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. 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 - JSON Representation

Page standards status: Informative Maturity Level: 2

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{
  "resourceType" : "ConceptMap",
  "id" : "payer2FHIR-eu-lab",
  "text" : {
    "status" : "extensions",
    "div" : "<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 08:44:57+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>\n</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>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 2
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "informative"
    }
  ],
  "url" : "http://hl7.eu/fhir/laboratory/ConceptMap/payer2FHIR-eu-lab",
  "version" : "0.1.0",
  "name" : "Payer2Fhir",
  "title" : "eHN Payer to this guide Map",
  "status" : "draft",
  "experimental" : true,
  "date" : "2024-02-26T08:44:57+01:00",
  "publisher" : "HL7 Europe",
  "contact" : [
    {
      "name" : "HL7 Europe",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.eu"
        }
      ]
    }
  ],
  "description" : "eHN Payer Model to this guide Map",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "150",
          "display" : "Europe"
        }
      ]
    }
  ],
  "purpose" : "It shows how the Laboratory Report Payer data set defined by the EU eHN guidelines is mapped into this guide",
  "copyright" : "Used by permission of HL7 Europe, all rights reserved Creative Commons License",
  "sourceUri" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer",
  "targetUri" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Bundle-eu-lab",
  "group" : [
    {
      "source" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer",
      "target" : "http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab",
      "element" : [
        {
          "code" : "Payer.insurance",
          "display" : "A.1.3.1 Health insurance information",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "relatedto"
                }
              ],
              "code" : "ServiceRequest.insurance",
              "equivalence" : "relatedto",
              "comment" : "insurance.ofType(Coverage)"
            }
          ]
        },
        {
          "code" : "Payer.insurance.identifier",
          "display" : "A.1.3.1.1 Health insurance code",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "relatedto"
                }
              ],
              "code" : "ServiceRequest.insurance",
              "equivalence" : "relatedto",
              "comment" : "details in Group 2"
            }
          ]
        },
        {
          "code" : "Payer.insurance.name",
          "display" : "A.1.3.1.2 Health insurance name",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "relatedto"
                }
              ],
              "code" : "ServiceRequest.insurance",
              "equivalence" : "relatedto",
              "comment" : "details in Group 2"
            }
          ]
        },
        {
          "code" : "Payer.insurance.subjectIdentifier",
          "display" : "A.1.3.1.3 Health insurance number",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "relatedto"
                }
              ],
              "code" : "ServiceRequest.insurance",
              "equivalence" : "relatedto",
              "comment" : "details in Group 2"
            }
          ]
        }
      ]
    },
    {
      "source" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer",
      "target" : "http://hl7.org/fhir/StructureDefinition/Coverage",
      "element" : [
        {
          "code" : "Payer.insurance",
          "display" : "A.1.3.1 Health insurance information",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "relatedto"
                }
              ],
              "code" : "Coverage",
              "equivalence" : "relatedto"
            }
          ]
        },
        {
          "code" : "Payer.insurance.identifier",
          "display" : "A.1.3.1.1 Health insurance code",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "equivalent"
                }
              ],
              "code" : "Coverage.payor.identifier",
              "equivalence" : "equivalent",
              "comment" : "payor.ofType(Organization)"
            }
          ]
        },
        {
          "code" : "Payer.insurance.name",
          "display" : "A.1.3.1.2 Health insurance name",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "equivalent"
                }
              ],
              "code" : "Coverage.payor.name",
              "equivalence" : "equivalent",
              "comment" : "payor.ofType(Organization)"
            }
          ]
        },
        {
          "code" : "Payer.insurance.subjectIdentifier",
          "display" : "A.1.3.1.3 Health insurance number",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "equivalent"
                }
              ],
              "code" : "Coverage.policyHolder.identifier",
              "equivalence" : "equivalent",
              "comment" : "If it refers to the owner of the policy"
            }
          ]
        },
        {
          "code" : "Payer.insurance.subjectIdentifier",
          "display" : "A.1.3.1.3 Health insurance number",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "equivalent"
                }
              ],
              "code" : "Coverage.beneficiary.identifier",
              "equivalence" : "equivalent",
              "comment" : "If it refers to the plan beneficiary"
            }
          ]
        },
        {
          "code" : "Payer.insurance.subjectIdentifier",
          "display" : "A.1.3.1.3 Health insurance number",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "equivalent"
                }
              ],
              "code" : "Coverage.subscriberId",
              "equivalence" : "equivalent",
              "comment" : "If it is the ID assigned to the subscriber"
            }
          ]
        },
        {
          "code" : "Payer.insurance.subjectIdentifier",
          "display" : "A.1.3.1.3 Health insurance number",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "equivalent"
                }
              ],
              "code" : "Coverage.subscriber.identifier",
              "equivalence" : "equivalent",
              "comment" : "If it refers to the subscriber to the policy and the Subscriber is of type Patient"
            }
          ]
        }
      ]
    },
    {
      "source" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer",
      "target" : "http://hl7.eu/fhir/laboratory/StructureDefinition/Patient-eu-lab",
      "element" : [
        {
          "code" : "Payer.insurance",
          "display" : "A.1.3.1 Health insurance information",
          "target" : [
            {
              "equivalence" : "unmatched"
            }
          ]
        },
        {
          "code" : "Payer.insurance.identifier",
          "display" : "A.1.3.1.1 Health insurance code",
          "target" : [
            {
              "equivalence" : "unmatched"
            }
          ]
        },
        {
          "code" : "Payer.insurance.name",
          "display" : "A.1.3.1.2 Health insurance name",
          "target" : [
            {
              "equivalence" : "unmatched"
            }
          ]
        },
        {
          "code" : "Payer.insurance.subjectIdentifier",
          "display" : "A.1.3.1.3 Health insurance number",
          "target" : [
            {
              "modifierExtension" : [
                {
                  "url" : "http://hl7.org/fhir/1.0/StructureDefinition/extension-ConceptMap.element.target.equivalence",
                  "valueCode" : "relatedto"
                }
              ],
              "code" : "Patient.identifier",
              "equivalence" : "relatedto",
              "comment" : "Sometimes the identifier assigned by the payor (e.g. the SSN) is used as one of the Patient Identifiers"
            }
          ]
        }
      ]
    }
  ]
}