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

Logical Model: PayerLabEhn - Detailed Descriptions

Page standards status: Informative Maturity Level: 2

Definitions for the Payer logical model.

Guidance on how to interpret the contents of this table can be found here

0. Payer
Definition

Health insurance and payment information. Section A1.3 of the eHN guideline.

ShortA.1.3 - Health insurance and payment information
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Payer.insurance
Definition

Health insurance information is not always required, however, in some jurisdictions, the insurance number is also used as the patient identifier. It is necessary not just for identification but also forms access to funding for care.

ShortA.1.3.1 Health insurance information
Control0..1
TypeBackboneElement
4. Payer.insurance.identifier
Definition

Unique health insurance company identification code.

ShortA.1.3.1.1 Health insurance code
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
6. Payer.insurance.name
Definition

Full, official name of the healthcare insurance provider.

ShortA.1.3.1.2 Health insurance name
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
8. Payer.insurance.subjectIdentifier
Definition

Number or code under which the insured person is registered at the insurance provider.

ShortA.1.3.1.3 Health insurance number
Control0..*
TypeIdentifier

Guidance on how to interpret the contents of this table can be found here

0. Payer
Definition

Health insurance and payment information. Section A1.3 of the eHN guideline.

ShortA.1.3 - Health insurance and payment information
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Payer.insurance
Definition

Health insurance information is not always required, however, in some jurisdictions, the insurance number is also used as the patient identifier. It is necessary not just for identification but also forms access to funding for care.

ShortA.1.3.1 Health insurance information
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Payer.insurance.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
6. Payer.insurance.identifier
Definition

Unique health insurance company identification code.

ShortA.1.3.1.1 Health insurance code
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
8. Payer.insurance.name
Definition

Full, official name of the healthcare insurance provider.

ShortA.1.3.1.2 Health insurance name
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
10. Payer.insurance.subjectIdentifier
Definition

Number or code under which the insured person is registered at the insurance provider.

ShortA.1.3.1.3 Health insurance number
Control0..*
TypeIdentifier

Guidance on how to interpret the contents of this table can be found here

0. Payer
Definition

Health insurance and payment information. Section A1.3 of the eHN guideline.

ShortA.1.3 - Health insurance and payment information
Control0..*
Is Modifierfalse
Logical ModelInstances of this logical model are not marked to be the target of a Reference
2. Payer.insurance
Definition

Health insurance information is not always required, however, in some jurisdictions, the insurance number is also used as the patient identifier. It is necessary not just for identification but also forms access to funding for care.

ShortA.1.3.1 Health insurance information
Control0..1
TypeBackboneElement
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. Payer.insurance.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

ShortUnique id for inter-element referencing
Control0..1
Typestring
Is Modifierfalse
XML FormatIn the XML format, this property is represented as an attribute.
Summaryfalse
6. Payer.insurance.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

ShortAdditional content defined by implementations
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on Payer.insurance.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
  • value @ url
8. Payer.insurance.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

ShortExtensions that cannot be ignored even if unrecognized
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Summarytrue
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content, modifiers
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
10. Payer.insurance.identifier
Definition

Unique health insurance company identification code.

ShortA.1.3.1.1 Health insurance code
NoteThis is a business identifier, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
12. Payer.insurance.name
Definition

Full, official name of the healthcare insurance provider.

ShortA.1.3.1.2 Health insurance name
Control0..*
Typestring
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
14. Payer.insurance.subjectIdentifier
Definition

Number or code under which the insured person is registered at the insurance provider.

ShortA.1.3.1.3 Health insurance number
Control0..*
TypeIdentifier