Definition

Extensões do identificador do plano

ShortExtensões do identificador do plano
42. InsurancePlan.identifier:rpsScpa.use
Definition

Uso do identificador do plano

ShortUso do identificador do plano
Fixed Valueofficial
44. InsurancePlan.identifier:rpsScpa.type
Definition

Tipo do identificador do plano

ShortTipo do identificador do plano
Fixed Value&lt;valueCodeableConcept&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;NH&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;display&nbsp;value=&quot;National&nbsp;Health&nbsp;Plan&nbsp;Identifier&quot;/&gt;<br/>&nbsp;&nbsp;&lt;/coding&gt;<br/>&lt;/valueCodeableConcept&gt;<br/>
46. InsurancePlan.identifier:rpsScpa.system
Definition

Sistema de identificação do plano

ShortSistema de identificação do plano
Control1..?
Fixed Valuehttps://fhir.ans.gov.br/sid/registro-rps-scpa
48. InsurancePlan.identifier:rpsScpa.value
Definition

Valor do identificador do plano

ShortValor do identificador do plano
Control1..?
50. InsurancePlan.identifier:rpsScpa.period
Definition

Período de validade do identificador do plano

ShortPeríodo de validade do identificador do plano
52. InsurancePlan.identifier:rpsScpa.assigner
Definition

Entidade que atribuiu o identificador do plano

ShortEntidade que atribuiu o identificador do plano
54. InsurancePlan.status
Definition

Status do plano

ShortStatus do plano
56. InsurancePlan.type
Definition

Tipo do plano

ShortTipo do plano
58. InsurancePlan.name
Definition

Nome oficial do plano

ShortNome oficial do plano
60. InsurancePlan.alias
Definition

Outros nomes do plano

ShortOutros nomes do plano
62. InsurancePlan.period
Definition

Período em que o plano esteve disponível

ShortPeríodo em que o plano esteve disponível
64. InsurancePlan.ownedBy
Definition

Entidade proprietária do plano

ShortEntidade proprietária do plano
Control1..?
TypeReference(Operadora de plano privado de assistência à saúde)
66. InsurancePlan.administeredBy
Definition

Entidade administradora do plano

ShortEntidade administradora do plano
68. InsurancePlan.coverageArea
Definition

Área de cobertura do plano

ShortÁrea de cobertura do plano
70. InsurancePlan.contact
Definition

Contatos do plano

ShortContatos do plano
72. InsurancePlan.contact.purpose
Definition

Propósito do contato

ShortPropósito do contato
74. InsurancePlan.contact.name
Definition

Nome do contato

ShortNome do contato
76. InsurancePlan.contact.telecom
Definition

Contatos do contato

ShortContatos do contato
78. InsurancePlan.contact.address
Definition

Endereço do contato

ShortEndereço do contato
80. InsurancePlan.endpoint
Definition

API do plano

ShortAPI do plano
82. InsurancePlan.network
Definition

Rede do plano

ShortRede do plano
84. InsurancePlan.coverage
Definition

Cobertura do plano

ShortCobertura do plano
86. InsurancePlan.coverage.type
Definition

Tipo de cobertura

ShortTipo de cobertura
88. InsurancePlan.coverage.network
Definition

Rede de cobertura

ShortRede de cobertura
90. InsurancePlan.coverage.benefit
Definition

Benefícios da cobertura

ShortBenefícios da cobertura
92. InsurancePlan.coverage.benefit.type
Definition

Tipo de benefício

ShortTipo de benefício
94. InsurancePlan.coverage.benefit.requirement
Definition

Requisitos para o benefício

ShortRequisitos para o benefício
96. InsurancePlan.coverage.benefit.limit
Definition

Limites do benefício

ShortLimites do benefício
98. InsurancePlan.coverage.benefit.limit.value
Definition

Valor do limite

ShortValor do limite
100. InsurancePlan.coverage.benefit.limit.code
Definition

Código do limite

ShortCódigo do limite
102. InsurancePlan.plan
Definition

Planos

ShortPlanos
104. InsurancePlan.plan.identifier
Definition

Identificador do plano

ShortIdentificador do plano
NoteThis is a business identifier, not a resource identifier (see discussion)
106. InsurancePlan.plan.type
Definition

Tipo do plano

ShortTipo do plano
108. InsurancePlan.plan.coverageArea
Definition

Área de cobertura do plano

ShortÁrea de cobertura do plano
110. InsurancePlan.plan.network
Definition

Rede do plano

ShortRede do plano
112. InsurancePlan.plan.generalCost
Definition

Custo geral do plano

ShortCusto geral do plano
114. InsurancePlan.plan.generalCost.type
Definition

Tipo de custo geral

ShortTipo de custo geral
116. InsurancePlan.plan.generalCost.groupSize
Definition

Tamanho do grupo

ShortTamanho do grupo
118. InsurancePlan.plan.generalCost.cost
Definition

Custo

ShortCusto
120. InsurancePlan.plan.generalCost.comment
Definition

Comentário

ShortComentário
122. InsurancePlan.plan.specificCost
Definition

Custo específico do plano

ShortCusto específico do plano
124. InsurancePlan.plan.specificCost.category
Definition

Categoria do custo específico

ShortCategoria do custo específico
126. InsurancePlan.plan.specificCost.benefit
Definition

Benefício do custo específico

ShortBenefício do custo específico
128. InsurancePlan.plan.specificCost.benefit.type
Definition

Tipo do benefício

ShortTipo do benefício
130. InsurancePlan.plan.specificCost.benefit.cost
Definition

Custo

ShortCusto
132. InsurancePlan.plan.specificCost.benefit.cost.type
Definition

Tipo do custo

ShortTipo do custo
134. InsurancePlan.plan.specificCost.benefit.cost.applicability
Definition

Aplicabilidade do custo

ShortAplicabilidade do custo
136. InsurancePlan.plan.specificCost.benefit.cost.qualifiers
Definition

Qualificadores do custo

ShortQualificadores do custo
138. InsurancePlan.plan.specificCost.benefit.cost.value
Definition

Valor do qualificador

ShortValor do qualificador

Guidance on how to interpret the contents of this table can be found here

0. InsurancePlan
Definition

Plano de Saúde


Details of a Health Insurance product/plan provided by an organization.

ShortPlano de SaúdeDetails of a Health Insurance product/plan provided by an organization
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one ((identifier.count() + name.count()) > 0)
ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one ((identifier.count() + name.count()) > 0)
2. InsurancePlan.id
Definition

Identificador lógico e único deste recurso


The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortIdentificador lógico do planoLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeidstring
Is Modifierfalse
Summarytrue
4. InsurancePlan.meta
Definition

Metadados sobre o recurso


The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadados do planoMetadata about the resource
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. InsurancePlan.implicitRules
Definition

Regras de negócio que se aplicam a este recurso


A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortRegras implícitas de negócioA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. InsurancePlan.language
Definition

Idioma do plano


The base language in which the resource is written.

ShortIdioma do planoLanguage of the resource content
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguageshttp://hl7.org/fhir/ValueSet/languages

Uma linguagem humana.


A human language.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. InsurancePlan.text
Definition

Elemento narrativo do plano. Descreve em texto livre e compreensível por humanos o conteúdo deste recurso.


A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

ShortElemento narrativo do planoText summary of the resource, for human interpretation
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. InsurancePlan.contained
Definition

Recursos contidos neste recurso


These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

ShortRecursos contidosContained, inline Resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. InsurancePlan.extension
Definition

Extensões do plano


May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensões do planoAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on InsurancePlan.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. InsurancePlan.modifierExtension
Definition

Extensões modificadores do plano


May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensões modificadores do planoExtensions that cannot be ignored
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. InsurancePlan.identifier
Definition

Identificadores externos do plano


Business identifiers assigned to this health insurance product which remain constant as the resource is updated and propagates from server to server.

ShortIdentificadores externos do planoBusiness Identifier for Product
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
This element is affected by the following invariants: ipn-1
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on InsurancePlan.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
20. InsurancePlan.identifier.id
Definition

Identificador do plano


Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortIdentificador do planoUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
22. InsurancePlan.identifier.extension
Definition

Extensões do identificador do plano


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensões do identificador do planoAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on InsurancePlan.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
24. InsurancePlan.identifier.use
Definition

Uso do identificador do plano


The purpose of this identifier.

ShortUso do identificador do planousual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Fixed Valueofficial
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. InsurancePlan.identifier.type
Definition

Tipo do identificador do plano


A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortTipo do identificador do planoDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. InsurancePlan.identifier.system
Definition

Sistema de identificação do plano


Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortSistema de identificação do planoThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. InsurancePlan.identifier.value
Definition

Valor do identificador do plano


The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortValor do identificador do planoThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. InsurancePlan.identifier.period
Definition

Período de validade do identificador do plano


Time period during which identifier is/was valid for use.

ShortPeríodo de validade do identificador do planoTime period when id is/was valid for use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. InsurancePlan.identifier.assigner
Definition

Entidade que atribuiu o identificador do plano


Organization that issued/manages the identifier.

ShortEntidade que atribuiu o identificador do planoOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. InsurancePlan.identifier:rpsScpa
Slice NamerpsScpa
Definition

RPS SCPA


Business identifiers assigned to this health insurance product which remain constant as the resource is updated and propagates from server to server.

ShortRPS SCPABusiness Identifier for Product
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..*
This element is affected by the following invariants: ipn-1
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. InsurancePlan.identifier:rpsScpa.id
Definition

Identificador do plano


Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortIdentificador do planoUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
40. InsurancePlan.identifier:rpsScpa.extension
Definition

Extensões do identificador do plano


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortExtensões do identificador do planoAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on InsurancePlan.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
42. InsurancePlan.identifier:rpsScpa.use
Definition

Uso do identificador do plano


The purpose of this identifier.

ShortUso do identificador do planousual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Fixed Valueofficial
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. InsurancePlan.identifier:rpsScpa.type
Definition

Tipo do identificador do plano


A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortTipo do identificador do planoDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Fixed Value&lt;valueCodeableConcept&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;NH&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;display&nbsp;value=&quot;National&nbsp;Health&nbsp;Plan&nbsp;Identifier&quot;/&gt;<br/>&nbsp;&nbsp;&lt;/coding&gt;<br/>&lt;/valueCodeableConcept&gt;<br/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. InsurancePlan.identifier:rpsScpa.system
Definition

Sistema de identificação do plano


Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortSistema de identificação do planoThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control10..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Fixed Valuehttps://fhir.ans.gov.br/sid/registro-rps-scpa
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. InsurancePlan.identifier:rpsScpa.value
Definition

Valor do identificador do plano


The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortValor do identificador do planoThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. InsurancePlan.identifier:rpsScpa.period
Definition

Período de validade do identificador do plano


Time period during which identifier is/was valid for use.

ShortPeríodo de validade do identificador do planoTime period when id is/was valid for use
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. InsurancePlan.identifier:rpsScpa.assigner
Definition

Entidade que atribuiu o identificador do plano


Organization that issued/manages the identifier.

ShortEntidade que atribuiu o identificador do planoOrganization that issued id (may be just text)
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. InsurancePlan.status
Definition

Status do plano


The current state of the health insurance product.

ShortStatus do planodraft | active | retired | unknown
Control0..1
BindingThe codes SHALL be taken from PublicationStatushttp://hl7.org/fhir/ValueSet/publication-status|4.0.1

The lifecycle status of an artifact.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains codes which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

Meaning if MissingDefault interpretation is active.
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. InsurancePlan.type
Definition

Tipo do plano


The kind of health insurance product.

ShortTipo do planoKind of product
Control0..*
BindingFor example codes, see InsurancePlanTypehttp://hl7.org/fhir/ValueSet/insuranceplan-type

Used to categorize the product/plan.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. InsurancePlan.name
Definition

Nome oficial do plano


Official name of the health insurance product as designated by the owner.

ShortNome oficial do planoOfficial name
Comments

If the name of the product/plan changes, consider putting the old name in the alias column so that it can still be located through searches.

Control0..1
This element is affected by the following invariants: ipn-1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. InsurancePlan.alias
Definition

Outros nomes do plano


A list of alternate names that the product is known as, or was known as in the past.

ShortOutros nomes do planoAlternate names
Comments

There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the product/plan.

Control0..*
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

Over time products/plans go through many changes and can be known by different names.

For searching knowing previous names that the product/plan was known by can be very useful.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. InsurancePlan.period
Definition

Período em que o plano esteve disponível


The period of time that the health insurance product is available.

ShortPeríodo em que o plano esteve disponívelWhen the product is available
Control0..1
TypePeriod
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. InsurancePlan.ownedBy
Definition

Entidade proprietária do plano


The entity that is providing the health insurance product and underwriting the risk. This is typically an insurance carriers, other third-party payers, or health plan sponsors comonly referred to as 'payers'.

ShortEntidade proprietária do planoPlan issuer
Control10..1
TypeReference(Operadora de plano privado de assistência à saúde, Organization)
Is Modifierfalse
Summarytrue
Alternate NamesPayer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. InsurancePlan.administeredBy
Definition

Entidade administradora do plano


An organization which administer other services such as underwriting, customer service and/or claims processing on behalf of the health insurance product owner.

ShortEntidade administradora do planoProduct administrator
Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. InsurancePlan.coverageArea
Definition

Área de cobertura do plano


The geographic region in which a health insurance product's benefits apply.

ShortÁrea de cobertura do planoWhere product applies
Control0..*
TypeReference(Location)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. InsurancePlan.contact
Definition

Contatos do plano


The contact for the health insurance product for a certain purpose.

ShortContatos do planoContact for the product
Comments

Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.

Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Requirements

Need to keep track of assigned contact points within bigger organization.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. InsurancePlan.contact.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
74. InsurancePlan.contact.purpose
Definition

Propósito do contato


Indicates a purpose for which the contact can be reached.

ShortPropósito do contatoThe type of contact
Control0..1
BindingUnless not suitable, these codes SHALL be taken from ContactEntityTypehttp://hl7.org/fhir/ValueSet/contactentity-type

The purpose for which you would contact a contact party.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Requirements

Need to distinguish between multiple contact persons.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
76. InsurancePlan.contact.name
Definition

Nome do contato


A name associated with the contact.

ShortNome do contatoA name associated with the contact
Control0..1
TypeHumanName
Is Modifierfalse
Summaryfalse
Requirements

Need to be able to track the person by name.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
78. InsurancePlan.contact.telecom
Definition

Contatos do contato


A contact detail (e.g. a telephone number or an email address) by which the party may be contacted.

ShortContatos do contatoContact details (telephone, email, etc.) for a contact
Control0..*
TypeContactPoint
Is Modifierfalse
Summaryfalse
Requirements

People have (primary) ways to contact them in some way such as phone, email.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. InsurancePlan.contact.address
Definition

Endereço do contato


Visiting or postal addresses for the contact.

ShortEndereço do contatoVisiting or postal addresses for the contact
Control0..1
TypeAddress
Is Modifierfalse
Summaryfalse
Requirements

May need to keep track of a contact party's address for contacting, billing or reporting requirements.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. InsurancePlan.endpoint
Definition

API do plano


The technical endpoints providing access to services operated for the health insurance product.

ShortAPI do planoTechnical endpoint
Control0..*
TypeReference(Endpoint)
Is Modifierfalse
Summaryfalse
Requirements

Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. InsurancePlan.network
Definition

Rede do plano


Reference to the network included in the health insurance product.

ShortRede do planoWhat networks are Included
Comments

Networks are represented as a hierarchy of organization resources.

Control0..*
TypeReference(Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. InsurancePlan.coverage
Definition

Cobertura do plano


Details about the coverage offered by the insurance product.

ShortCobertura do planoCoverage details
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. InsurancePlan.coverage.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
90. InsurancePlan.coverage.type
Definition

Tipo de cobertura


Type of coverage (Medical; Dental; Mental Health; Substance Abuse; Vision; Drug; Short Term; Long Term Care; Hospice; Home Health).

ShortTipo de coberturaType of coverage
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. InsurancePlan.coverage.network
Definition

Rede de cobertura


Reference to the network that providing the type of coverage.

ShortRede de coberturaWhat networks provide coverage
Comments

Networks are represented as a hierarchy of organization resources.

Control0..*
TypeReference(Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
94. InsurancePlan.coverage.benefit
Definition

Benefícios da cobertura


Specific benefits under this type of coverage.

ShortBenefícios da coberturaList of benefits
Control1..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
96. InsurancePlan.coverage.benefit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
98. InsurancePlan.coverage.benefit.type
Definition

Tipo de benefício


Type of benefit (primary care; speciality care; inpatient; outpatient).

ShortTipo de benefícioType of benefit
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. InsurancePlan.coverage.benefit.requirement
Definition

Requisitos para o benefício


The referral requirements to have access/coverage for this benefit.

ShortRequisitos para o benefícioReferral requirements
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. InsurancePlan.coverage.benefit.limit
Definition

Limites do benefício


The specific limits on the benefit.

ShortLimites do benefícioBenefit limits
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. InsurancePlan.coverage.benefit.limit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
106. InsurancePlan.coverage.benefit.limit.value
Definition

Valor do limite


The maximum amount of a service item a plan will pay for a covered benefit. For examples. wellness visits, or eyeglasses.

ShortValor do limiteMaximum value allowed
Comments

May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”.

Control0..1
TypeQuantity
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
108. InsurancePlan.coverage.benefit.limit.code
Definition

Código do limite


The specific limit on the benefit.

ShortCódigo do limiteBenefit limit details
Comments

Use CodeableConcept.text element if the data is free (uncoded) text.

Control0..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
110. InsurancePlan.plan
Definition

Planos


Details about an insurance plan.

ShortPlanosPlan details
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. InsurancePlan.plan.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
114. InsurancePlan.plan.identifier
Definition

Identificador do plano


Business identifiers assigned to this health insurance plan which remain constant as the resource is updated and propagates from server to server.

ShortIdentificador do planoBusiness Identifier for Product
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. InsurancePlan.plan.type
Definition

Tipo do plano


Type of plan. For example, "Platinum" or "High Deductable".

ShortTipo do planoType of plan
Control0..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
118. InsurancePlan.plan.coverageArea
Definition

Área de cobertura do plano


The geographic region in which a health insurance plan's benefits apply.

ShortÁrea de cobertura do planoWhere product applies
Control0..*
TypeReference(Location)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
120. InsurancePlan.plan.network
Definition

Rede do plano


Reference to the network that providing the type of coverage.

ShortRede do planoWhat networks provide coverage
Comments

Networks are represented as a hierarchy of organization resources.

Control0..*
TypeReference(Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
122. InsurancePlan.plan.generalCost
Definition

Custo geral do plano


Overall costs associated with the plan.

ShortCusto geral do planoOverall costs
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. InsurancePlan.plan.generalCost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
126. InsurancePlan.plan.generalCost.type
Definition

Tipo de custo geral


Type of cost.

ShortTipo de custo geralType of cost
Control0..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. InsurancePlan.plan.generalCost.groupSize
Definition

Tamanho do grupo


Number of participants enrolled in the plan.

ShortTamanho do grupoNumber of enrollees
Control0..1
TypepositiveInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
130. InsurancePlan.plan.generalCost.cost
Definition

Custo


Value of the cost.

ShortCustoCost value
Control0..1
TypeMoney
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
132. InsurancePlan.plan.generalCost.comment
Definition

Comentário


Additional information about the general costs associated with this plan.

ShortComentárioAdditional cost information
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
134. InsurancePlan.plan.specificCost
Definition

Custo específico do plano


Costs associated with the coverage provided by the product.

ShortCusto específico do planoSpecific costs
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. InsurancePlan.plan.specificCost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
138. InsurancePlan.plan.specificCost.category
Definition

Categoria do custo específico


General category of benefit (Medical; Dental; Vision; Drug; Mental Health; Substance Abuse; Hospice, Home Health).

ShortCategoria do custo específicoGeneral category of benefit
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. InsurancePlan.plan.specificCost.benefit
Definition

Benefício do custo específico


List of the specific benefits under this category of benefit.

ShortBenefício do custo específicoBenefits list
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. InsurancePlan.plan.specificCost.benefit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
144. InsurancePlan.plan.specificCost.benefit.type
Definition

Tipo do benefício


Type of specific benefit (preventative; primary care office visit; speciality office visit; hospitalization; emergency room; urgent care).

ShortTipo do benefícioType of specific benefit
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
146. InsurancePlan.plan.specificCost.benefit.cost
Definition

Custo


List of the costs associated with a specific benefit.

ShortCustoList of the costs
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
148. InsurancePlan.plan.specificCost.benefit.cost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
150. InsurancePlan.plan.specificCost.benefit.cost.type
Definition

Tipo do custo


Type of cost (copay; individual cap; family cap; coinsurance; deductible).

ShortTipo do custoType of cost
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
152. InsurancePlan.plan.specificCost.benefit.cost.applicability
Definition

Aplicabilidade do custo


Whether the cost applies to in-network or out-of-network providers (in-network; out-of-network; other).

ShortAplicabilidade do custoin-network | out-of-network | other
Control0..1
BindingThe codes SHALL be taken from BenefitCostApplicabilityhttp://hl7.org/fhir/ValueSet/insuranceplan-applicability|4.0.1

Whether the cost applies to in-network or out-of-network providers.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
154. InsurancePlan.plan.specificCost.benefit.cost.qualifiers
Definition

Qualificadores do custo


Additional information about the cost, such as information about funding sources (e.g. HSA, HRA, FSA, RRA).

ShortQualificadores do custoAdditional information about the cost
Control0..*
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
156. InsurancePlan.plan.specificCost.benefit.cost.value
Definition

Valor do qualificador


The actual cost value. (some of the costs may be represented as percentages rather than currency, e.g. 10% coinsurance).

ShortValor do qualificadorThe actual cost value
Control0..1
TypeQuantity
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

Guidance on how to interpret the contents of this table can be found here

0. InsurancePlan
Definition

Plano de Saúde

ShortPlano de Saúde
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
ipn-1: The organization SHALL at least have a name or an idendtifier, and possibly more than one ((identifier.count() + name.count()) > 0)
2. InsurancePlan.id
Definition

Identificador lógico e único deste recurso

ShortIdentificador lógico do plano
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control0..1
Typeid
Is Modifierfalse
Summarytrue
4. InsurancePlan.meta
Definition

Metadados sobre o recurso

ShortMetadados do plano
Control0..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. InsurancePlan.implicitRules
Definition

Regras de negócio que se aplicam a este recurso

ShortRegras implícitas de negócio
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. InsurancePlan.language
Definition

Idioma do plano

ShortIdioma do plano
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Control0..1
BindingThe codes SHOULD be taken from CommonLanguages

Uma linguagem humana.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. InsurancePlan.text
Definition

Elemento narrativo do plano. Descreve em texto livre e compreensível por humanos o conteúdo deste recurso.

ShortElemento narrativo do plano
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

Control0..1
TypeNarrative
Is Modifierfalse
Summaryfalse
Alternate Namesnarrative, html, xhtml, display
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. InsurancePlan.contained
Definition

Recursos contidos neste recurso

ShortRecursos contidos
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Control0..*
TypeResource
Is Modifierfalse
Summaryfalse
Alternate Namesinline resources, anonymous resources, contained resources
14. InsurancePlan.extension
Definition

Extensões do plano

ShortExtensões do plano
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on InsurancePlan.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
16. InsurancePlan.modifierExtension
Definition

Extensões modificadores do plano

ShortExtensões modificadores do plano
Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
18. InsurancePlan.identifier
Definition

Identificadores externos do plano

ShortIdentificadores externos do plano
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
This element is affected by the following invariants: ipn-1
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
SlicingThis element introduces a set of slices on InsurancePlan.identifier. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ system
20. InsurancePlan.identifier.id
Definition

Identificador do plano

ShortIdentificador do plano
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
22. InsurancePlan.identifier.extension
Definition

Extensões do identificador do plano

ShortExtensões do identificador do plano
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on InsurancePlan.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
24. InsurancePlan.identifier.use
Definition

Uso do identificador do plano

ShortUso do identificador do plano
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Fixed Valueofficial
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. InsurancePlan.identifier.type
Definition

Tipo do identificador do plano

ShortTipo do identificador do plano
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. InsurancePlan.identifier.system
Definition

Sistema de identificação do plano

ShortSistema de identificação do plano
Comments

Identifier.system is always case sensitive.

Control1..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. InsurancePlan.identifier.value
Definition

Valor do identificador do plano

ShortValor do identificador do plano
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. InsurancePlan.identifier.period
Definition

Período de validade do identificador do plano

ShortPeríodo de validade do identificador do plano
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. InsurancePlan.identifier.assigner
Definition

Entidade que atribuiu o identificador do plano

ShortEntidade que atribuiu o identificador do plano
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. InsurancePlan.identifier:rpsScpa
Slice NamerpsScpa
Definition

RPS SCPA

ShortRPS SCPA
NoteThis is a business identifier, not a resource identifier (see discussion)
Control1..*
This element is affected by the following invariants: ipn-1
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. InsurancePlan.identifier:rpsScpa.id
Definition

Identificador do plano

ShortIdentificador do plano
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
40. InsurancePlan.identifier:rpsScpa.extension
Definition

Extensões do identificador do plano

ShortExtensões do identificador do plano
Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on InsurancePlan.identifier.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
42. InsurancePlan.identifier:rpsScpa.use
Definition

Uso do identificador do plano

ShortUso do identificador do plano
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUse

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as &quot;Is Modifier&quot; because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Fixed Valueofficial
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. InsurancePlan.identifier:rpsScpa.type
Definition

Tipo do identificador do plano

ShortTipo do identificador do plano
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control0..1
BindingUnless not suitable, these codes SHALL be taken from Identifier Type Codes

A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Fixed Value&lt;valueCodeableConcept&nbsp;xmlns=&quot;http://hl7.org/fhir&quot;&gt;<br/>&nbsp;&nbsp;&lt;coding&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;system&nbsp;value=&quot;http://terminology.hl7.org/CodeSystem/v2-0203&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;code&nbsp;value=&quot;NH&quot;/&gt;<br/>&nbsp;&nbsp;&nbsp;&nbsp;&lt;display&nbsp;value=&quot;National&nbsp;Health&nbsp;Plan&nbsp;Identifier&quot;/&gt;<br/>&nbsp;&nbsp;&lt;/coding&gt;<br/>&lt;/valueCodeableConcept&gt;<br/>
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. InsurancePlan.identifier:rpsScpa.system
Definition

Sistema de identificação do plano

ShortSistema de identificação do plano
Comments

Identifier.system is always case sensitive.

Control1..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Fixed Valuehttps://fhir.ans.gov.br/sid/registro-rps-scpa
Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. InsurancePlan.identifier:rpsScpa.value
Definition

Valor do identificador do plano

ShortValor do identificador do plano
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control1..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
50. InsurancePlan.identifier:rpsScpa.period
Definition

Período de validade do identificador do plano

ShortPeríodo de validade do identificador do plano
Control0..1
TypePeriod
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
52. InsurancePlan.identifier:rpsScpa.assigner
Definition

Entidade que atribuiu o identificador do plano

ShortEntidade que atribuiu o identificador do plano
Comments

The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
54. InsurancePlan.status
Definition

Status do plano

ShortStatus do plano
Control0..1
BindingThe codes SHALL be taken from PublicationStatus

The lifecycle status of an artifact.

Typecode
Is Modifiertrue because This element is labeled as a modifier because it is a status element that contains codes which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need a flag to indicate a record is no longer to be used and should generally be hidden for the user in the UI.

Meaning if MissingDefault interpretation is active.
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
56. InsurancePlan.type
Definition

Tipo do plano

ShortTipo do plano
Control0..*
BindingFor example codes, see InsurancePlanType

Used to categorize the product/plan.

TypeCodeableConcept
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
58. InsurancePlan.name
Definition

Nome oficial do plano

ShortNome oficial do plano
Comments

If the name of the product/plan changes, consider putting the old name in the alias column so that it can still be located through searches.

Control0..1
This element is affected by the following invariants: ipn-1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
60. InsurancePlan.alias
Definition

Outros nomes do plano

ShortOutros nomes do plano
Comments

There are no dates associated with the alias/historic names, as this is not intended to track when names were used, but to assist in searching so that older names can still result in identifying the product/plan.

Control0..*
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

Over time products/plans go through many changes and can be known by different names.

For searching knowing previous names that the product/plan was known by can be very useful.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
62. InsurancePlan.period
Definition

Período em que o plano esteve disponível

ShortPeríodo em que o plano esteve disponível
Control0..1
TypePeriod
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
64. InsurancePlan.ownedBy
Definition

Entidade proprietária do plano

ShortEntidade proprietária do plano
Control1..1
TypeReference(Operadora de plano privado de assistência à saúde)
Is Modifierfalse
Summarytrue
Alternate NamesPayer
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
66. InsurancePlan.administeredBy
Definition

Entidade administradora do plano

ShortEntidade administradora do plano
Control0..1
TypeReference(Organization)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
68. InsurancePlan.coverageArea
Definition

Área de cobertura do plano

ShortÁrea de cobertura do plano
Control0..*
TypeReference(Location)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
70. InsurancePlan.contact
Definition

Contatos do plano

ShortContatos do plano
Comments

Where multiple contacts for the same purpose are provided there is a standard extension that can be used to determine which one is the preferred contact to use.

Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Requirements

Need to keep track of assigned contact points within bigger organization.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
72. InsurancePlan.contact.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
74. InsurancePlan.contact.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
76. InsurancePlan.contact.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
78. InsurancePlan.contact.purpose
Definition

Propósito do contato

ShortPropósito do contato
Control0..1
BindingUnless not suitable, these codes SHALL be taken from ContactEntityType

The purpose for which you would contact a contact party.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Requirements

Need to distinguish between multiple contact persons.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
80. InsurancePlan.contact.name
Definition

Nome do contato

ShortNome do contato
Control0..1
TypeHumanName
Is Modifierfalse
Summaryfalse
Requirements

Need to be able to track the person by name.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
82. InsurancePlan.contact.telecom
Definition

Contatos do contato

ShortContatos do contato
Control0..*
TypeContactPoint
Is Modifierfalse
Summaryfalse
Requirements

People have (primary) ways to contact them in some way such as phone, email.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
84. InsurancePlan.contact.address
Definition

Endereço do contato

ShortEndereço do contato
Control0..1
TypeAddress
Is Modifierfalse
Summaryfalse
Requirements

May need to keep track of a contact party's address for contacting, billing or reporting requirements.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
86. InsurancePlan.endpoint
Definition

API do plano

ShortAPI do plano
Control0..*
TypeReference(Endpoint)
Is Modifierfalse
Summaryfalse
Requirements

Organizations have multiple systems that provide various services and need to be able to define the technical connection details for how to connect to them, and for what purpose.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
88. InsurancePlan.network
Definition

Rede do plano

ShortRede do plano
Comments

Networks are represented as a hierarchy of organization resources.

Control0..*
TypeReference(Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
90. InsurancePlan.coverage
Definition

Cobertura do plano

ShortCobertura do plano
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
92. InsurancePlan.coverage.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
94. InsurancePlan.coverage.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
96. InsurancePlan.coverage.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
98. InsurancePlan.coverage.type
Definition

Tipo de cobertura

ShortTipo de cobertura
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
100. InsurancePlan.coverage.network
Definition

Rede de cobertura

ShortRede de cobertura
Comments

Networks are represented as a hierarchy of organization resources.

Control0..*
TypeReference(Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
102. InsurancePlan.coverage.benefit
Definition

Benefícios da cobertura

ShortBenefícios da cobertura
Control1..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
104. InsurancePlan.coverage.benefit.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
106. InsurancePlan.coverage.benefit.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
108. InsurancePlan.coverage.benefit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
110. InsurancePlan.coverage.benefit.type
Definition

Tipo de benefício

ShortTipo de benefício
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
112. InsurancePlan.coverage.benefit.requirement
Definition

Requisitos para o benefício

ShortRequisitos para o benefício
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
114. InsurancePlan.coverage.benefit.limit
Definition

Limites do benefício

ShortLimites do benefício
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
116. InsurancePlan.coverage.benefit.limit.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
118. InsurancePlan.coverage.benefit.limit.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
120. InsurancePlan.coverage.benefit.limit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
122. InsurancePlan.coverage.benefit.limit.value
Definition

Valor do limite

ShortValor do limite
Comments

May also be called “eligible expense,” “payment allowance,” or “negotiated rate.”.

Control0..1
TypeQuantity
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
124. InsurancePlan.coverage.benefit.limit.code
Definition

Código do limite

ShortCódigo do limite
Comments

Use CodeableConcept.text element if the data is free (uncoded) text.

Control0..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
126. InsurancePlan.plan
Definition

Planos

ShortPlanos
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
128. InsurancePlan.plan.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
130. InsurancePlan.plan.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
132. InsurancePlan.plan.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
134. InsurancePlan.plan.identifier
Definition

Identificador do plano

ShortIdentificador do plano
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
136. InsurancePlan.plan.type
Definition

Tipo do plano

ShortTipo do plano
Control0..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
138. InsurancePlan.plan.coverageArea
Definition

Área de cobertura do plano

ShortÁrea de cobertura do plano
Control0..*
TypeReference(Location)
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
140. InsurancePlan.plan.network
Definition

Rede do plano

ShortRede do plano
Comments

Networks are represented as a hierarchy of organization resources.

Control0..*
TypeReference(Organization)
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
142. InsurancePlan.plan.generalCost
Definition

Custo geral do plano

ShortCusto geral do plano
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
144. InsurancePlan.plan.generalCost.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
146. InsurancePlan.plan.generalCost.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
148. InsurancePlan.plan.generalCost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
150. InsurancePlan.plan.generalCost.type
Definition

Tipo de custo geral

ShortTipo de custo geral
Control0..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
152. InsurancePlan.plan.generalCost.groupSize
Definition

Tamanho do grupo

ShortTamanho do grupo
Control0..1
TypepositiveInt
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
154. InsurancePlan.plan.generalCost.cost
Definition

Custo

ShortCusto
Control0..1
TypeMoney
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
156. InsurancePlan.plan.generalCost.comment
Definition

Comentário

ShortComentário
Control0..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
158. InsurancePlan.plan.specificCost
Definition

Custo específico do plano

ShortCusto específico do plano
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
160. InsurancePlan.plan.specificCost.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
162. InsurancePlan.plan.specificCost.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
164. InsurancePlan.plan.specificCost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
166. InsurancePlan.plan.specificCost.category
Definition

Categoria do custo específico

ShortCategoria do custo específico
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
168. InsurancePlan.plan.specificCost.benefit
Definition

Benefício do custo específico

ShortBenefício do custo específico
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
170. InsurancePlan.plan.specificCost.benefit.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
172. InsurancePlan.plan.specificCost.benefit.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
174. InsurancePlan.plan.specificCost.benefit.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
176. InsurancePlan.plan.specificCost.benefit.type
Definition

Tipo do benefício

ShortTipo do benefício
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
178. InsurancePlan.plan.specificCost.benefit.cost
Definition

Custo

ShortCusto
Control0..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
180. InsurancePlan.plan.specificCost.benefit.cost.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
182. InsurancePlan.plan.specificCost.benefit.cost.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
184. InsurancePlan.plan.specificCost.benefit.cost.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
186. InsurancePlan.plan.specificCost.benefit.cost.type
Definition

Tipo do custo

ShortTipo do custo
Control1..1
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
188. InsurancePlan.plan.specificCost.benefit.cost.applicability
Definition

Aplicabilidade do custo

ShortAplicabilidade do custo
Control0..1
BindingThe codes SHALL be taken from BenefitCostApplicability

Whether the cost applies to in-network or out-of-network providers.

TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
190. InsurancePlan.plan.specificCost.benefit.cost.qualifiers
Definition

Qualificadores do custo

ShortQualificadores do custo
Control0..*
TypeCodeableConcept
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
192. InsurancePlan.plan.specificCost.benefit.cost.value
Definition

Valor do qualificador

ShortValor do qualificador
Control0..1
TypeQuantity
Is Modifierfalse
Summaryfalse
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))