Details
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Change Request
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Resolution: Persuasive
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Medium
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FHIR Core (FHIR)
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STU3
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Patient Administration
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InsurancePlan
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8.30.4
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Paul Knapp / Bob Dieterle : 19-0-2
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Enhancement
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Non-compatible
Description
During the September 2019 WGM we discussed the possibility of splitting this resource to have separate resources for plans and products (see minutes for details). As an alternative I propose adding a new InsurancePlan.parent element with cardinality 0..1 and type Reference(InsurancePlan). That would allow payers to construct flexible hierarchies of insurance offerings to suit their own business practices.
The fundamental problem is that payers all have different practices and often use the same words to mean different things. But if we simply allow InsurancePlan to have parent/child relationships then payers can use InsurancePlan to model plans, products, brands, groups, or whatever else they use to organize and describe their offerings. That way we can sidestep the need to reconcile differences between payers and leave it to Implementation Guide authors to work out the details of how to map plans, products, groups, etc to InsurancePlan for their use cases.
There will be several competing proposals for how to resolve this issue so we should discuss them all together before holding a vote on this one.
Attachments
Issue Links
- is duplicated by
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FHIR-24694 Refactor InsurancePlan to allow referencing specific plans.
- Duplicate
- relates to
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FHIR-24667 Create reference from Coverage to InsurancePlan
- Published
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FHIR-19432 InsurancePlan.identifier use for plan and group number
- Applied
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FHIR-33272 Add Members to InsurancePlan Resource
- Applied
- mentioned in
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