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  1. FHIR Specification Feedback
  2. FHIR-27106

Coverage.order has conflict between description and requirement

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • R5
    • Financial Mgmt
    • Coverage
    • 13.1.4
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      Expand the definition to provide an example where there are several insurance coverages, ordered in COB order, and a use case for which only a subset of the coverages are applicable such that they are the primary, secondary etc. for that use case.

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      Expand the definition to provide an example where there are several insurance coverages, ordered in COB order, and a use case for which only a subset of the coverages are applicable such that they are the primary, secondary etc. for that use case.
    • Kathleen Connor/Andy Stechishin: 6-0-0
    • Clarification
    • Non-substantive
    • R5

    Description

      The definition for Coverage.order says "does not imply primary secondary etc as the specifying positioning of coverage relates to the episode of care"  However, the requirement notes that this is used for "managing coordination of benefits" which is the positioning of coverage as it relates to an episode of care.

      Coverage.order
      Element Id Coverage.order
      Definition The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care.
      Cardinality 0..1
      Type positiveInt
      Requirements Used in managing the coordination of benefits.

       

      Note:  This is from the Coverage Nomenclature Subgroup work

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            pknapp Paul Knapp
            lmichaelsen Linda Michaelsen
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