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  1. FHIR Specification Feedback
  2. FHIR-24915

Harmonize Coverage and InsurancePlan type

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    Details

    • Type: Change Request
    • Status: Triaged (View Workflow)
    • Priority: Medium
    • Resolution: Unresolved
    • Specification:
      FHIR Core (FHIR)
    • Raised in Version:
      STU3
    • Work Group:
      Patient Administration
    • Related Artifact(s):
      InsurancePlan
    • Change Category:
      Enhancement

      Description

      Variances to be harmonized: value set bindings, cardinality, etc.

      For example:
      * Coverage.type is 0..1 and binds to valueset-coverage-type (e.g. HMO, PPO, dental, LTC, vision)
      * InsurancePlan.type (product type) is 0..* and binds to valueset-insuranceplan-type (e.g. medical, dental)
      * InsurancePlan.coverage.type (one type per coverage) and has no binding, but definition implies medical, dental, LTC. Why is this different than InsurancePlan.type?

      Recommentation is to:

      • Change Coverage.type to 0..* (will log another FM request)
        * Change InsurancePlan.type and/or InsurancePlan.coverage.type to bind to the same value set (valueset-coverage-type) as well as differentiate between why both of these types are needed?

      --------------------------------------------------------

      These are additional types, but don't seem to have as much overlap as the aforementioned types. They do need value set bindings though.

      • InsurancePlan.coverage.benefit.type have no bindings, but definition implies primary care; speciality care; inpatient; outpatient.
        * InsurancePlan.plan.type is 0..1 and has no binding, but definition implies "Platinum" or "High Deductable"

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            Assignee:
            Unassigned Unassigned
            Reporter:
            michelle.m.miller Michelle Miller
            Watchers:
            1 Start watching this issue

              Dates

              Created:
              Updated: