fhirtypes
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TypeScript
import { ICoverageClass, ICoverageCostToBeneficiary } from '../backbones';
import { IDomainResource, IElement } from '../base';
import { ICodeableConcept, IIdentifier, IPeriod, IReference } from '../datatypes';
import { FinancialResourceStatusCodesType } from '../types';
/**
* @name ICoverage
* @description Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
* @see <a href="https://hl7.org/fhir/R4/coverage.html">Coverage</a>
* @version R4
* @extends {IDomainResource}
* @author Claudia Alarcón Lazo
*/
export interface ICoverage extends IDomainResource {
/**
* @description A unique identifier assigned to this coverage.
*/
identifier?: IIdentifier[];
/**
* @description The status of the resource instance.
* @description active | cancelled | draft | entered-in-error
* @see <a href="https://hl7.org/fhir/R4/valueset-fm-status.html">FinancialResourceStatusCodes</a>
*/
status: FinancialResourceStatusCodesType;
/**
* @description The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
*/
type?: ICodeableConcept;
/**
* @description The party who 'owns' the insurance policy.
*/
policyHolder?: IReference;
/**
* @description The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.
*/
subscriber?: IReference;
/**
* @description The insurer assigned ID for the Subscriber.
*/
subscriberId?: string;
/**
* @description The party who benefits from the insurance coverage; the patient when products and/or services are provided.
*/
beneficiary: IReference;
/**
* @description A unique identifier for a dependent under the coverage.
*/
dependent?: string;
/**
* @description The relationship of beneficiary (patient) to the subscriber.
*/
relationship?: ICodeableConcept;
/**
* @description Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
*/
period?: IPeriod;
/**
* @description The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.
*/
payor: IReference[];
/**
* @description Additional information regarding the plan.
*/
class?: ICoverageClass[];
/**
* @description The order of applicability of this coverage relative to other coverages which are currently in force.
*/
order?: number;
/**
* @description The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.
*/
network?: string;
/**
* @description A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
*/
costToBeneficiary?: ICoverageCostToBeneficiary[];
/**
* @description When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
*/
subrogation?: boolean;
/**
* @description The policy(s) which constitute this insurance coverage.
*/
contract?: IReference[];
/**
* @description Extensions for status
*/
_status?: IElement;
/**
* @description Extensions for subscriberId
*/
_subscriberId?: IElement;
/**
* @description Extensions for dependent
*/
_dependent?: IElement;
/**
* @description Extensions for order
*/
_order?: IElement;
/**
* @description Extensions for network
*/
_network?: IElement;
/**
* @description Extensions for subrogation
*/
_subrogation?: IElement;
}