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 - TTL Representation

Page standards status: Informative Maturity Level: 2

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

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