Guia de Implementação do Projeto de Padronização e Qualificação dos Dados Assistenciais da Saúde Suplementar (PQDAS)
202309 - CI Build
Guia de Implementação do Projeto de Padronização e Qualificação dos Dados Assistenciais da Saúde Suplementar (PQDAS)
202309 - CI Build
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| URL Canônica: https://fhir.ans.gov.br/StructureDefinition/plano-saude | Versão: 202309 | |||
| Active as of 2023-08-03 | Nome computável: PlanoSaude | |||
Plano de saúde
O Plano de saúde descreve uma oferta de seguro de saúde composta por uma lista de benefícios cobertos (ou seja, o produto), custos associados a esses benefícios (ou seja, o plano) e informações adicionais sobre a oferta, como quem é de propriedade e administração por uma área de cobertura, informações de contato, etc.
Usage:
Descrição de perfis, diferenciais, instantâneos e como as diferentes apresentações funcionam.
Esta estrutura é derivada de InsurancePlan
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  InsurancePlan | 0..* | InsurancePlan | Plano de Saúde | |
  id | 0..1 | id | Identificador lógico do plano | |
| meta | 0..1 | Meta | Metadados do plano | |
| implicitRules | 0..1 | uri | Regras implícitas de negócio | |
| language | 0..1 | code | Idioma do plano Binding: CommonLanguages (preferred): Uma linguagem humana. | |
| text | 0..1 | Narrative | Elemento narrativo do plano | |
| contained | 0..* | Resource | Recursos contidos | |
 extension | 0..* | Extension | Extensões do plano Slice: Unordered, Open by value:url | |
 modifierExtension | 0..* | Extension | Extensões modificadores do plano | |
  Slices for identifier | 1..* | Identifier | Identificadores externos do plano Slice: Unordered, Open by value:system | |
  identifier:All Slices | Content/Rules for all slices | |||
  id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano | |
| use | 0..1 | code | Uso do identificador do plano Fixed Value: official | |
| type | 0..1 | CodeableConcept | Tipo do identificador do plano | |
| system | 1..1 | uri | Sistema de identificação do plano | |
| value | 0..1 | string | Valor do identificador do plano | |
| period | 0..1 | Period | Período de validade do identificador do plano | |
 assigner | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano | |
  identifier:rpsScpa | 1..* | Identifier | RPS SCPA | |
  id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano | |
| use | 0..1 | code | Uso do identificador do plano Fixed Value: official | |
 type | 0..1 | CodeableConcept | Tipo do identificador do plano Fixed Value: As shown | |
   coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: NH | |
 display | 1..1 | string | Representation defined by the system Fixed Value: National Health Plan Identifier | |
| system | 1..1 | uri | Sistema de identificação do plano Fixed Value: https://fhir.ans.gov.br/sid/registro-rps-scpa | |
| value | 1..1 | string | Valor do identificador do plano | |
| period | 0..1 | Period | Período de validade do identificador do plano | |
 assigner | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano | |
| status | 0..1 | code | Status do plano | |
| type | 0..* | CodeableConcept | Tipo do plano | |
| name | 0..1 | string | Nome oficial do plano | |
| alias | 0..* | string | Outros nomes do plano | |
| period | 0..1 | Period | Período em que o plano esteve disponível | |
 ownedBy | 1..1 | Reference(Operadora de plano privado de assistência à saúde) | Entidade proprietária do plano | |
| administeredBy | 0..1 | Reference(Organization) | Entidade administradora do plano | |
| coverageArea | 0..* | Reference(Location) | Área de cobertura do plano | |
| contact | 0..* | BackboneElement | Contatos do plano | |
| purpose | 0..1 | CodeableConcept | Propósito do contato | |
| name | 0..1 | HumanName | Nome do contato | |
| telecom | 0..* | ContactPoint | Contatos do contato | |
| address | 0..1 | Address | Endereço do contato | |
| endpoint | 0..* | Reference(Endpoint) | API do plano | |
| network | 0..* | Reference(Organization) | Rede do plano | |
| coverage | 0..* | BackboneElement | Cobertura do plano | |
| type | 1..1 | CodeableConcept | Tipo de cobertura | |
| network | 0..* | Reference(Organization) | Rede de cobertura | |
| benefit | 1..* | BackboneElement | Benefícios da cobertura | |
| type | 1..1 | CodeableConcept | Tipo de benefício | |
| requirement | 0..1 | string | Requisitos para o benefício | |
| limit | 0..* | BackboneElement | Limites do benefício | |
| value | 0..1 | Quantity | Valor do limite | |
| code | 0..1 | CodeableConcept | Código do limite | |
| plan | 0..* | BackboneElement | Planos | |
| identifier | 0..* | Identifier | Identificador do plano | |
| type | 0..1 | CodeableConcept | Tipo do plano | |
| coverageArea | 0..* | Reference(Location) | Área de cobertura do plano | |
| network | 0..* | Reference(Organization) | Rede do plano | |
| generalCost | 0..* | BackboneElement | Custo geral do plano | |
| type | 0..1 | CodeableConcept | Tipo de custo geral | |
| groupSize | 0..1 | positiveInt | Tamanho do grupo | |
| cost | 0..1 | Money | Custo | |
| comment | 0..1 | string | Comentário | |
| specificCost | 0..* | BackboneElement | Custo específico do plano | |
| category | 1..1 | CodeableConcept | Categoria do custo específico | |
| benefit | 0..* | BackboneElement | Benefício do custo específico | |
| type | 1..1 | CodeableConcept | Tipo do benefício | |
| cost | 0..* | BackboneElement | Custo | |
| type | 1..1 | CodeableConcept | Tipo do custo | |
| applicability | 0..1 | CodeableConcept | Aplicabilidade do custo | |
| qualifiers | 0..* | CodeableConcept | Qualificadores do custo | |
| value | 0..1 | Quantity | Valor do qualificador | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| InsurancePlan.language | preferred | CommonLanguages |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | C | 0..* | InsurancePlan | Plano de Saúde |
 id | Σ | 0..1 | id | Identificador lógico do plano |
 meta | Σ | 0..1 | Meta | Metadados do plano |
| implicitRules | ?!Σ | 0..1 | uri | Regras implícitas de negócio |
| language | 0..1 | code | Idioma do plano Binding: CommonLanguages (preferred): Uma linguagem humana. | |
| text | 0..1 | Narrative | Elemento narrativo do plano | |
| contained | 0..* | Resource | Recursos contidos | |
| extension | 0..* | Extension | Extensões do plano Slice: Unordered, Open by value:url | |
| modifierExtension | ?! | 0..* | Extension | Extensões modificadores do plano |
| Slices for identifier | ΣC | 1..* | Identifier | Identificadores externos do plano Slice: Unordered, Open by value:system |
| identifier:All Slices | Content/Rules for all slices | |||
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | Uso do identificador do plano Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official |
| type | Σ | 0..1 | CodeableConcept | Tipo do identificador do plano Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 1..1 | uri | Sistema de identificação do plano Example General: http://www.acme.com/identifiers/patient |
| value | Σ | 0..1 | string | Valor do identificador do plano Example General: 123456 |
| period | Σ | 0..1 | Period | Período de validade do identificador do plano |
| assigner | Σ | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano |
| identifier:rpsScpa | ΣC | 1..* | Identifier | RPS SCPA |
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | Uso do identificador do plano Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official |
| type | Σ | 0..1 | CodeableConcept | Tipo do identificador do plano Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Fixed Value: As shown |
| id | 0..0 | string | Unique id for inter-element referencing | |
| extension | 0..0 | Extension | Additional content defined by implementations | |
| coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| id | 0..0 | string | Unique id for inter-element referencing | |
| extension | 0..0 | Extension | Additional content defined by implementations | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
| version | 0..0 | string | Version of the system - if relevant | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: NH | |
| display | 1..1 | string | Representation defined by the system Fixed Value: National Health Plan Identifier | |
| userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |
| text | 0..0 | string | Plain text representation of the concept | |
| system | Σ | 1..1 | uri | Sistema de identificação do plano Fixed Value: https://fhir.ans.gov.br/sid/registro-rps-scpa |
| value | Σ | 1..1 | string | Valor do identificador do plano Example General: 123456 |
| period | Σ | 0..1 | Period | Período de validade do identificador do plano |
| assigner | Σ | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano |
| status | ?!Σ | 0..1 | code | Status do plano Binding: PublicationStatus (required): The lifecycle status of an artifact. |
| type | Σ | 0..* | CodeableConcept | Tipo do plano Binding: InsurancePlanType (example): Used to categorize the product/plan. |
| name | ΣC | 0..1 | string | Nome oficial do plano |
| alias | 0..* | string | Outros nomes do plano | |
| period | 0..1 | Period | Período em que o plano esteve disponível | |
| ownedBy | Σ | 1..1 | Reference(Operadora de plano privado de assistência à saúde) | Entidade proprietária do plano |
| administeredBy | Σ | 0..1 | Reference(Organization) | Entidade administradora do plano |
| coverageArea | Σ | 0..* | Reference(Location) | Área de cobertura do plano |
| contact | 0..* | BackboneElement | Contatos do plano | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| purpose | 0..1 | CodeableConcept | Propósito do contato Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |
| name | 0..1 | HumanName | Nome do contato | |
| telecom | 0..* | ContactPoint | Contatos do contato | |
| address | 0..1 | Address | Endereço do contato | |
| endpoint | 0..* | Reference(Endpoint) | API do plano | |
| network | 0..* | Reference(Organization) | Rede do plano | |
| coverage | 0..* | BackboneElement | Cobertura do plano | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo de cobertura | |
| network | 0..* | Reference(Organization) | Rede de cobertura | |
| benefit | 1..* | BackboneElement | Benefícios da cobertura | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo de benefício | |
| requirement | 0..1 | string | Requisitos para o benefício | |
| limit | 0..* | BackboneElement | Limites do benefício | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| value | 0..1 | Quantity | Valor do limite | |
| code | 0..1 | CodeableConcept | Código do limite | |
| plan | 0..* | BackboneElement | Planos | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| identifier | Σ | 0..* | Identifier | Identificador do plano |
| type | 0..1 | CodeableConcept | Tipo do plano | |
| coverageArea | Σ | 0..* | Reference(Location) | Área de cobertura do plano |
| network | 0..* | Reference(Organization) | Rede do plano | |
| generalCost | 0..* | BackboneElement | Custo geral do plano | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 0..1 | CodeableConcept | Tipo de custo geral | |
| groupSize | 0..1 | positiveInt | Tamanho do grupo | |
| cost | 0..1 | Money | Custo | |
| comment | 0..1 | string | Comentário | |
| specificCost | 0..* | BackboneElement | Custo específico do plano | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| category | 1..1 | CodeableConcept | Categoria do custo específico | |
| benefit | 0..* | BackboneElement | Benefício do custo específico | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo do benefício | |
| cost | 0..* | BackboneElement | Custo | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo do custo | |
| applicability | 0..1 | CodeableConcept | Aplicabilidade do custo Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers. | |
| qualifiers | 0..* | CodeableConcept | Qualificadores do custo | |
| value | 0..1 | Quantity | Valor do qualificador | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| InsurancePlan.language | preferred | CommonLanguages |
| InsurancePlan.identifier.use | required | Fixed Value: official |
| InsurancePlan.identifier.type | extensible | Identifier Type Codes |
| InsurancePlan.identifier:rpsScpa.use | required | Fixed Value: official |
| InsurancePlan.identifier:rpsScpa.type | extensible | Fixed Value: NH("National Health Plan Identifier") |
| InsurancePlan.status | required | PublicationStatus |
| InsurancePlan.type | example | InsurancePlanType |
| InsurancePlan.contact.purpose | extensible | ContactEntityType |
| InsurancePlan.plan.specificCost.benefit.cost.applicability | required | BenefitCostApplicability |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | InsurancePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | InsurancePlan | 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 | error | InsurancePlan | 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 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | InsurancePlan | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ipn-1 | error | InsurancePlan | The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0 |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | C | 0..* | InsurancePlan | Plano de Saúde |
| id | Σ | 0..1 | id | Identificador lógico do plano |
| meta | Σ | 0..1 | Meta | Metadados do plano |
| implicitRules | ?!Σ | 0..1 | uri | Regras implícitas de negócio |
| language | 0..1 | code | Idioma do plano Binding: CommonLanguages (preferred): Uma linguagem humana. | |
| text | 0..1 | Narrative | Elemento narrativo do plano | |
| contained | 0..* | Resource | Recursos contidos | |
| extension | 0..* | Extension | Extensões do plano Slice: Unordered, Open by value:url | |
| modifierExtension | ?! | 0..* | Extension | Extensões modificadores do plano |
| Slices for identifier | ΣC | 1..* | Identifier | Identificadores externos do plano Slice: Unordered, Open by value:system |
| identifier:All Slices | Content/Rules for all slices | |||
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | Uso do identificador do plano Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official |
| type | Σ | 0..1 | CodeableConcept | Tipo do identificador do plano Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 1..1 | uri | Sistema de identificação do plano Example General: http://www.acme.com/identifiers/patient |
| value | Σ | 0..1 | string | Valor do identificador do plano Example General: 123456 |
| period | Σ | 0..1 | Period | Período de validade do identificador do plano |
| assigner | Σ | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano |
| identifier:rpsScpa | ΣC | 1..* | Identifier | RPS SCPA |
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | Uso do identificador do plano Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official |
| type | Σ | 0..1 | CodeableConcept | Tipo do identificador do plano Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Fixed Value: As shown |
| id | 0..0 | string | Unique id for inter-element referencing | |
| extension | 0..0 | Extension | Additional content defined by implementations | |
| coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| id | 0..0 | string | Unique id for inter-element referencing | |
| extension | 0..0 | Extension | Additional content defined by implementations | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
| version | 0..0 | string | Version of the system - if relevant | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: NH | |
| display | 1..1 | string | Representation defined by the system Fixed Value: National Health Plan Identifier | |
| userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |
| text | 0..0 | string | Plain text representation of the concept | |
| system | Σ | 1..1 | uri | Sistema de identificação do plano Fixed Value: https://fhir.ans.gov.br/sid/registro-rps-scpa |
| value | Σ | 1..1 | string | Valor do identificador do plano Example General: 123456 |
| period | Σ | 0..1 | Period | Período de validade do identificador do plano |
| assigner | Σ | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano |
| status | ?!Σ | 0..1 | code | Status do plano Binding: PublicationStatus (required): The lifecycle status of an artifact. |
| type | Σ | 0..* | CodeableConcept | Tipo do plano Binding: InsurancePlanType (example): Used to categorize the product/plan. |
| name | ΣC | 0..1 | string | Nome oficial do plano |
| alias | 0..* | string | Outros nomes do plano | |
| period | 0..1 | Period | Período em que o plano esteve disponível | |
| ownedBy | Σ | 1..1 | Reference(Operadora de plano privado de assistência à saúde) | Entidade proprietária do plano |
| administeredBy | Σ | 0..1 | Reference(Organization) | Entidade administradora do plano |
| coverageArea | Σ | 0..* | Reference(Location) | Área de cobertura do plano |
| contact | 0..* | BackboneElement | Contatos do plano | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| purpose | 0..1 | CodeableConcept | Propósito do contato Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |
| name | 0..1 | HumanName | Nome do contato | |
| telecom | 0..* | ContactPoint | Contatos do contato | |
| address | 0..1 | Address | Endereço do contato | |
| endpoint | 0..* | Reference(Endpoint) | API do plano | |
| network | 0..* | Reference(Organization) | Rede do plano | |
| coverage | 0..* | BackboneElement | Cobertura do plano | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo de cobertura | |
| network | 0..* | Reference(Organization) | Rede de cobertura | |
| benefit | 1..* | BackboneElement | Benefícios da cobertura | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo de benefício | |
| requirement | 0..1 | string | Requisitos para o benefício | |
| limit | 0..* | BackboneElement | Limites do benefício | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| value | 0..1 | Quantity | Valor do limite | |
| code | 0..1 | CodeableConcept | Código do limite | |
| plan | 0..* | BackboneElement | Planos | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| identifier | Σ | 0..* | Identifier | Identificador do plano |
| type | 0..1 | CodeableConcept | Tipo do plano | |
| coverageArea | Σ | 0..* | Reference(Location) | Área de cobertura do plano |
| network | 0..* | Reference(Organization) | Rede do plano | |
| generalCost | 0..* | BackboneElement | Custo geral do plano | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 0..1 | CodeableConcept | Tipo de custo geral | |
| groupSize | 0..1 | positiveInt | Tamanho do grupo | |
| cost | 0..1 | Money | Custo | |
| comment | 0..1 | string | Comentário | |
| specificCost | 0..* | BackboneElement | Custo específico do plano | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| category | 1..1 | CodeableConcept | Categoria do custo específico | |
| benefit | 0..* | BackboneElement | Benefício do custo específico | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo do benefício | |
| cost | 0..* | BackboneElement | Custo | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo do custo | |
| applicability | 0..1 | CodeableConcept | Aplicabilidade do custo Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers. | |
| qualifiers | 0..* | CodeableConcept | Qualificadores do custo | |
| value | 0..1 | Quantity | Valor do qualificador | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| InsurancePlan.language | preferred | CommonLanguages |
| InsurancePlan.identifier.use | required | Fixed Value: official |
| InsurancePlan.identifier.type | extensible | Identifier Type Codes |
| InsurancePlan.identifier:rpsScpa.use | required | Fixed Value: official |
| InsurancePlan.identifier:rpsScpa.type | extensible | Fixed Value: NH("National Health Plan Identifier") |
| InsurancePlan.status | required | PublicationStatus |
| InsurancePlan.type | example | InsurancePlanType |
| InsurancePlan.contact.purpose | extensible | ContactEntityType |
| InsurancePlan.plan.specificCost.benefit.cost.applicability | required | BenefitCostApplicability |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | InsurancePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | InsurancePlan | 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 | error | InsurancePlan | 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 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | InsurancePlan | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ipn-1 | error | InsurancePlan | The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0 |
Esta estrutura é derivada de InsurancePlan
Summary
Mandatory: 6 elements
Fixed Value: 4 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Visão diferencial
Esta estrutura é derivada de InsurancePlan
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | 0..* | InsurancePlan | Plano de Saúde | |
| id | 0..1 | id | Identificador lógico do plano | |
| meta | 0..1 | Meta | Metadados do plano | |
| implicitRules | 0..1 | uri | Regras implícitas de negócio | |
| language | 0..1 | code | Idioma do plano Binding: CommonLanguages (preferred): Uma linguagem humana. | |
| text | 0..1 | Narrative | Elemento narrativo do plano | |
| contained | 0..* | Resource | Recursos contidos | |
| extension | 0..* | Extension | Extensões do plano Slice: Unordered, Open by value:url | |
| modifierExtension | 0..* | Extension | Extensões modificadores do plano | |
| Slices for identifier | 1..* | Identifier | Identificadores externos do plano Slice: Unordered, Open by value:system | |
| identifier:All Slices | Content/Rules for all slices | |||
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano | |
| use | 0..1 | code | Uso do identificador do plano Fixed Value: official | |
| type | 0..1 | CodeableConcept | Tipo do identificador do plano | |
| system | 1..1 | uri | Sistema de identificação do plano | |
| value | 0..1 | string | Valor do identificador do plano | |
| period | 0..1 | Period | Período de validade do identificador do plano | |
| assigner | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano | |
| identifier:rpsScpa | 1..* | Identifier | RPS SCPA | |
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano | |
| use | 0..1 | code | Uso do identificador do plano Fixed Value: official | |
| type | 0..1 | CodeableConcept | Tipo do identificador do plano Fixed Value: As shown | |
| coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: NH | |
| display | 1..1 | string | Representation defined by the system Fixed Value: National Health Plan Identifier | |
| system | 1..1 | uri | Sistema de identificação do plano Fixed Value: https://fhir.ans.gov.br/sid/registro-rps-scpa | |
| value | 1..1 | string | Valor do identificador do plano | |
| period | 0..1 | Period | Período de validade do identificador do plano | |
| assigner | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano | |
| status | 0..1 | code | Status do plano | |
| type | 0..* | CodeableConcept | Tipo do plano | |
| name | 0..1 | string | Nome oficial do plano | |
| alias | 0..* | string | Outros nomes do plano | |
| period | 0..1 | Period | Período em que o plano esteve disponível | |
| ownedBy | 1..1 | Reference(Operadora de plano privado de assistência à saúde) | Entidade proprietária do plano | |
| administeredBy | 0..1 | Reference(Organization) | Entidade administradora do plano | |
| coverageArea | 0..* | Reference(Location) | Área de cobertura do plano | |
| contact | 0..* | BackboneElement | Contatos do plano | |
| purpose | 0..1 | CodeableConcept | Propósito do contato | |
| name | 0..1 | HumanName | Nome do contato | |
| telecom | 0..* | ContactPoint | Contatos do contato | |
| address | 0..1 | Address | Endereço do contato | |
| endpoint | 0..* | Reference(Endpoint) | API do plano | |
| network | 0..* | Reference(Organization) | Rede do plano | |
| coverage | 0..* | BackboneElement | Cobertura do plano | |
| type | 1..1 | CodeableConcept | Tipo de cobertura | |
| network | 0..* | Reference(Organization) | Rede de cobertura | |
| benefit | 1..* | BackboneElement | Benefícios da cobertura | |
| type | 1..1 | CodeableConcept | Tipo de benefício | |
| requirement | 0..1 | string | Requisitos para o benefício | |
| limit | 0..* | BackboneElement | Limites do benefício | |
| value | 0..1 | Quantity | Valor do limite | |
| code | 0..1 | CodeableConcept | Código do limite | |
| plan | 0..* | BackboneElement | Planos | |
| identifier | 0..* | Identifier | Identificador do plano | |
| type | 0..1 | CodeableConcept | Tipo do plano | |
| coverageArea | 0..* | Reference(Location) | Área de cobertura do plano | |
| network | 0..* | Reference(Organization) | Rede do plano | |
| generalCost | 0..* | BackboneElement | Custo geral do plano | |
| type | 0..1 | CodeableConcept | Tipo de custo geral | |
| groupSize | 0..1 | positiveInt | Tamanho do grupo | |
| cost | 0..1 | Money | Custo | |
| comment | 0..1 | string | Comentário | |
| specificCost | 0..* | BackboneElement | Custo específico do plano | |
| category | 1..1 | CodeableConcept | Categoria do custo específico | |
| benefit | 0..* | BackboneElement | Benefício do custo específico | |
| type | 1..1 | CodeableConcept | Tipo do benefício | |
| cost | 0..* | BackboneElement | Custo | |
| type | 1..1 | CodeableConcept | Tipo do custo | |
| applicability | 0..1 | CodeableConcept | Aplicabilidade do custo | |
| qualifiers | 0..* | CodeableConcept | Qualificadores do custo | |
| value | 0..1 | Quantity | Valor do qualificador | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet |
| InsurancePlan.language | preferred | CommonLanguages |
Visualização de elementos -chave
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | C | 0..* | InsurancePlan | Plano de Saúde |
| id | Σ | 0..1 | id | Identificador lógico do plano |
| meta | Σ | 0..1 | Meta | Metadados do plano |
| implicitRules | ?!Σ | 0..1 | uri | Regras implícitas de negócio |
| language | 0..1 | code | Idioma do plano Binding: CommonLanguages (preferred): Uma linguagem humana. | |
| text | 0..1 | Narrative | Elemento narrativo do plano | |
| contained | 0..* | Resource | Recursos contidos | |
| extension | 0..* | Extension | Extensões do plano Slice: Unordered, Open by value:url | |
| modifierExtension | ?! | 0..* | Extension | Extensões modificadores do plano |
| Slices for identifier | ΣC | 1..* | Identifier | Identificadores externos do plano Slice: Unordered, Open by value:system |
| identifier:All Slices | Content/Rules for all slices | |||
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | Uso do identificador do plano Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official |
| type | Σ | 0..1 | CodeableConcept | Tipo do identificador do plano Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 1..1 | uri | Sistema de identificação do plano Example General: http://www.acme.com/identifiers/patient |
| value | Σ | 0..1 | string | Valor do identificador do plano Example General: 123456 |
| period | Σ | 0..1 | Period | Período de validade do identificador do plano |
| assigner | Σ | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano |
| identifier:rpsScpa | ΣC | 1..* | Identifier | RPS SCPA |
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | Uso do identificador do plano Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official |
| type | Σ | 0..1 | CodeableConcept | Tipo do identificador do plano Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Fixed Value: As shown |
| id | 0..0 | string | Unique id for inter-element referencing | |
| extension | 0..0 | Extension | Additional content defined by implementations | |
| coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| id | 0..0 | string | Unique id for inter-element referencing | |
| extension | 0..0 | Extension | Additional content defined by implementations | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
| version | 0..0 | string | Version of the system - if relevant | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: NH | |
| display | 1..1 | string | Representation defined by the system Fixed Value: National Health Plan Identifier | |
| userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |
| text | 0..0 | string | Plain text representation of the concept | |
| system | Σ | 1..1 | uri | Sistema de identificação do plano Fixed Value: https://fhir.ans.gov.br/sid/registro-rps-scpa |
| value | Σ | 1..1 | string | Valor do identificador do plano Example General: 123456 |
| period | Σ | 0..1 | Period | Período de validade do identificador do plano |
| assigner | Σ | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano |
| status | ?!Σ | 0..1 | code | Status do plano Binding: PublicationStatus (required): The lifecycle status of an artifact. |
| type | Σ | 0..* | CodeableConcept | Tipo do plano Binding: InsurancePlanType (example): Used to categorize the product/plan. |
| name | ΣC | 0..1 | string | Nome oficial do plano |
| alias | 0..* | string | Outros nomes do plano | |
| period | 0..1 | Period | Período em que o plano esteve disponível | |
| ownedBy | Σ | 1..1 | Reference(Operadora de plano privado de assistência à saúde) | Entidade proprietária do plano |
| administeredBy | Σ | 0..1 | Reference(Organization) | Entidade administradora do plano |
| coverageArea | Σ | 0..* | Reference(Location) | Área de cobertura do plano |
| contact | 0..* | BackboneElement | Contatos do plano | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| purpose | 0..1 | CodeableConcept | Propósito do contato Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |
| name | 0..1 | HumanName | Nome do contato | |
| telecom | 0..* | ContactPoint | Contatos do contato | |
| address | 0..1 | Address | Endereço do contato | |
| endpoint | 0..* | Reference(Endpoint) | API do plano | |
| network | 0..* | Reference(Organization) | Rede do plano | |
| coverage | 0..* | BackboneElement | Cobertura do plano | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo de cobertura | |
| network | 0..* | Reference(Organization) | Rede de cobertura | |
| benefit | 1..* | BackboneElement | Benefícios da cobertura | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo de benefício | |
| requirement | 0..1 | string | Requisitos para o benefício | |
| limit | 0..* | BackboneElement | Limites do benefício | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| value | 0..1 | Quantity | Valor do limite | |
| code | 0..1 | CodeableConcept | Código do limite | |
| plan | 0..* | BackboneElement | Planos | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| identifier | Σ | 0..* | Identifier | Identificador do plano |
| type | 0..1 | CodeableConcept | Tipo do plano | |
| coverageArea | Σ | 0..* | Reference(Location) | Área de cobertura do plano |
| network | 0..* | Reference(Organization) | Rede do plano | |
| generalCost | 0..* | BackboneElement | Custo geral do plano | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 0..1 | CodeableConcept | Tipo de custo geral | |
| groupSize | 0..1 | positiveInt | Tamanho do grupo | |
| cost | 0..1 | Money | Custo | |
| comment | 0..1 | string | Comentário | |
| specificCost | 0..* | BackboneElement | Custo específico do plano | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| category | 1..1 | CodeableConcept | Categoria do custo específico | |
| benefit | 0..* | BackboneElement | Benefício do custo específico | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo do benefício | |
| cost | 0..* | BackboneElement | Custo | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo do custo | |
| applicability | 0..1 | CodeableConcept | Aplicabilidade do custo Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers. | |
| qualifiers | 0..* | CodeableConcept | Qualificadores do custo | |
| value | 0..1 | Quantity | Valor do qualificador | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| InsurancePlan.language | preferred | CommonLanguages |
| InsurancePlan.identifier.use | required | Fixed Value: official |
| InsurancePlan.identifier.type | extensible | Identifier Type Codes |
| InsurancePlan.identifier:rpsScpa.use | required | Fixed Value: official |
| InsurancePlan.identifier:rpsScpa.type | extensible | Fixed Value: NH("National Health Plan Identifier") |
| InsurancePlan.status | required | PublicationStatus |
| InsurancePlan.type | example | InsurancePlanType |
| InsurancePlan.contact.purpose | extensible | ContactEntityType |
| InsurancePlan.plan.specificCost.benefit.cost.applicability | required | BenefitCostApplicability |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | InsurancePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | InsurancePlan | 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 | error | InsurancePlan | 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 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | InsurancePlan | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ipn-1 | error | InsurancePlan | The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0 |
Visualização instantânea
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| InsurancePlan | C | 0..* | InsurancePlan | Plano de Saúde |
| id | Σ | 0..1 | id | Identificador lógico do plano |
| meta | Σ | 0..1 | Meta | Metadados do plano |
| implicitRules | ?!Σ | 0..1 | uri | Regras implícitas de negócio |
| language | 0..1 | code | Idioma do plano Binding: CommonLanguages (preferred): Uma linguagem humana. | |
| text | 0..1 | Narrative | Elemento narrativo do plano | |
| contained | 0..* | Resource | Recursos contidos | |
| extension | 0..* | Extension | Extensões do plano Slice: Unordered, Open by value:url | |
| modifierExtension | ?! | 0..* | Extension | Extensões modificadores do plano |
| Slices for identifier | ΣC | 1..* | Identifier | Identificadores externos do plano Slice: Unordered, Open by value:system |
| identifier:All Slices | Content/Rules for all slices | |||
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | Uso do identificador do plano Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official |
| type | Σ | 0..1 | CodeableConcept | Tipo do identificador do plano Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. |
| system | Σ | 1..1 | uri | Sistema de identificação do plano Example General: http://www.acme.com/identifiers/patient |
| value | Σ | 0..1 | string | Valor do identificador do plano Example General: 123456 |
| period | Σ | 0..1 | Period | Período de validade do identificador do plano |
| assigner | Σ | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano |
| identifier:rpsScpa | ΣC | 1..* | Identifier | RPS SCPA |
| id | 0..1 | string | Identificador do plano | |
| extension | 0..* | Extension | Extensões do identificador do plano Slice: Unordered, Open by value:url | |
| use | ?!Σ | 0..1 | code | Uso do identificador do plano Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official |
| type | Σ | 0..1 | CodeableConcept | Tipo do identificador do plano Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Fixed Value: As shown |
| id | 0..0 | string | Unique id for inter-element referencing | |
| extension | 0..0 | Extension | Additional content defined by implementations | |
| coding | 1..1 | Coding | Code defined by a terminology system Fixed Value: (complex) | |
| id | 0..0 | string | Unique id for inter-element referencing | |
| extension | 0..0 | Extension | Additional content defined by implementations | |
| system | 1..1 | uri | Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203 | |
| version | 0..0 | string | Version of the system - if relevant | |
| code | 1..1 | code | Symbol in syntax defined by the system Fixed Value: NH | |
| display | 1..1 | string | Representation defined by the system Fixed Value: National Health Plan Identifier | |
| userSelected | 0..0 | boolean | If this coding was chosen directly by the user | |
| text | 0..0 | string | Plain text representation of the concept | |
| system | Σ | 1..1 | uri | Sistema de identificação do plano Fixed Value: https://fhir.ans.gov.br/sid/registro-rps-scpa |
| value | Σ | 1..1 | string | Valor do identificador do plano Example General: 123456 |
| period | Σ | 0..1 | Period | Período de validade do identificador do plano |
| assigner | Σ | 0..1 | Reference(Organization) | Entidade que atribuiu o identificador do plano |
| status | ?!Σ | 0..1 | code | Status do plano Binding: PublicationStatus (required): The lifecycle status of an artifact. |
| type | Σ | 0..* | CodeableConcept | Tipo do plano Binding: InsurancePlanType (example): Used to categorize the product/plan. |
| name | ΣC | 0..1 | string | Nome oficial do plano |
| alias | 0..* | string | Outros nomes do plano | |
| period | 0..1 | Period | Período em que o plano esteve disponível | |
| ownedBy | Σ | 1..1 | Reference(Operadora de plano privado de assistência à saúde) | Entidade proprietária do plano |
| administeredBy | Σ | 0..1 | Reference(Organization) | Entidade administradora do plano |
| coverageArea | Σ | 0..* | Reference(Location) | Área de cobertura do plano |
| contact | 0..* | BackboneElement | Contatos do plano | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| purpose | 0..1 | CodeableConcept | Propósito do contato Binding: ContactEntityType (extensible): The purpose for which you would contact a contact party. | |
| name | 0..1 | HumanName | Nome do contato | |
| telecom | 0..* | ContactPoint | Contatos do contato | |
| address | 0..1 | Address | Endereço do contato | |
| endpoint | 0..* | Reference(Endpoint) | API do plano | |
| network | 0..* | Reference(Organization) | Rede do plano | |
| coverage | 0..* | BackboneElement | Cobertura do plano | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo de cobertura | |
| network | 0..* | Reference(Organization) | Rede de cobertura | |
| benefit | 1..* | BackboneElement | Benefícios da cobertura | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo de benefício | |
| requirement | 0..1 | string | Requisitos para o benefício | |
| limit | 0..* | BackboneElement | Limites do benefício | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| value | 0..1 | Quantity | Valor do limite | |
| code | 0..1 | CodeableConcept | Código do limite | |
| plan | 0..* | BackboneElement | Planos | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| identifier | Σ | 0..* | Identifier | Identificador do plano |
| type | 0..1 | CodeableConcept | Tipo do plano | |
| coverageArea | Σ | 0..* | Reference(Location) | Área de cobertura do plano |
| network | 0..* | Reference(Organization) | Rede do plano | |
| generalCost | 0..* | BackboneElement | Custo geral do plano | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 0..1 | CodeableConcept | Tipo de custo geral | |
| groupSize | 0..1 | positiveInt | Tamanho do grupo | |
| cost | 0..1 | Money | Custo | |
| comment | 0..1 | string | Comentário | |
| specificCost | 0..* | BackboneElement | Custo específico do plano | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| category | 1..1 | CodeableConcept | Categoria do custo específico | |
| benefit | 0..* | BackboneElement | Benefício do custo específico | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo do benefício | |
| cost | 0..* | BackboneElement | Custo | |
| id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations | |
| modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized |
| type | 1..1 | CodeableConcept | Tipo do custo | |
| applicability | 0..1 | CodeableConcept | Aplicabilidade do custo Binding: BenefitCostApplicability (required): Whether the cost applies to in-network or out-of-network providers. | |
| qualifiers | 0..* | CodeableConcept | Qualificadores do custo | |
| value | 0..1 | Quantity | Valor do qualificador | |
| Documentation for this format | ||||
| Path | Conformance | ValueSet / Code |
| InsurancePlan.language | preferred | CommonLanguages |
| InsurancePlan.identifier.use | required | Fixed Value: official |
| InsurancePlan.identifier.type | extensible | Identifier Type Codes |
| InsurancePlan.identifier:rpsScpa.use | required | Fixed Value: official |
| InsurancePlan.identifier:rpsScpa.type | extensible | Fixed Value: NH("National Health Plan Identifier") |
| InsurancePlan.status | required | PublicationStatus |
| InsurancePlan.type | example | InsurancePlanType |
| InsurancePlan.contact.purpose | extensible | ContactEntityType |
| InsurancePlan.plan.specificCost.benefit.cost.applicability | required | BenefitCostApplicability |
| Id | Grade | Path(s) | Details | Requirements |
| dom-2 | error | InsurancePlan | If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty() | |
| dom-3 | error | InsurancePlan | 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 | error | InsurancePlan | 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 | error | InsurancePlan | If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty() | |
| dom-6 | best practice | InsurancePlan | A resource should have narrative for robust management : text.`div`.exists() | |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() | |
| ipn-1 | error | InsurancePlan | The organization SHALL at least have a name or an idendtifier, and possibly more than one : (identifier.count() + name.count()) > 0 |
Esta estrutura é derivada de InsurancePlan
Summary
Mandatory: 6 elements
Fixed Value: 4 elements
Structures
This structure refers to these other structures:
Slices
This structure defines the following Slices:
Outras representações de perfil: CSV, Excel, Schematron