Uploaded image for project: 'FHIR Specification Feedback'
  1. FHIR Specification Feedback
  2. FHIR-24915

Harmonize Coverage and InsurancePlan type

    XMLWordPrintableJSON

Details

    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • STU3
    • Patient Administration
    • InsurancePlan
    • Hide

      The coverage-type value set looks reasonably complete.  We will update the following properties in InsurancePlan to use this ValueSet:

      • InsurancePlan.type
      • InsurancePlan.coverage.type
      • InsurancePlan.plan.specificCost.benefit.type
      Show
      The coverage-type value set looks reasonably complete.  We will update the following properties in InsurancePlan to use this ValueSet: InsurancePlan.type InsurancePlan.coverage.type InsurancePlan.plan.specificCost.benefit.type
    • 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"

      Attachments

        Activity

          People

            pknapp Paul Knapp
            michelle.m.miller Michelle Miller
            Watchers:
            3 Start watching this issue

            Dates

              Created:
              Updated:
              Resolved: