Details
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Change Request
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Resolution: Unresolved
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Medium
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FHIR Core (FHIR)
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R5
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Financial Mgmt
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STU
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Coverage
Description
When working with coverage effective dates, there are two ways of looking at it:
- What is the objective truth of when a coverage is effective? This will normally be a single period.
- What do end users and billing systems actually know about when the coverages are effective?
While there is usually (always?) a single effective period for a coverage from an "objective truth" perspective, often the end users or billing systems where coverage information is collected don't have the knowledge of that objective truth. This leads to real-world practices where users document multiple effective periods for a coverage, where those periods are fragments of the "objective truth".
I propose updating coverage.period to be 0..* so that billing systems can communicate the fragments of the effective period that they know about.
This is very much a practical request rather than a theoretical modeling one. But in order to interoperate real-world data, I think we need the enable the practical exchange here.
The payer can always validate that all the "fragment" periods are within the overall effective period the payer knows about, if the Coverage is communicated to the payer from the billing system.
Attachments
Issue Links
- is voted on by
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BALLOT-41731 Negative - Christopher Schaut : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43041 Negative - David Sundaram-Stukel : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43076 Negative - Thanos Tsiolis : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43111 Negative - Carl Dvorak : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43167 Negative - Isaac Vetter : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43291 Negative - Chris Courville : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43411 Negative - Kimberly Herman : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43454 Negative - Amit Popat : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43614 Negative - Vassil Peytchev : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43649 Negative - Daniel Rutz : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43684 Negative - Danielle Friend : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43719 Negative - Cooper Thompson : 2022-Sep-FHIR R5 STU
- Closed
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BALLOT-43848 Negative - Daniel Zhang : 2022-Sep-FHIR R5 STU
- Closed