HL7 Europe Laboratory Report
0.1.0 - trial-use 150

This page is part of the HL7 Europe Laboratory Report (v0.1.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: A.1.3 - Health insurance and payment information model to this guide - XML Representation

Page standards status: Informative Maturity Level: 2

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<ConceptMap xmlns="http://hl7.org/fhir">
  <id value="payer2FHIR-eu-lab"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="StructureDefinition-Bundle-eu-lab.html">Bundle: Laboratory Report</a></p><p>DRAFT (not intended for production usage). Published on 2024-02-26 08:16:21+0100 by HL7 Europe (HL7 Europe: <a href="http://hl7.eu">http://hl7.eu</a>). Used by permission of HL7 Europe, all rights reserved Creative Commons License</p><div><p>eHN Payer Model to this guide Map</p>
</div><br/><p><b>Group 1</b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="StructureDefinition-ServiceRequest-eu-lab.html">ServiceRequest: Laboratory Order</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>ServiceRequest.insurance</td><td>insurance.ofType(Coverage)</td></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr></table><hr/><p><b>Group 2</b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>Coverage</td><td/></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>Coverage.payor.identifier</td><td>payor.ofType(Organization)</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>Coverage.payor.name</td><td>payor.ofType(Organization)</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>Coverage.policyHolder.identifier</td><td>If it refers to the owner of the policy</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>Coverage.beneficiary.identifier</td><td>If it refers to the plan beneficiary</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>Coverage.subscriberId</td><td>If it is the ID assigned to the subscriber</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>Coverage.subscriber.identifier</td><td>If it refers to the subscriber to the policy and the Subscriber is of type Patient</td></tr></table><hr/><p><b>Group 3</b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="StructureDefinition-Patient-eu-lab.html">Patient: Person</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R4/codesystem-concept-map-equivalence.html#null"/></td><td>Patient.identifier</td><td>Sometimes the identifier assigned by the payor (e.g. the SSN) is used as one of the Patient Identifiers</td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="2"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="informative"/>
  </extension>
  <url value="http://hl7.eu/fhir/laboratory/ConceptMap/payer2FHIR-eu-lab"/>
  <version value="0.1.0"/>
  <name value="Payer2Fhir"/>
  <title value="eHN Payer to this guide Map"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2024-02-26T08:16:21+01:00"/>
  <publisher value="HL7 Europe"/>
  <contact>
    <name value="HL7 Europe"/>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.eu"/>
    </telecom>
  </contact>
  <description value="eHN Payer Model to this guide Map"/>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="150"/>
      <display value="Europe"/>
    </coding>
  </jurisdiction>
  <purpose
           value="It shows how the Laboratory Report Payer data set defined by the EU eHN guidelines is mapped into this guide"/>
  <copyright
             value="Used by permission of HL7 Europe, all rights reserved Creative Commons License"/>
  <sourceUri value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
  <targetUri
             value="http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab"/>
  <group>
    <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
    <target
            value="http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab"/>
    <element>
      <code value="Payer.insurance"/>
      <display value="A.1.3.1 Health insurance information"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="relatedto"/>
        </modifierExtension>
        <code value="ServiceRequest.insurance"/>
        <equivalence value="relatedto"/>
        <comment value="insurance.ofType(Coverage)"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.identifier"/>
      <display value="A.1.3.1.1 Health insurance code"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="relatedto"/>
        </modifierExtension>
        <code value="ServiceRequest.insurance"/>
        <equivalence value="relatedto"/>
        <comment value="details in Group 2"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.name"/>
      <display value="A.1.3.1.2 Health insurance name"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="relatedto"/>
        </modifierExtension>
        <code value="ServiceRequest.insurance"/>
        <equivalence value="relatedto"/>
        <comment value="details in Group 2"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="relatedto"/>
        </modifierExtension>
        <code value="ServiceRequest.insurance"/>
        <equivalence value="relatedto"/>
        <comment value="details in Group 2"/>
      </target>
    </element>
  </group>
  <group>
    <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
    <target value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
    <element>
      <code value="Payer.insurance"/>
      <display value="A.1.3.1 Health insurance information"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="relatedto"/>
        </modifierExtension>
        <code value="Coverage"/>
        <equivalence value="relatedto"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.identifier"/>
      <display value="A.1.3.1.1 Health insurance code"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="equivalent"/>
        </modifierExtension>
        <code value="Coverage.payor.identifier"/>
        <equivalence value="equivalent"/>
        <comment value="payor.ofType(Organization)"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.name"/>
      <display value="A.1.3.1.2 Health insurance name"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="equivalent"/>
        </modifierExtension>
        <code value="Coverage.payor.name"/>
        <equivalence value="equivalent"/>
        <comment value="payor.ofType(Organization)"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="equivalent"/>
        </modifierExtension>
        <code value="Coverage.policyHolder.identifier"/>
        <equivalence value="equivalent"/>
        <comment value="If it refers to the owner of the policy"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="equivalent"/>
        </modifierExtension>
        <code value="Coverage.beneficiary.identifier"/>
        <equivalence value="equivalent"/>
        <comment value="If it refers to the plan beneficiary"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="equivalent"/>
        </modifierExtension>
        <code value="Coverage.subscriberId"/>
        <equivalence value="equivalent"/>
        <comment value="If it is the ID assigned to the subscriber"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="equivalent"/>
        </modifierExtension>
        <code value="Coverage.subscriber.identifier"/>
        <equivalence value="equivalent"/>
        <comment
                 value="If it refers to the subscriber to the policy and the Subscriber is of type Patient"/>
      </target>
    </element>
  </group>
  <group>
    <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
    <target
            value="http://hl7.eu/fhir/laboratory/StructureDefinition/Patient-eu-lab"/>
    <element>
      <code value="Payer.insurance"/>
      <display value="A.1.3.1 Health insurance information"/>
      <target>
        <equivalence value="unmatched"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.identifier"/>
      <display value="A.1.3.1.1 Health insurance code"/>
      <target>
        <equivalence value="unmatched"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.name"/>
      <display value="A.1.3.1.2 Health insurance name"/>
      <target>
        <equivalence value="unmatched"/>
      </target>
    </element>
    <element>
      <code value="Payer.insurance.subjectIdentifier"/>
      <display value="A.1.3.1.3 Health insurance number"/>
      <target>
        <modifierExtension
                           url="http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence">
          <valueCode value="relatedto"/>
        </modifierExtension>
        <code value="Patient.identifier"/>
        <equivalence value="relatedto"/>
        <comment
                 value="Sometimes the identifier assigned by the payor (e.g. the SSN) is used as one of the Patient Identifiers"/>
      </target>
    </element>
  </group>
</ConceptMap>