Details
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Change Request
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Resolution: Persuasive with Modification
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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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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?
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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"