【2026.8.31リリース予定の公開準備版】電子カルテ情報共有サービス2文書5情報+患者サマリー FHIR実装ガイド JP-CLINS(CLinical Information Sharing ImplementationGuide) v1.13.0-preR1
1.13.0-preR1 - update
Japan
【2026.8.31リリース予定の公開準備版】電子カルテ情報共有サービス2文書5情報+患者サマリー FHIR実装ガイド JP-CLINS(CLinical Information Sharing ImplementationGuide) v1.13.0-preR1 - Local Development build (v1.13.0-preR1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Active as of 2024-09-14 |
Definitions for the JP-Coverage-eCS-insurance resource profile.
Guidance on how to interpret the contents of this table can be foundhere
| 0. Coverage | |
| Definition | Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment. Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment. |
| Short | Insurance or medical plan or a payment agreement 保険または医療費支払いプラン、または合意された支払い方法 |
| Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers. The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers. |
| Control | 0..* |
| Is Modifier | false |
| Summary | false |
| Invariants | dom-2: リソースが別のリソースに含まれている場合、ネストされたリソースを含めてはなりません / If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())dom-3: リソースが別のリソースに含まれている場合、それはリソースの他の場所から参照されるか、含有リソースを参照するものとします / If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource ( contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())dom-4: リソースが別のリソースに含まれている場合、meta.versionidもmeta.lastupdatedも持ってはならない。 / If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated ( contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())dom-5: 別のリソースにリソースが含まれている場合、セキュリティラベルはありません / If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty())dom-6: リソースには、堅牢な管理のための叙述(Narative)が存在することが望ましい / A resource should have narrative for robust management ( text.`div`.exists())dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty()) dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()) dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()) dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty()) dom-6: A resource should have narrative for robust management (text.`div`.exists()) |
| 2. Coverage.meta | |
| Definition | リソースに関するMetadata。これは、インフラストラクチャによって維持されるコンテンツです。コンテンツの変更は、常にリソースのバージョンの変更に関連付けられているとは限りません。 / The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
| Short | リソースに関するMetadata / Metadata about the resourceMetadata about the resource |
| Control | 10..1 |
| Type | Meta |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 4. Coverage.meta.lastUpdated | |
| Definition | このリソースのデータが最後に作成、更新、複写された日時。最終更新日時。YYYY-MM-DDThh:mm:ss.sss+zz:zz 例:2015-02-07T13:28:17.239+09:00 When the resource last changed - e.g. when the version changed. |
| Short | このリソースのデータが最後に作成、更新、複写された日時。最終更新日時。YYYY-MM-DDThh:mm:ss.sss+zz:zz 例:2015-02-07T13:28:17.239+09:00When the resource version last changed |
| Comments | この要素は、このリソースのデータを取り込んで蓄積していたシステムが、このリソースになんらかの変更があった可能性があった日時を取得し、このデータを再取り込みする必要性の判断をするために使われる。本要素に前回取り込んだ時点より後の日時が設定されている場合には、なんらかの変更があった可能性がある(変更がない場合もある)ものとして判断される。したがって、内容になんらかの変更があった場合、またはこのリソースのデータが初めて作成された場合には、その時点以降の日時(たとえば、このリソースのデータを作成した日時)を設定しなければならない。内容の変更がない場合でも、このリソースのデータが作り直された場合や単に複写された場合にその日時を設定しなおしてもよい。ただし、内容に変更がないのであれば、日時を変更しなくてもよい。また、この要素の変更とmeta.versionIdの変更とは、必ずしも連動しないことがある。 This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction. |
| Control | 10..1 |
| Type | instant |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 6. Coverage.meta.profile | |
| Definition | 本プロファイルを識別するURLとバージョンを指定する。バージョン指定を省略した場合には、データ受信時点の最新バージョンとみなされる。 A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url. |
| Short | 本プロファイルを識別するURLとバージョンを指定する。バージョン指定を省略した場合には、データ受信時点の最新バージョンとみなされる。Profiles this resource claims to conform to |
| Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. |
| Control | 10..* |
| Type | canonical(StructureDefinition) |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 8. Coverage.implicitRules | |
| Definition | リソースが構築されたときに従った一連のルールへの参照。コンテンツの処理時に理解する必要があります。多くの場合、これは他のプロファイルなどとともに特別なルールを定義する実装ガイドへの参照です。 / A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
| Short | このコンテンツが作成されたルールのセット / A set of rules under which this content was createdA set of rules under which this content was created |
| Comments | このルールセットを主張することは、コンテンツが限られた取引パートナーのセットによってのみ理解されることを制限します。これにより、本質的に長期的にデータの有用性が制限されます。ただし、既存の健康エコシステムは非常に破壊されており、一般的に計算可能な意味でデータを定義、収集、交換する準備ができていません。可能な限り、実装者や仕様ライターはこの要素の使用を避ける必要があります。多くの場合、使用する場合、URLは、これらの特別なルールを他のプロファイル、バリューセットなどとともに叙述(Narative)の一部として定義する実装ガイドへの参照です。 / Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
| Control | 0..1 |
| Type | uri |
| Is Modifier | true because 暗黙のルールは、意味または解釈を変更するリソースに関する追加の知識を提供する可能性があるため、この要素は修飾子としてラベル付けされています。 / This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretationThis element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 10. Coverage.contained | |
| Definition | これらのリソースには、それらを含むリソースを除いて独立した存在はありません - 独立して特定することはできず、独自の独立したトランザクションスコープを持つこともできません。 / These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
| Short | インラインリソースが含まれています / Contained, inline ResourcesContained, inline Resources |
| Comments | 識別が失われると、コンテンツを適切に識別できる場合は、これを行うべきではありません。含まれるリソースには、メタ要素にプロファイルとタグがある場合がありますが、セキュリティラベルはありません。 / This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
| Control | 0..0* |
| Type | Resource |
| Is Modifier | false |
| Summary | false |
| Alternate Names | inline resources, anonymous resources, contained resources |
| 12. Coverage.extension:insuredPersonSymbol | |
| Slice Name | insuredPersonSymbol |
| Definition | 健康保険における被保険者証記号を示す拡張 |
| Short | 被保険者証記号情報 |
| Comments | 健康保険における被保険者証記号を示す拡張。被保険者記号の全角文字列。 |
| Control | 0..1 |
| Type | Extension(JP Core Coverage InsuredPersonSymbol Extension) (Extension Type: string) |
| Is Modifier | false |
| Must Support | true |
| Summary | false |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-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()) |
| 14. Coverage.extension:insuredPersonSymbol.extension | |
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. 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. |
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementationsAdditional content defined by implementations |
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. 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. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-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()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 16. Coverage.extension:insuredPersonSymbol.url | |
| Definition | 拡張コードの定義のソース - 論理名またはURL。 / Source of the definition for the extension code - a logical name or a URL. Source of the definition for the extension code - a logical name or a URL. |
| Short | 拡張機能の意味を識別します / identifies the meaning of the extensionidentifies the meaning of the extension |
| Comments | 定義は、拡張性コードの計算可能または人間が読み取る可能性のある定義を直接指している場合があります。または、他の仕様で宣言されているように、論理的なURIである場合があります。定義は、拡張機能を定義する構造定義のURIでなければなりません。 / The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| Must Support | true |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSymbol |
| 18. Coverage.extension:insuredPersonSymbol.value[x] | |
| Definition | 被保険者証記号。記録形式は「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従う。 被保険者証(手帳)等の記号。英数又は漢字、最大38 バイト。1 健康保険被保険者証、船員保険被保険者証、受給資格者票及び国民健康保険被保険者証等の「記号及び番号」欄の記号を記録する。英数モードと漢字モードの文字を混在して記録しない。番号のみ設定されている場合は、記録を省略する。記号と番号を合せた文字数の上限は、モードごとに次のとおりとする。英数19バイト、漢字19バイト。 Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | 被保険者証記号Value of extension |
| Control | 10..1 |
| Type | string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | false |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 20. Coverage.extension:insuredPersonNumber | |
| Slice Name | insuredPersonNumber |
| Definition | 被保険者証番号を表す拡張「insuredPersonNumber」。 保険種別が「1:医保」、「2:国保」、「7:後期高齢者」の場合に記録する。 それ以外の場合は、本拡張要素自体出現しない。 |
| Short | 被保険者証番号情報 |
| Comments | 健康保険における被保険者証番号を示す拡張。被保険者記号の全角文字列。 |
| Control | 0..1 |
| Type | Extension(JP Core Coverage InsuredPersonNumber Extension) (Extension Type: string) |
| Is Modifier | false |
| Must Support | true |
| Summary | false |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-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()) |
| 22. Coverage.extension:insuredPersonNumber.extension | |
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. 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. |
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementationsAdditional content defined by implementations |
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. 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. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-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()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 24. Coverage.extension:insuredPersonNumber.url | |
| Definition | 拡張コードの定義のソース - 論理名またはURL。 / Source of the definition for the extension code - a logical name or a URL. Source of the definition for the extension code - a logical name or a URL. |
| Short | 拡張機能の意味を識別します / identifies the meaning of the extensionidentifies the meaning of the extension |
| Comments | 定義は、拡張性コードの計算可能または人間が読み取る可能性のある定義を直接指している場合があります。または、他の仕様で宣言されているように、論理的なURIである場合があります。定義は、拡張機能を定義する構造定義のURIでなければなりません。 / The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| Must Support | true |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonNumber |
| 26. Coverage.extension:insuredPersonNumber.value[x] | |
| Definition | 被保険者証番号。記録形式は「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従う。 被保険者証(手帳)等の番号。最大バイト数38,英数モードまたは漢字モード。1 健康保険被保険者証、船員保険被保険者証、受給資格者票及び国民健康保険被保険者証等の「記号及び番号」欄の番号を記録する。後期高齢者被保険者証の被保険者番号を記録する。英数モードと漢字モードの文字を混在して記 録しない。バイト数の上限については被保険者記号の説明を参照のこと。 Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | 被保険者証番号Value of extension |
| Control | 10..1 |
| Type | string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | false |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 28. Coverage.extension:insuredPersonSubNumber | |
| Slice Name | insuredPersonSubNumber |
| Definition | 被保険者証等に「枝番」が記載されていない場合は、記録を省略しても差し支えない。保険者が後期高齢者医療である場合又は負担者種別が公費負担医療であ場合は、記録を省略する。 |
| Short | 被保険者証等「枝番」情報 |
| Comments | 健康保険における被保険者証番号を示す拡張。2桁の全角数字文字列。一桁の場合には先頭に0をつけて2桁にする。 |
| Control | 0..1 |
| Type | Extension(JP Core Coverage InsuredPersonSubNumber Extension) (Extension Type: string) |
| Is Modifier | false |
| Must Support | true |
| Summary | false |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-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()) |
| 30. Coverage.extension:insuredPersonSubNumber.extension | |
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. 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. |
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementationsAdditional content defined by implementations |
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. 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. |
| Control | 0..0* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-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()) |
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 32. Coverage.extension:insuredPersonSubNumber.url | |
| Definition | 拡張コードの定義のソース - 論理名またはURL。 / Source of the definition for the extension code - a logical name or a URL. Source of the definition for the extension code - a logical name or a URL. |
| Short | 拡張機能の意味を識別します / identifies the meaning of the extensionidentifies the meaning of the extension |
| Comments | 定義は、拡張性コードの計算可能または人間が読み取る可能性のある定義を直接指している場合があります。または、他の仕様で宣言されているように、論理的なURIである場合があります。定義は、拡張機能を定義する構造定義のURIでなければなりません。 / The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Control | 1..1 |
| Type | uri |
| Is Modifier | false |
| Must Support | true |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| Fixed Value | http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSubNumber |
| 34. Coverage.extension:insuredPersonSubNumber.value[x] | |
| Definition | 被保険者証記号・番号に対する個人単位被保険者番号(枝番)。「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従い、桁数が2桁に満たない場合は、先頭に"0"を記録し2桁で記録する。 最大2バイトで数字半角文字。 電子資格確認を行った場合は、資格確認時にオンライン資格確認等システムから通知した枝番を記録する。健康保険被保険者証、受給資格者票及び国民健康保険被保険者証等による資格確認を行った場合は、当該証の「枝番」欄の番号を記録する。 「枝番」が2桁に満たない場合は、先頭に“0”を記録し、2桁で記録する。 被保険者証等に「枝番」が記載されていない場合は、記録を省略しても差し支えない。保険者が後期高齢者医療である場合又は負担者種別が公費負担医療であ場合は、記録を省略する。 Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Short | 個人単位被保険者番号(枝番)Value of extension |
| Control | 10..1 |
| Type | string, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | false |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 36. Coverage.modifierExtension | |
| Definition | リソースの基本的な定義の一部ではなく、それを含む要素の理解および/または含有要素の子孫の理解を変更するために使用される場合があります。通常、修飾子要素は否定または資格を提供します。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義することが許可されていますが、拡張機能の定義の一部として満たされる一連の要件があります。アプリケーションの処理リソースは、修飾子拡張機能をチェックする必要があります。 モディファイア拡張は、リソースまたはdomainResource上の要素の意味を変更してはなりません(修飾軸自体の意味を変更することはできません)。 / May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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). May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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). |
| Short | 無視できない拡張機能 / Extensions that cannot be ignoredExtensions that cannot be ignored |
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. 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. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because モディファイア拡張は、それらを含むリソースの意味または解釈を変更することが期待されています / Modifier extensions are expected to modify the meaning or interpretation of the resource that contains themModifier extensions are expected to modify the meaning or interpretation of the resource that contains them |
| Summary | false |
| Requirements | 修飾子拡張機能により、安全に無視できる大部分の拡張機能と明確に区別できるように、安全に無視できない拡張機能が可能になります。これにより、実装者が拡張の存在を禁止する必要性を排除することにより、相互運用性が促進されます。詳細については、[修飾子拡張の定義](拡張性.html#modifierextension)を参照してください。 / 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. 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 Names | extensions, user content |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-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()) |
| 38. Coverage.status | |
| Definition | リソースインスタンスのステータス。固定値active。真に有効な保険かどうかは意味しない。 The status of the resource instance. |
| Short | リソースインスタンスのステータスactive | cancelled | draft | entered-in-error |
| Comments | This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid. This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid. |
| Control | 1..1 |
| Binding | The codes SHALL be taken from FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1 (required to http://hl7.org/fhir/ValueSet/fm-status|4.0.1)リソースインスタンスの状態を指定するコード。 / A code specifying the state of the resource instance. A code specifying the state of the resource instance. |
| Type | code |
| Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid / この要素は、エラーで入力されたステータスを含むステータス要素であるため、修飾子としてラベル付けされている。これは、リソースが有効として扱われるべきではないことを意味する。 |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'. Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'. |
| Fixed Value | active |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 40. Coverage.type | |
| Definition | The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. |
| Short | 保険種別コードCoverage category such as medical or accident |
| Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
| Control | 10..1 |
| Binding | The codes SHALL be taken from The codes SHOULD be taken from MHLW_valueSet_ePreCDA_insuranceCategory_tbl11 (1.0.0)http://hl7.org/fhir/ValueSet/coverage-type|4.0.1 (required to http://jpfhir.jp/fhir/Common/ValueSet/mhlw-ePreCDA-insuranceCategory|1.0.0) |
| Type | CodeableConcept |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | The order of application of coverages is dependent on the types of coverage. The order of application of coverages is dependent on the types of coverage. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 42. Coverage.type.coding | |
| Definition | A reference to a code defined by a terminology system. |
| Short | Code defined by a terminology system |
| Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
| Control | 10..1* |
| Type | Coding |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 44. Coverage.type.coding.system | |
| Definition | 保険種別コード 厚生労働省電子処方箋等の CDA 記述仕様第1版 別表11のOID The identification of the code system that defines the meaning of the symbol in the code. |
| Short | 保険種別コード体系を識別するURIIdentity of the terminology system |
| Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
| Control | 10..1 |
| Type | uri |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need to be unambiguous about the source of the definition of the symbol. |
| Fixed Value | http://jpfhir.jp/fhir/core/mhlw/CodeSystem/InsuranceMajorCategory |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 46. Coverage.type.coding.code | |
| Definition | 保険種別コード 厚生労働省電子処方箋等の医療 CDA 記述仕様第1版 別表11のコード表に従う。8以外を使用する。 1 医保 2 国保 3 労災 4 自賠責 5 公害 6 自費 7 後期高齢者 8 公費 A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
| Short | 保険種別コードSymbol in syntax defined by the system |
| Control | 10..1 |
| Type | code |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need to refer to a particular code in the system. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 48. Coverage.type.coding.userSelected | |
| Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). |
| Short | If this coding was chosen directly by the user |
| Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. |
| Control | 0..01 |
| Type | boolean |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 50. Coverage.type.text | |
| Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
| Short | Plain text representation of the concept |
| Comments | Very often the text is the same as a displayName of one of the codings. |
| Control | 0..01 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 52. Coverage.policyHolder | |
| Definition | The party who 'owns' the insurance policy. The party who 'owns' the insurance policy. |
| Short | Owner of the policy ポリシの所有者 |
| Comments | For example: may be an individual, corporation or the subscriber's employer. For example: may be an individual, corporation or the subscriber's employer. |
| Control | 0..01 |
| Type | Reference(JP Core Patient Profile, RelatedPerson, JP Core Organization Profile, Patient, Organization) |
| Is Modifier | false |
| Summary | true |
| Requirements | This provides employer information in the case of Worker's Compensation and other policies. This provides employer information in the case of Worker's Compensation and other policies. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 54. Coverage.subscriber | |
| Definition | 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. 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. |
| Short | Subscriber to the policy 被保険者 |
| Comments | May be self or a parent in the case of dependents. May be self or a parent in the case of dependants. |
| Control | 0..01 |
| Type | Reference(JP Core Patient Profile, RelatedPerson, Patient) |
| Is Modifier | false |
| Summary | true |
| Requirements | This is the party who is entitled to the benefits under the policy. This is the party who is entitled to the benfits under the policy. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 56. Coverage.subscriberId | |
| Definition | The insurer assigned ID for the Subscriber. The insurer assigned ID for the Subscriber. |
| Short | ID assigned to the subscriber 被保険者に割り当てられたID |
| Control | 0..01 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | The insurer requires this identifier on correspondence and claims (digital and otherwise). The insurer requires this identifier on correspondance and claims (digital and otherwise). |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 58. Coverage.beneficiary | |
| Definition | この保険で給付される患者情報(Patientリソース)へのリテラル参照 The party who benefits from the insurance coverage; the patient when products and/or services are provided. |
| Short | 被給付者情報Plan beneficiary |
| Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
| Control | 1..1 |
| Type | Reference(JP Core Patient Profile, Patient) |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | This is the party who receives treatment for which the costs are reimbursed under the coverage. This is the party who receives treatment for which the costs are reimbursed under the coverage. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 60. Coverage.beneficiary.reference | |
| Definition | Budleリソースに記述されるPatientリソースのfullUrl要素に指定されるUUIDを指定 A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. |
| Short | PatientリソースのfullUrl要素に指定されるUUIDを指定Literal reference, Relative, internal or absolute URL |
| Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. |
| Control | 0..1 This element is affected by the following invariants: ref-1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 62. Coverage.dependent | |
| Definition | 被保険者証記号・番号に対する個人単位被保険者番号(枝番)。 被保険者番号の枝番を記述する拡張要素と同一の値を記述すること。 A unique identifier for a dependent under the coverage. |
| Short | 被保険者番号(枝番)Dependent number |
| Comments | Periodically the member number is constructed from the subscriberId and the dependent number. Periodically the member number is constructed from the subscriberId and the dependant number. |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary. For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 64. Coverage.relationship | |
| Definition | The relationship of beneficiary (patient) to the subscriber. The relationship of beneficiary (patient) to the subscriber. |
| Short | Beneficiary relationship to the subscriber 加入者との受益者関係 |
| Comments | Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others. Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others. |
| Control | 10..1 |
| Binding | Unless not suitable, these codes SHALL be taken from SubscriberRelationshipCodeshttp://hl7.org/fhir/ValueSet/subscriber-relationship|4.0.1 (extensible to http://hl7.org/fhir/ValueSet/subscriber-relationship|4.0.1)加入者と受益者(被保険者/対象当事者/患者)の関係。 / The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). |
| Type | CodeableConcept |
| Is Modifier | false |
| Must Support | true |
| Summary | false |
| Requirements | To determine relationship between the patient and the subscriber to determine coordination of benefits. To determine relationship between the patient and the subscriber to determine coordination of benefits. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 66. Coverage.relationship.coding | |
| Definition | A reference to a code defined by a terminology system. |
| Short | Code defined by a terminology system |
| Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
| Control | 10..1* |
| Type | Coding |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | Allows for alternative encodings within a code system, and translations to other code systems. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 68. Coverage.relationship.coding.system | |
| Definition | 被保険者区分コードのコード体系を識別するURI。厚生労働省電子処方箋等の医療文書 CDA 記述仕様第1版 別表12のOID The identification of the code system that defines the meaning of the symbol in the code. |
| Short | コード体系を識別するURIIdentity of the terminology system |
| Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
| Control | 0..1 |
| Type | uri |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need to be unambiguous about the source of the definition of the symbol. |
| Fixed Value | http://jpfhir.jp/fhir/core/mhlw/CodeSystem/InsuredPersonCategory |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 70. Coverage.relationship.coding.code | |
| Definition | 被保険者区分コード。厚生労働省電子処方箋 CDA 記述仕様第1版 別表12に従う。 1 被保険者 2 被扶養者 A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
| Short | 被保険者区分コードSymbol in syntax defined by the system |
| Control | 0..1 |
| Type | code |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need to refer to a particular code in the system. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 72. Coverage.relationship.coding.display | |
| Definition | 以下の文字列のいずれかを設定するが、省略可能。 コード1 文字列: "被保険者" コード2 文字列:"被扶養者" A representation of the meaning of the code in the system, following the rules of the system. |
| Short | コードに対応する表示文字列Representation defined by the system |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 74. Coverage.relationship.coding.userSelected | |
| Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). |
| Short | If this coding was chosen directly by the user |
| Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. |
| Control | 0..01 |
| Type | boolean |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 76. Coverage.relationship.text | |
| Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
| Short | Plain text representation of the concept |
| Comments | Very often the text is the same as a displayName of one of the codings. |
| Control | 0..01 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 78. Coverage.period | |
| Definition | 保険証の有効期間。保険証に明示的に記載がある場合、かつ、医療機関がその情報を把握している場合のみ記録する。 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. |
| Short | 保険証の有効期間Coverage start and end dates |
| Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration. |
| Control | 0..1 |
| Type | Period |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | Some insurers require the submission of the coverage term. Some insurers require the submission of the coverage term. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 80. Coverage.period.start | |
| Definition | 保険証の有効期間の開始日。資格取得日。ISO8601に準拠してyyyy_mm_dd形式で指定する。 The start of the period. The boundary is inclusive. |
| Short | 保険証の有効期間の開始日Starting time with inclusive boundary |
| Comments | If the low element is missing, the meaning is that the low boundary is not known. |
| Control | 0..1 This element is affected by the following invariants: per-1 |
| Type | dateTime |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 82. Coverage.period.end | |
| Definition | 保険証の有効期間の終了日。資格喪失日。ISO8601に準拠してyyyy_mm_dd形式で指定する。 The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time. |
| Short | 保険証の有効期間の終了日End time with inclusive boundary, if not ongoing |
| Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. |
| Control | 0..1 This element is affected by the following invariants: per-1 |
| Type | dateTime |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Meaning if Missing | If the end of the period is missing, it means that the period is ongoing |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 84. Coverage.payor | |
| Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. |
| Short | ポリシーの発行者 / Issuer of the policyIssuer of the policy |
| Comments | May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
For selfpay it may provide multiple paying persons and/or organizations. May provide multiple identifiers such as insurance company identifier or business identifier (BIN number). For selfpay it may provide multiple paying persons and/or organizations. |
| Control | 1..1* |
| Type | Reference(JP Core Organization Profile, JP Core Patient Profile, RelatedPerson, Organization, Patient) |
| Is Modifier | false |
| Must Support | true |
| Must Support Types | No must-support rules about the choice of types/profiles |
| Summary | true |
| Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. Need to identify the issuer to target for claim processing and for coordination of benefit processing. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Coverage.payor. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 86. Coverage.payor:insurer | |
| Slice Name | insurer |
| Definition | 保険者を表すOrganizationリソースへの参照 The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. |
| Short | 保険者情報Issuer of the policy |
| Comments | May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
For selfpay it may provide multiple paying persons and/or organizations. May provide multiple identifiers such as insurance company identifier or business identifier (BIN number). For selfpay it may provide multiple paying persons and/or organizations. |
| Control | 01..1* |
| Type | Reference(JP_Organization_eCS_coveragePayer, Organization, Patient, RelatedPerson) |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. Need to identify the issuer to target for claim processing and for coordination of benefit processing. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 88. Coverage.payor:insurer.reference | |
| Definition | Bundleリソースに記述される保険者を表すOrganizationリソースのfullUrl要素に指定されるUUIDを指定。 自費以外の場合に使用する。 A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. |
| Short | OrganizationリソースのfullUrl要素に指定されるUUIDを指定Literal reference, Relative, internal or absolute URL |
| Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. |
| Control | 0..1 This element is affected by the following invariants: ref-1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 90. Coverage.payor:selfPayment | |
| Slice Name | selfPayment |
| Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. |
| Short | ポリシーの発行者 / Issuer of the policyIssuer of the policy |
| Comments | May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
For selfpay it may provide multiple paying persons and/or organizations. May provide multiple identifiers such as insurance company identifier or business identifier (BIN number). For selfpay it may provide multiple paying persons and/or organizations. |
| Control | 01..1* |
| Type | Reference(JP_Patient_eCS, Organization, Patient, RelatedPerson) |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. Need to identify the issuer to target for claim processing and for coordination of benefit processing. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 92. Coverage.payor:selfPayment.reference | |
| Definition | Bundleリソースに記述される受給者本人(患者)を表すPatientリソースのfullUrl要素に指定されるUUIDを指定。 自費の場合に使用する。 A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. |
| Short | PatientリソースのfullUrl要素に指定されるUUIDを指定Literal reference, Relative, internal or absolute URL |
| Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. |
| Control | 0..1 This element is affected by the following invariants: ref-1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 94. Coverage.class | |
| Definition | A suite of underwriter specific classifiers. A suite of underwriter specific classifiers. |
| Short | 追加のカバレッジ分類 / Additional coverage classificationsAdditional coverage classifications |
| Comments | For example may be used to identify a class of coverage or employer group, Policy, Plan. For example may be used to identify a class of coverage or employer group, Policy, Plan. |
| Control | 0..0* |
| Type | BackboneElement |
| Is Modifier | false |
| Summary | false |
| Requirements | The codes provided on the health card which identify or confirm the specific policy for the insurer. The codes provided on the health card which identify or confirm the specific policy for the insurer. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 99. Coverage.order | |
| Definition | The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care. The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care. |
| Short | カバレッジの相対順序 / Relative order of the coverageRelative order of the coverage |
| Comments | 32 bit number; for values larger than this, use decimal |
| Control | 0..01 |
| Type | positiveInt |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | Used in managing the coordination of benefits. Used in managing the coordination of benefits. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 101. Coverage.network | |
| Definition | 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. 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. |
| Short | 保険会社ネットワーク / Insurer networkInsurer network |
| Control | 0..01 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | Used in referral for treatment and in claims processing. Used in referral for treatment and in claims processing. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 103. Coverage.costToBeneficiary | |
| Definition | 自己負担率。記録が可能な場合にのみ記録する。 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. |
| Short | 自己負担率Patient payments for services/products |
| Comments | For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment. For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment. |
| Control | 0..* |
| Type | BackboneElement |
| Is Modifier | false |
| Must Support | true |
| Summary | false |
| Requirements | Required by providers to manage financial transaction with the patient. Required by providers to manage financial transaction with the patient. |
| Alternate Names | CoPay, Deductible, Exceptions |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 105. Coverage.costToBeneficiary.modifierExtension | |
| Definition | 要素の基本的な定義の一部ではなく、それが含まれている要素の理解、および/または含まれる要素の子孫の理解を変更するために使用される場合があります。通常、修飾子要素は否定または資格を提供します。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。アプリケーションの処理リソースは、修飾子拡張機能をチェックする必要があります。 モディファイア拡張は、リソースまたはdomainResource上の要素の意味を変更してはなりません(修飾軸自体の意味を変更することはできません)。 / 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). 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). |
| Short | 認識されていなくても無視できない拡張機能 / Extensions that cannot be ignored even if unrecognizedExtensions that cannot be ignored even if unrecognized |
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. 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. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because 修飾子拡張は、それらを含む要素の意味または解釈を変更することが期待されています / Modifier extensions are expected to modify the meaning or interpretation of the element that contains themModifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | 修飾子拡張機能により、安全に無視できる大部分の拡張機能と明確に区別できるように、安全に無視できない拡張機能が可能になります。これにより、実装者が拡張の存在を禁止する必要性を排除することにより、相互運用性が促進されます。詳細については、[修飾子拡張の定義](拡張性.html#modifierextension)を参照してください。 / 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. 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 Names | extensions, user content, modifiers |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists())ele-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()) |
| 107. Coverage.costToBeneficiary.type | |
| Definition | The category of patient centric costs associated with treatment. The category of patient centric costs associated with treatment. |
| Short | コストカテゴリ / Cost categoryCost category |
| Comments | For example visit, specialist visits, emergency, inpatient care, etc. For example visit, specialist visits, emergency, inpatient care, etc. |
| Control | 10..1 |
| Binding | Unless not suitable, these codes SHALL be taken from CoverageCopayTypeCodeshttp://hl7.org/fhir/ValueSet/coverage-copay-type|4.0.1 (extensible to http://hl7.org/fhir/ValueSet/coverage-copay-type|4.0.1)患者の自己負担が指定されているサービスの種類。 / The types of services to which patient copayments are specified. The types of services to which patient copayments are specified. |
| Type | CodeableConcept |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | Needed to identify the category associated with the amount for the patient. Needed to identify the category associated with the amount for the patient. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 109. Coverage.costToBeneficiary.type.coding | |
| Definition | 用語システムによって定義されたコードへの参照。 / A reference to a code defined by a terminology system. A reference to a code defined by a terminology system. |
| Short | 用語システムによって定義されたコード / Code defined by a terminology systemCode defined by a terminology system |
| Comments | コードは、列挙されたCTなどの非常に正式な定義まで、列挙またはコードリストで非常にさりげなく定義される場合があります。詳細については、HL7 V3コアプリンシップを参照してください。コーディングの順序付けは未定義であり、意味を推測するために使用されません。一般に、せいぜい、コーディング値の1つのみがuserselected = trueとしてラベル付けされます。 / Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. |
| Control | 10..1* |
| Type | Coding |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | コードシステム内の代替エンコーディング、および他のコードシステムへの翻訳が可能になります。 / Allows for alternative encodings within a code system, and translations to other code systems. Allows for alternative encodings within a code system, and translations to other code systems. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 111. Coverage.costToBeneficiary.type.coding.system | |
| Definition | 自己負担の種別を識別するコードのコード体系を識別するURI。固定値。 The identification of the code system that defines the meaning of the symbol in the code. |
| Short | 自己負担の種別を識別するコードのコード体系を識別するURIIdentity of the terminology system |
| Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. |
| Control | 10..1 |
| Type | uri |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | シンボルの定義のソースについて明確である必要があります。 / Need to be unambiguous about the source of the definition of the symbol. Need to be unambiguous about the source of the definition of the symbol. |
| Fixed Value | http://terminology.hl7.org/CodeSystem/coverage-copay-type |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 113. Coverage.costToBeneficiary.type.coding.code | |
| Definition | 固定値 copaypct A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). |
| Short | 自己負担率を表すコードSymbol in syntax defined by the system |
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
| Control | 10..1 |
| Type | code |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | システム内の特定のコードを参照する必要があります。 / Need to refer to a particular code in the system. Need to refer to a particular code in the system. |
| Fixed Value | copaypct |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 115. Coverage.costToBeneficiary.type.coding.display | |
| Definition | システムのルールに従って、システム内のコードの意味の表現。 / A representation of the meaning of the code in the system, following the rules of the system. A representation of the meaning of the code in the system, following the rules of the system. |
| Short | コードの表示名Representation defined by the system |
| Control | 0..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | システムを知らない読者のために、コードの人間の読み取り可能な意味を持ち込むことができる必要があります。 / Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. |
| Fixed Value | 負担率 |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 117. Coverage.costToBeneficiary.type.text | |
| Definition | データを入力したユーザー、および/またはユーザーの意図された意味を表すユーザーによって見られる/選択/発言された概念の人間の言語表現。 / A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. |
| Short | コンセプトの単純なテキスト表現 / Plain text representation of the conceptPlain text representation of the concept |
| Comments | 多くの場合、テキストはコーディングの1つの表示名と同じです。 / Very often the text is the same as a displayName of one of the codings. Very often the text is the same as a displayName of one of the codings. |
| Control | 0..01 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | 用語からのコードは、それらを使用する人間のすべてのニュアンスを使用して、常に正しい意味をキャプチャするとは限りません。または、適切なコードがまったくない場合があります。これらの場合、テキストはソースの完全な意味をキャプチャするために使用されます。 / The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 119. Coverage.costToBeneficiary.value[x] | |
| Definition | 自己負担割合 The amount due from the patient for the cost category. |
| Short | 自己負担割合The amount or percentage due from the beneficiary |
| Comments | Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency. Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency. |
| Control | 1..1 |
| Type | Quantity(SimpleQuantity), Money |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Is Modifier | false |
| Must Support | true |
| Summary | true |
| Requirements | Needed to identify the amount for the patient associated with the category. Needed to identify the amount for the patient associated with the category. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 121. Coverage.costToBeneficiary.value[x].value | |
| Definition | 自己負担割合を%で指定する。 例)数値で 10 The value of the measured amount. The value includes an implicit precision in the presentation of the value. |
| Short | 自己負担割合Numerical value (with implicit precision) |
| Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). |
| Control | 10..1 |
| Type | decimal |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Precision is handled implicitly in almost all cases of measurement. |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 123. Coverage.costToBeneficiary.value[x].comparator | |
| Definition | Not allowed to be used in this context How the value should be understood and represented - whether the actual value is greater or less than the stated value due to measurement issues; e.g. if the comparator is "<" , then the real value is < stated value. |
| Short | < | <= | >= | > - how to understand the value |
| Control | 0..01 |
| Binding | The codes SHALL be taken from QuantityComparatorhttp://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1 (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)How the Quantity should be understood and represented. |
| Type | code |
| Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | true |
| Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. |
| Meaning if Missing | If there is no comparator, then there is no modification of the value |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 125. Coverage.costToBeneficiary.value[x].unit | |
| Definition | 人が解釈可能な単位文字列。固定値 A human-readable form of the unit. |
| Short | 単位Unit representation |
| Control | 10..1 |
| Type | string |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. |
| Fixed Value | % |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 127. Coverage.costToBeneficiary.value[x].system | |
| Definition | UCUMを識別するURI。 The identification of the system that provides the coded form of the unit. |
| Short | 単位コードSystem that defines coded unit form |
| Control | 10..1 This element is affected by the following invariants: qty-3 |
| Type | uri |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need to know the system that defines the coded form of the unit. |
| Fixed Value | http://unitsofmeasure.org |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 129. Coverage.costToBeneficiary.value[x].code | |
| Definition | 固定値 A computer processable form of the unit in some unit representation system. |
| Short | パーセントを表すUCUMコードCoded form of the unit |
| Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. |
| Control | 10..1 |
| Type | code |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Must Support | true |
| Summary | true |
| Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. |
| Fixed Value | % |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 131. Coverage.costToBeneficiary.exception | |
| Definition | A suite of codes indicating exceptions or reductions to patient costs and their effective periods. A suite of codes indicating exceptions or reductions to patient costs and their effective periods. |
| Short | 患者の支払いの例外 / Exceptions for patient paymentsExceptions for patient payments |
| Control | 0..0* |
| Type | BackboneElement |
| Is Modifier | false |
| Summary | false |
| Requirements | Required by providers to manage financial transaction with the patient. Required by providers to manage financial transaction with the patient. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 135. Coverage.subrogation | |
| Definition | When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs. When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs. |
| Short | Reimbursement to insurer 保険者への償還 |
| Comments | Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims. Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims. |
| Control | 0..01 |
| Type | boolean |
| Is Modifier | false |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| Summary | false |
| Requirements | See definition for when to be used. See definition for when to be used. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 137. Coverage.contract | |
| Definition | The policy(s) which constitute this insurance coverage. The policy(s) which constitute this insurance coverage. |
| Short | Contract details 契約の詳細 |
| Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
| Control | 0..0* |
| Type | Reference(Contract) |
| Is Modifier | false |
| Summary | false |
| Requirements | To reference the legally binding contract between the policy holder and the insurer. To reference the legally binding contract between the policy holder and the insurer. |
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Coverage | |
| 2. Coverage.meta | |
| Control | 1..? |
| Must Support | true |
| 4. Coverage.meta.lastUpdated | |
| Definition | このリソースのデータが最後に作成、更新、複写された日時。最終更新日時。YYYY-MM-DDThh:mm:ss.sss+zz:zz 例:2015-02-07T13:28:17.239+09:00 |
| Short | このリソースのデータが最後に作成、更新、複写された日時。最終更新日時。YYYY-MM-DDThh:mm:ss.sss+zz:zz 例:2015-02-07T13:28:17.239+09:00 |
| Comments | この要素は、このリソースのデータを取り込んで蓄積していたシステムが、このリソースになんらかの変更があった可能性があった日時を取得し、このデータを再取り込みする必要性の判断をするために使われる。本要素に前回取り込んだ時点より後の日時が設定されている場合には、なんらかの変更があった可能性がある(変更がない場合もある)ものとして判断される。したがって、内容になんらかの変更があった場合、またはこのリソースのデータが初めて作成された場合には、その時点以降の日時(たとえば、このリソースのデータを作成した日時)を設定しなければならない。内容の変更がない場合でも、このリソースのデータが作り直された場合や単に複写された場合にその日時を設定しなおしてもよい。ただし、内容に変更がないのであれば、日時を変更しなくてもよい。また、この要素の変更とmeta.versionIdの変更とは、必ずしも連動しないことがある。 |
| Control | 1..? |
| Must Support | true |
| 6. Coverage.meta.profile | |
| Definition | 本プロファイルを識別するURLとバージョンを指定する。バージョン指定を省略した場合には、データ受信時点の最新バージョンとみなされる。 |
| Short | 本プロファイルを識別するURLとバージョンを指定する。バージョン指定を省略した場合には、データ受信時点の最新バージョンとみなされる。 |
| Control | 1..? |
| Must Support | true |
| 8. Coverage.contained | |
| Control | 0..0 |
| 10. Coverage.extension:insuredPersonSymbol | |
| Slice Name | insuredPersonSymbol |
| Short | 被保険者証記号情報 |
| Control | 0..1 |
| Must Support | true |
| 12. Coverage.extension:insuredPersonSymbol.url | |
| Must Support | true |
| 14. Coverage.extension:insuredPersonSymbol.value[x] | |
| Definition | 被保険者証記号。記録形式は「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従う。 被保険者証(手帳)等の記号。英数又は漢字、最大38 バイト。1 健康保険被保険者証、船員保険被保険者証、受給資格者票及び国民健康保険被保険者証等の「記号及び番号」欄の記号を記録する。英数モードと漢字モードの文字を混在して記録しない。番号のみ設定されている場合は、記録を省略する。記号と番号を合せた文字数の上限は、モードごとに次のとおりとする。英数19バイト、漢字19バイト。 |
| Short | 被保険者証記号 |
| Control | 1..? |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Must Support | true |
| 16. Coverage.extension:insuredPersonNumber | |
| Slice Name | insuredPersonNumber |
| Definition | 被保険者証番号を表す拡張「insuredPersonNumber」。 保険種別が「1:医保」、「2:国保」、「7:後期高齢者」の場合に記録する。 それ以外の場合は、本拡張要素自体出現しない。 |
| Short | 被保険者証番号情報 |
| Control | 0..1 |
| Must Support | true |
| 18. Coverage.extension:insuredPersonNumber.url | |
| Must Support | true |
| 20. Coverage.extension:insuredPersonNumber.value[x] | |
| Definition | 被保険者証番号。記録形式は「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従う。 被保険者証(手帳)等の番号。最大バイト数38,英数モードまたは漢字モード。1 健康保険被保険者証、船員保険被保険者証、受給資格者票及び国民健康保険被保険者証等の「記号及び番号」欄の番号を記録する。後期高齢者被保険者証の被保険者番号を記録する。英数モードと漢字モードの文字を混在して記 録しない。バイト数の上限については被保険者記号の説明を参照のこと。 |
| Short | 被保険者証番号 |
| Control | 1..? |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Must Support | true |
| 22. Coverage.extension:insuredPersonSubNumber | |
| Slice Name | insuredPersonSubNumber |
| Definition | 被保険者証等に「枝番」が記載されていない場合は、記録を省略しても差し支えない。保険者が後期高齢者医療である場合又は負担者種別が公費負担医療であ場合は、記録を省略する。 |
| Short | 被保険者証等「枝番」情報 |
| Control | 0..1 |
| Must Support | true |
| 24. Coverage.extension:insuredPersonSubNumber.url | |
| Must Support | true |
| 26. Coverage.extension:insuredPersonSubNumber.value[x] | |
| Definition | 被保険者証記号・番号に対する個人単位被保険者番号(枝番)。「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従い、桁数が2桁に満たない場合は、先頭に"0"を記録し2桁で記録する。 最大2バイトで数字半角文字。 電子資格確認を行った場合は、資格確認時にオンライン資格確認等システムから通知した枝番を記録する。健康保険被保険者証、受給資格者票及び国民健康保険被保険者証等による資格確認を行った場合は、当該証の「枝番」欄の番号を記録する。 「枝番」が2桁に満たない場合は、先頭に“0”を記録し、2桁で記録する。 被保険者証等に「枝番」が記載されていない場合は、記録を省略しても差し支えない。保険者が後期高齢者医療である場合又は負担者種別が公費負担医療であ場合は、記録を省略する。 |
| Short | 個人単位被保険者番号(枝番) |
| Control | 1..? |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Must Support | true |
| 28. Coverage.status | |
| Definition | リソースインスタンスのステータス。固定値active。真に有効な保険かどうかは意味しない。 |
| Short | リソースインスタンスのステータス |
| Fixed Value | active |
| 30. Coverage.type | |
| Short | 保険種別コード |
| Control | 1..? |
| Binding | The codes SHALL be taken from MHLW_valueSet_ePreCDA_insuranceCategory_tbl11 (1.0.0) (required to http://jpfhir.jp/fhir/Common/ValueSet/mhlw-ePreCDA-insuranceCategory|1.0.0) |
| Must Support | true |
| 32. Coverage.type.coding | |
| Control | 1..1 |
| Must Support | true |
| 34. Coverage.type.coding.system | |
| Definition | 保険種別コード 厚生労働省電子処方箋等の CDA 記述仕様第1版 別表11のOID |
| Short | 保険種別コード体系を識別するURI |
| Control | 1..? |
| Must Support | true |
| Fixed Value | http://jpfhir.jp/fhir/core/mhlw/CodeSystem/InsuranceMajorCategory |
| 36. Coverage.type.coding.code | |
| Definition | 保険種別コード 厚生労働省電子処方箋等の医療 CDA 記述仕様第1版 別表11のコード表に従う。8以外を使用する。 1 医保 2 国保 3 労災 4 自賠責 5 公害 6 自費 7 後期高齢者 8 公費 |
| Short | 保険種別コード |
| Control | 1..? |
| Must Support | true |
| 38. Coverage.type.coding.userSelected | |
| Control | 0..0 |
| 40. Coverage.type.text | |
| Control | 0..0 |
| 42. Coverage.policyHolder | |
| Control | 0..0 |
| 44. Coverage.subscriber | |
| Control | 0..0 |
| 46. Coverage.subscriberId | |
| Control | 0..0 |
| 48. Coverage.beneficiary | |
| Definition | この保険で給付される患者情報(Patientリソース)へのリテラル参照 |
| Short | 被給付者情報 |
| Must Support | true |
| 50. Coverage.beneficiary.reference | |
| Definition | Budleリソースに記述されるPatientリソースのfullUrl要素に指定されるUUIDを指定 |
| Short | PatientリソースのfullUrl要素に指定されるUUIDを指定 |
| Must Support | true |
| 52. Coverage.dependent | |
| Definition | 被保険者証記号・番号に対する個人単位被保険者番号(枝番)。 被保険者番号の枝番を記述する拡張要素と同一の値を記述すること。 |
| Short | 被保険者番号(枝番) |
| Must Support | true |
| 54. Coverage.relationship | |
| Control | 1..? |
| Must Support | true |
| 56. Coverage.relationship.coding | |
| Control | 1..1 |
| Must Support | true |
| 58. Coverage.relationship.coding.system | |
| Definition | 被保険者区分コードのコード体系を識別するURI。厚生労働省電子処方箋等の医療文書 CDA 記述仕様第1版 別表12のOID |
| Short | コード体系を識別するURI |
| Must Support | true |
| Fixed Value | http://jpfhir.jp/fhir/core/mhlw/CodeSystem/InsuredPersonCategory |
| 60. Coverage.relationship.coding.code | |
| Definition | 被保険者区分コード。厚生労働省電子処方箋 CDA 記述仕様第1版 別表12に従う。 1 被保険者 2 被扶養者 |
| Short | 被保険者区分コード |
| Must Support | true |
| 62. Coverage.relationship.coding.display | |
| Definition | 以下の文字列のいずれかを設定するが、省略可能。 コード1 文字列: "被保険者" コード2 文字列:"被扶養者" |
| Short | コードに対応する表示文字列 |
| Must Support | true |
| 64. Coverage.relationship.coding.userSelected | |
| Control | 0..0 |
| 66. Coverage.relationship.text | |
| Control | 0..0 |
| 68. Coverage.period | |
| Definition | 保険証の有効期間。保険証に明示的に記載がある場合、かつ、医療機関がその情報を把握している場合のみ記録する。 |
| Short | 保険証の有効期間 |
| Must Support | true |
| 70. Coverage.period.start | |
| Definition | 保険証の有効期間の開始日。資格取得日。ISO8601に準拠してyyyy_mm_dd形式で指定する。 |
| Short | 保険証の有効期間の開始日 |
| Must Support | true |
| 72. Coverage.period.end | |
| Definition | 保険証の有効期間の終了日。資格喪失日。ISO8601に準拠してyyyy_mm_dd形式で指定する。 |
| Short | 保険証の有効期間の終了日 |
| Must Support | true |
| 74. Coverage.payor | |
| Control | 0..1 |
| Must Support | true |
| Slicing | This element introduces a set of slices on Coverage.payor. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 76. Coverage.payor:insurer | |
| Slice Name | insurer |
| Definition | 保険者を表すOrganizationリソースへの参照 |
| Short | 保険者情報 |
| Control | 0..1 |
| Type | Reference(JP_Organization_eCS_coveragePayer) |
| Must Support | true |
| 78. Coverage.payor:insurer.reference | |
| Definition | Bundleリソースに記述される保険者を表すOrganizationリソースのfullUrl要素に指定されるUUIDを指定。 自費以外の場合に使用する。 |
| Short | OrganizationリソースのfullUrl要素に指定されるUUIDを指定 |
| Must Support | true |
| 80. Coverage.payor:selfPayment | |
| Slice Name | selfPayment |
| Control | 0..1 |
| Type | Reference(JP_Patient_eCS) |
| Must Support | true |
| 82. Coverage.payor:selfPayment.reference | |
| Definition | Bundleリソースに記述される受給者本人(患者)を表すPatientリソースのfullUrl要素に指定されるUUIDを指定。 自費の場合に使用する。 |
| Short | PatientリソースのfullUrl要素に指定されるUUIDを指定 |
| Must Support | true |
| 84. Coverage.class | |
| Control | 0..0 |
| 86. Coverage.order | |
| Control | 0..0 |
| 88. Coverage.network | |
| Control | 0..0 |
| 90. Coverage.costToBeneficiary | |
| Definition | 自己負担率。記録が可能な場合にのみ記録する。 |
| Short | 自己負担率 |
| Must Support | true |
| 92. Coverage.costToBeneficiary.type | |
| Control | 1..? |
| Must Support | true |
| 94. Coverage.costToBeneficiary.type.coding | |
| Control | 1..1 |
| Must Support | true |
| 96. Coverage.costToBeneficiary.type.coding.system | |
| Definition | 自己負担の種別を識別するコードのコード体系を識別するURI。固定値。 |
| Short | 自己負担の種別を識別するコードのコード体系を識別するURI |
| Control | 1..? |
| Must Support | true |
| Fixed Value | http://terminology.hl7.org/CodeSystem/coverage-copay-type |
| 98. Coverage.costToBeneficiary.type.coding.code | |
| Definition | 固定値 copaypct |
| Short | 自己負担率を表すコード |
| Control | 1..? |
| Must Support | true |
| Fixed Value | copaypct |
| 100. Coverage.costToBeneficiary.type.coding.display | |
| Short | コードの表示名 |
| Must Support | true |
| Fixed Value | 負担率 |
| 102. Coverage.costToBeneficiary.type.text | |
| Control | 0..0 |
| 104. Coverage.costToBeneficiary.value[x] | |
| Definition | 自己負担割合 |
| Short | 自己負担割合 |
| Type | Quantity(SimpleQuantity), Money |
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
| Must Support | true |
| 106. Coverage.costToBeneficiary.value[x].value | |
| Definition | 自己負担割合を%で指定する。 例)数値で 10 |
| Short | 自己負担割合 |
| Control | 1..? |
| Must Support | true |
| 108. Coverage.costToBeneficiary.value[x].unit | |
| Definition | 人が解釈可能な単位文字列。固定値 |
| Short | 単位 |
| Control | 1..? |
| Must Support | true |
| Fixed Value | % |
| 110. Coverage.costToBeneficiary.value[x].system | |
| Definition | UCUMを識別するURI。 |
| Short | 単位コード |
| Control | 1..? |
| Must Support | true |
| Fixed Value | http://unitsofmeasure.org |
| 112. Coverage.costToBeneficiary.value[x].code | |
| Definition | 固定値 |
| Short | パーセントを表すUCUMコード |
| Control | 1..? |
| Must Support | true |
| Fixed Value | % |
| 114. Coverage.costToBeneficiary.exception | |
| Control | 0..0 |
| 116. Coverage.subrogation | |
| Control | 0..0 |
| 118. Coverage.contract | |
| Control | 0..0 |
Guidance on how to interpret the contents of this table can be foundhere
| 0. Coverage | |||||
| Definition | Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment. | ||||
| Short | Insurance or medical plan or a payment agreement 保険または医療費支払いプラン、または合意された支払い方法 | ||||
| Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers. | ||||
| Control | 0..* | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Invariants | dom-2: リソースが別のリソースに含まれている場合、ネストされたリソースを含めてはなりません / If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())dom-3: リソースが別のリソースに含まれている場合、それはリソースの他の場所から参照されるか、含有リソースを参照するものとします / If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource ( contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())dom-4: リソースが別のリソースに含まれている場合、meta.versionidもmeta.lastupdatedも持ってはならない。 / If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated ( contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())dom-5: 別のリソースにリソースが含まれている場合、セキュリティラベルはありません / If a resource is contained in another resource, it SHALL NOT have a security label ( contained.meta.security.empty())dom-6: リソースには、堅牢な管理のための叙述(Narative)が存在することが望ましい / A resource should have narrative for robust management ( text.`div`.exists()) | ||||
| 2. Coverage.id | |||||
| Definition | リソースのURLで使用されるリソースの論理ID。割り当てられたら、この値は変更されません。 / The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. | ||||
| Short | このアーティファクトの論理ID / Logical id of this artifact | ||||
| Comments | リソースにIDがないのは、IDが作成操作を使用してサーバーに送信されている場合です。 / The only time that a resource does not have an id is when it is being submitted to the server using a create operation. | ||||
| Control | 0..1 | ||||
| Type | id | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| 4. Coverage.meta | |||||
| Definition | リソースに関するMetadata。これは、インフラストラクチャによって維持されるコンテンツです。コンテンツの変更は、常にリソースのバージョンの変更に関連付けられているとは限りません。 / The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. | ||||
| Short | リソースに関するMetadata / Metadata about the resource | ||||
| Control | 1..1 | ||||
| Type | Meta | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 6. Coverage.meta.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 8. Coverage.meta.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 10. Coverage.meta.versionId | |||||
| Definition | The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted. | ||||
| Short | Version specific identifier | ||||
| Comments | The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes. | ||||
| Control | 0..1 | ||||
| Type | id | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 12. Coverage.meta.lastUpdated | |||||
| Definition | このリソースのデータが最後に作成、更新、複写された日時。最終更新日時。YYYY-MM-DDThh:mm:ss.sss+zz:zz 例:2015-02-07T13:28:17.239+09:00 | ||||
| Short | このリソースのデータが最後に作成、更新、複写された日時。最終更新日時。YYYY-MM-DDThh:mm:ss.sss+zz:zz 例:2015-02-07T13:28:17.239+09:00 | ||||
| Comments | この要素は、このリソースのデータを取り込んで蓄積していたシステムが、このリソースになんらかの変更があった可能性があった日時を取得し、このデータを再取り込みする必要性の判断をするために使われる。本要素に前回取り込んだ時点より後の日時が設定されている場合には、なんらかの変更があった可能性がある(変更がない場合もある)ものとして判断される。したがって、内容になんらかの変更があった場合、またはこのリソースのデータが初めて作成された場合には、その時点以降の日時(たとえば、このリソースのデータを作成した日時)を設定しなければならない。内容の変更がない場合でも、このリソースのデータが作り直された場合や単に複写された場合にその日時を設定しなおしてもよい。ただし、内容に変更がないのであれば、日時を変更しなくてもよい。また、この要素の変更とmeta.versionIdの変更とは、必ずしも連動しないことがある。 | ||||
| Control | 1..1 | ||||
| Type | instant | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 14. Coverage.meta.source | |||||
| Definition | A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc. | ||||
| Short | Identifies where the resource comes from | ||||
| Comments | In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used. This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL. | ||||
| Control | 0..1 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 16. Coverage.meta.profile | |||||
| Definition | 本プロファイルを識別するURLとバージョンを指定する。バージョン指定を省略した場合には、データ受信時点の最新バージョンとみなされる。 | ||||
| Short | 本プロファイルを識別するURLとバージョンを指定する。バージョン指定を省略した場合には、データ受信時点の最新バージョンとみなされる。 | ||||
| Comments | It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set. | ||||
| Control | 1..* | ||||
| Type | canonical(StructureDefinition) | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 18. Coverage.meta.security | |||||
| Definition | Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure. | ||||
| Short | Security Labels applied to this resource | ||||
| Comments | The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored. | ||||
| Control | 0..* | ||||
| Binding | Unless not suitable, these codes SHALL be taken from All Security Labels (extensible to http://hl7.org/fhir/ValueSet/security-labels|4.0.1)Security Labels from the Healthcare Privacy and Security Classification System. | ||||
| Type | Coding | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 20. Coverage.meta.tag | |||||
| Definition | Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource. | ||||
| Short | Tags applied to this resource | ||||
| Comments | The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored. | ||||
| Control | 0..* | ||||
| Binding | For example codes, see CommonTags (example to http://hl7.org/fhir/ValueSet/common-tags|4.0.1)Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | ||||
| Type | Coding | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 22. Coverage.implicitRules | |||||
| Definition | リソースが構築されたときに従った一連のルールへの参照。コンテンツの処理時に理解する必要があります。多くの場合、これは他のプロファイルなどとともに特別なルールを定義する実装ガイドへの参照です。 / A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. | ||||
| Short | このコンテンツが作成されたルールのセット / A set of rules under which this content was created | ||||
| Comments | このルールセットを主張することは、コンテンツが限られた取引パートナーのセットによってのみ理解されることを制限します。これにより、本質的に長期的にデータの有用性が制限されます。ただし、既存の健康エコシステムは非常に破壊されており、一般的に計算可能な意味でデータを定義、収集、交換する準備ができていません。可能な限り、実装者や仕様ライターはこの要素の使用を避ける必要があります。多くの場合、使用する場合、URLは、これらの特別なルールを他のプロファイル、バリューセットなどとともに叙述(Narative)の一部として定義する実装ガイドへの参照です。 / Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. | ||||
| Control | 0..1 | ||||
| Type | uri | ||||
| Is Modifier | true because 暗黙のルールは、意味または解釈を変更するリソースに関する追加の知識を提供する可能性があるため、この要素は修飾子としてラベル付けされています。 / This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 24. Coverage.language | |||||
| Definition | リソースが書かれている基本言語。 / The base language in which the resource is written. | ||||
| Short | リソースコンテンツの言語 / Language of the resource content | ||||
| Comments | 言語は、インデックス作成とアクセシビリティをサポートするために提供されます(通常、テキストから音声までのサービスなどのサービスが言語タグを使用します)。叙述(Narative)のHTML言語タグは、叙述(Narative)に適用されます。リソース上の言語タグを使用して、リソース内のデータから生成された他のプレゼンテーションの言語を指定できます。すべてのコンテンツが基本言語である必要はありません。リソース。言語は、叙述(Narative)に自動的に適用されると想定されるべきではありません。言語が指定されている場合、HTMLのDIV要素にも指定されている場合(XML:LangとHTML Lang属性の関係については、HTML5のルールを参照してください)。 / Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). | ||||
| Control | 0..1 | ||||
| Binding | The codes SHOULD be taken from CommonLanguages (preferred to http://hl7.org/fhir/ValueSet/languages|4.0.1)人間の言語。 / A human language.
| ||||
| Type | code | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | false | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 26. Coverage.text | |||||
| Definition | リソースの概要を含み、人間へのリソースの内容を表すために使用できる人間の読み取り可能な叙述(Narative)。叙述(Narative)はすべての構造化されたデータをエンコードする必要はありませんが、人間が叙述(Narative)を読むだけで「臨床的に安全」にするために十分な詳細を含める必要があります。リソースの定義は、臨床的安全を確保するために、叙述(Narative)で表現するコンテンツを定義する場合があります。 / A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. | ||||
| Short | 人間の解釈のためのリソースのテキスト概要 / Text summary of the resource, for human interpretation | ||||
| Comments | 含まれるリソースには叙述(Narative)がありません。含まれていないリソースには叙述(Narative)が必要です。場合によっては、リソースには、追加の個別のデータがほとんどまたはまったくないテキストのみがあります(すべてのMinoccur = 1要素が満たされている限り)。これは、情報がtext blob (バイナリー ラージ オブジェクト)としてキャプチャされるレガシーシステムからのデータ、またはテキストが生またはナレーションされ、エンコードされた情報が後で追加される場合に必要になる場合があります。 / Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. | ||||
| Control | 0..1 | ||||
| Type | Narrative | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | narrative, html, xhtml, display | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 28. Coverage.contained | |||||
| Definition | これらのリソースには、それらを含むリソースを除いて独立した存在はありません - 独立して特定することはできず、独自の独立したトランザクションスコープを持つこともできません。 / These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. | ||||
| Short | インラインリソースが含まれています / Contained, inline Resources | ||||
| Comments | 識別が失われると、コンテンツを適切に識別できる場合は、これを行うべきではありません。含まれるリソースには、メタ要素にプロファイルとタグがある場合がありますが、セキュリティラベルはありません。 / This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. | ||||
| Control | 0..0 | ||||
| Type | Resource | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | inline resources, anonymous resources, contained resources | ||||
| 30. Coverage.extension | |||||
| Definition | リソースの基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / May be used to represent additional information that is not part of the basic definition of the resource. 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. | ||||
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementations | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 32. Coverage.extension:insuredPersonSymbol | |||||
| Slice Name | insuredPersonSymbol | ||||
| Definition | 健康保険における被保険者証記号を示す拡張 | ||||
| Short | 被保険者証記号情報 | ||||
| Comments | 健康保険における被保険者証記号を示す拡張。被保険者記号の全角文字列。 | ||||
| Control | 0..1 | ||||
| Type | Extension(JP Core Coverage InsuredPersonSymbol Extension) (Extension Type: string) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 34. Coverage.extension:insuredPersonSymbol.id | |||||
| Definition | リソース内の要素の一意のID(内部参照用)。これは、スペースを含まない文字列値である場合があります。 / Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | 要素間参照のための一意のID / Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 36. Coverage.extension:insuredPersonSymbol.extension | |||||
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. | ||||
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementations | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 38. Coverage.extension:insuredPersonSymbol.url | |||||
| Definition | 拡張コードの定義のソース - 論理名またはURL。 / Source of the definition for the extension code - a logical name or a URL. | ||||
| Short | 拡張機能の意味を識別します / identifies the meaning of the extension | ||||
| Comments | 定義は、拡張性コードの計算可能または人間が読み取る可能性のある定義を直接指している場合があります。または、他の仕様で宣言されているように、論理的なURIである場合があります。定義は、拡張機能を定義する構造定義のURIでなければなりません。 / The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| Fixed Value | http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSymbol | ||||
| 40. Coverage.extension:insuredPersonSymbol.value[x] | |||||
| Definition | 被保険者証記号。記録形式は「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従う。 被保険者証(手帳)等の記号。英数又は漢字、最大38 バイト。1 健康保険被保険者証、船員保険被保険者証、受給資格者票及び国民健康保険被保険者証等の「記号及び番号」欄の記号を記録する。英数モードと漢字モードの文字を混在して記録しない。番号のみ設定されている場合は、記録を省略する。記号と番号を合せた文字数の上限は、モードごとに次のとおりとする。英数19バイト、漢字19バイト。 | ||||
| Short | 被保険者証記号 | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 42. Coverage.extension:insuredPersonNumber | |||||
| Slice Name | insuredPersonNumber | ||||
| Definition | 被保険者証番号を表す拡張「insuredPersonNumber」。 保険種別が「1:医保」、「2:国保」、「7:後期高齢者」の場合に記録する。 それ以外の場合は、本拡張要素自体出現しない。 | ||||
| Short | 被保険者証番号情報 | ||||
| Comments | 健康保険における被保険者証番号を示す拡張。被保険者記号の全角文字列。 | ||||
| Control | 0..1 | ||||
| Type | Extension(JP Core Coverage InsuredPersonNumber Extension) (Extension Type: string) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 44. Coverage.extension:insuredPersonNumber.id | |||||
| Definition | リソース内の要素の一意のID(内部参照用)。これは、スペースを含まない文字列値である場合があります。 / Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | 要素間参照のための一意のID / Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 46. Coverage.extension:insuredPersonNumber.extension | |||||
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. | ||||
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementations | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 48. Coverage.extension:insuredPersonNumber.url | |||||
| Definition | 拡張コードの定義のソース - 論理名またはURL。 / Source of the definition for the extension code - a logical name or a URL. | ||||
| Short | 拡張機能の意味を識別します / identifies the meaning of the extension | ||||
| Comments | 定義は、拡張性コードの計算可能または人間が読み取る可能性のある定義を直接指している場合があります。または、他の仕様で宣言されているように、論理的なURIである場合があります。定義は、拡張機能を定義する構造定義のURIでなければなりません。 / The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| Fixed Value | http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonNumber | ||||
| 50. Coverage.extension:insuredPersonNumber.value[x] | |||||
| Definition | 被保険者証番号。記録形式は「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従う。 被保険者証(手帳)等の番号。最大バイト数38,英数モードまたは漢字モード。1 健康保険被保険者証、船員保険被保険者証、受給資格者票及び国民健康保険被保険者証等の「記号及び番号」欄の番号を記録する。後期高齢者被保険者証の被保険者番号を記録する。英数モードと漢字モードの文字を混在して記 録しない。バイト数の上限については被保険者記号の説明を参照のこと。 | ||||
| Short | 被保険者証番号 | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 52. Coverage.extension:insuredPersonSubNumber | |||||
| Slice Name | insuredPersonSubNumber | ||||
| Definition | 被保険者証等に「枝番」が記載されていない場合は、記録を省略しても差し支えない。保険者が後期高齢者医療である場合又は負担者種別が公費負担医療であ場合は、記録を省略する。 | ||||
| Short | 被保険者証等「枝番」情報 | ||||
| Comments | 健康保険における被保険者証番号を示す拡張。2桁の全角数字文字列。一桁の場合には先頭に0をつけて2桁にする。 | ||||
| Control | 0..1 | ||||
| Type | Extension(JP Core Coverage InsuredPersonSubNumber Extension) (Extension Type: string) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 54. Coverage.extension:insuredPersonSubNumber.id | |||||
| Definition | リソース内の要素の一意のID(内部参照用)。これは、スペースを含まない文字列値である場合があります。 / Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | 要素間参照のための一意のID / Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 56. Coverage.extension:insuredPersonSubNumber.extension | |||||
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. | ||||
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementations | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..0 | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.extension.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 58. Coverage.extension:insuredPersonSubNumber.url | |||||
| Definition | 拡張コードの定義のソース - 論理名またはURL。 / Source of the definition for the extension code - a logical name or a URL. | ||||
| Short | 拡張機能の意味を識別します / identifies the meaning of the extension | ||||
| Comments | 定義は、拡張性コードの計算可能または人間が読み取る可能性のある定義を直接指している場合があります。または、他の仕様で宣言されているように、論理的なURIである場合があります。定義は、拡張機能を定義する構造定義のURIでなければなりません。 / The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| Fixed Value | http://jpfhir.jp/fhir/core/Extension/StructureDefinition/JP_Coverage_InsuredPersonSubNumber | ||||
| 60. Coverage.extension:insuredPersonSubNumber.value[x] | |||||
| Definition | 被保険者証記号・番号に対する個人単位被保険者番号(枝番)。「オンライン又は光ディスク等による請求に係る記録条件仕様(医科用)」に従い、桁数が2桁に満たない場合は、先頭に"0"を記録し2桁で記録する。 最大2バイトで数字半角文字。 電子資格確認を行った場合は、資格確認時にオンライン資格確認等システムから通知した枝番を記録する。健康保険被保険者証、受給資格者票及び国民健康保険被保険者証等による資格確認を行った場合は、当該証の「枝番」欄の番号を記録する。 「枝番」が2桁に満たない場合は、先頭に“0”を記録し、2桁で記録する。 被保険者証等に「枝番」が記載されていない場合は、記録を省略しても差し支えない。保険者が後期高齢者医療である場合又は負担者種別が公費負担医療であ場合は、記録を省略する。 | ||||
| Short | 個人単位被保険者番号(枝番) | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 62. Coverage.modifierExtension | |||||
| Definition | リソースの基本的な定義の一部ではなく、それを含む要素の理解および/または含有要素の子孫の理解を変更するために使用される場合があります。通常、修飾子要素は否定または資格を提供します。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義することが許可されていますが、拡張機能の定義の一部として満たされる一連の要件があります。アプリケーションの処理リソースは、修飾子拡張機能をチェックする必要があります。 モディファイア拡張は、リソースまたはdomainResource上の要素の意味を変更してはなりません(修飾軸自体の意味を変更することはできません)。 / May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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). | ||||
| Short | 無視できない拡張機能 / Extensions that cannot be ignored | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because モディファイア拡張は、それらを含むリソースの意味または解釈を変更することが期待されています / Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them | ||||
| Summary | false | ||||
| Requirements | 修飾子拡張機能により、安全に無視できる大部分の拡張機能と明確に区別できるように、安全に無視できない拡張機能が可能になります。これにより、実装者が拡張の存在を禁止する必要性を排除することにより、相互運用性が促進されます。詳細については、[修飾子拡張の定義](拡張性.html#modifierextension)を参照してください。 / 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 Names | extensions, user content | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 64. Coverage.identifier | |||||
| Definition | A unique identifier assigned to this coverage. | ||||
| Short | Business Identifier for the coverage このカバレッジに割り当てられた一意の識別子【詳細参照】 | ||||
| Comments | The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependent. | ||||
| Note | This is a business identifier, not a resource identifier (see discussion) | ||||
| Control | 0..* | ||||
| Type | Identifier | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | Allows coverages to be distinguished and referenced. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 66. Coverage.status | |||||
| Definition | リソースインスタンスのステータス。固定値active。真に有効な保険かどうかは意味しない。 | ||||
| Short | リソースインスタンスのステータス | ||||
| Comments | This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid. | ||||
| Control | 1..1 | ||||
| Binding | The codes SHALL be taken from FinancialResourceStatusCodes (required to http://hl7.org/fhir/ValueSet/fm-status|4.0.1)リソースインスタンスの状態を指定するコード。 / A code specifying the state of the resource instance. | ||||
| Type | code | ||||
| Is Modifier | true because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid / この要素は、エラーで入力されたステータスを含むステータス要素であるため、修飾子としてラベル付けされている。これは、リソースが有効として扱われるべきではないことを意味する。 | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'. | ||||
| Fixed Value | active | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 68. Coverage.type | |||||
| Definition | The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. | ||||
| Short | 保険種別コード | ||||
| Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. | ||||
| Control | 1..1 | ||||
| Binding | The codes SHALL be taken from MHLW_valueSet_ePreCDA_insuranceCategory_tbl11 (1.0.0) (required to http://jpfhir.jp/fhir/Common/ValueSet/mhlw-ePreCDA-insuranceCategory|1.0.0) | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | The order of application of coverages is dependent on the types of coverage. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 70. Coverage.type.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 72. Coverage.type.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 74. Coverage.type.coding | |||||
| Definition | A reference to a code defined by a terminology system. | ||||
| Short | Code defined by a terminology system | ||||
| Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
| Control | 1..1 | ||||
| Type | Coding | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 76. Coverage.type.coding.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 78. Coverage.type.coding.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 80. Coverage.type.coding.system | |||||
| Definition | 保険種別コード 厚生労働省電子処方箋等の CDA 記述仕様第1版 別表11のOID | ||||
| Short | 保険種別コード体系を識別するURI | ||||
| Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
| Fixed Value | http://jpfhir.jp/fhir/core/mhlw/CodeSystem/InsuranceMajorCategory | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 82. Coverage.type.coding.version | |||||
| Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
| Short | Version of the system - if relevant | ||||
| Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
| Note | This is a business version Id, not a resource version Id (see discussion) | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 84. Coverage.type.coding.code | |||||
| Definition | 保険種別コード 厚生労働省電子処方箋等の医療 CDA 記述仕様第1版 別表11のコード表に従う。8以外を使用する。 1 医保 2 国保 3 労災 4 自賠責 5 公害 6 自費 7 後期高齢者 8 公費 | ||||
| Short | 保険種別コード | ||||
| Control | 1..1 | ||||
| Type | code | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need to refer to a particular code in the system. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 86. Coverage.type.coding.display | |||||
| Definition | A representation of the meaning of the code in the system, following the rules of the system. | ||||
| Short | Representation defined by the system | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 88. Coverage.type.coding.userSelected | |||||
| Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
| Short | If this coding was chosen directly by the user | ||||
| Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
| Control | 0..0 | ||||
| Type | boolean | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 90. Coverage.type.text | |||||
| Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
| Short | Plain text representation of the concept | ||||
| Comments | Very often the text is the same as a displayName of one of the codings. | ||||
| Control | 0..0 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 92. Coverage.policyHolder | |||||
| Definition | The party who 'owns' the insurance policy. | ||||
| Short | Owner of the policy ポリシの所有者 | ||||
| Comments | For example: may be an individual, corporation or the subscriber's employer. | ||||
| Control | 0..0 | ||||
| Type | Reference(JP Core Patient Profile, RelatedPerson, JP Core Organization Profile) | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | This provides employer information in the case of Worker's Compensation and other policies. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 94. Coverage.subscriber | |||||
| Definition | 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. | ||||
| Short | Subscriber to the policy 被保険者 | ||||
| Comments | May be self or a parent in the case of dependents. | ||||
| Control | 0..0 | ||||
| Type | Reference(JP Core Patient Profile, RelatedPerson) | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Requirements | This is the party who is entitled to the benefits under the policy. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 96. Coverage.subscriberId | |||||
| Definition | The insurer assigned ID for the Subscriber. | ||||
| Short | ID assigned to the subscriber 被保険者に割り当てられたID | ||||
| Control | 0..0 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | The insurer requires this identifier on correspondence and claims (digital and otherwise). | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 98. Coverage.beneficiary | |||||
| Definition | この保険で給付される患者情報(Patientリソース)へのリテラル参照 | ||||
| Short | 被給付者情報 | ||||
| Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||
| Control | 1..1 | ||||
| Type | Reference(JP Core Patient Profile) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | This is the party who receives treatment for which the costs are reimbursed under the coverage. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 100. Coverage.beneficiary.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 102. Coverage.beneficiary.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.beneficiary.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 104. Coverage.beneficiary.reference | |||||
| Definition | Budleリソースに記述されるPatientリソースのfullUrl要素に指定されるUUIDを指定 | ||||
| Short | PatientリソースのfullUrl要素に指定されるUUIDを指定 | ||||
| Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. | ||||
| Control | 0..1 This element is affected by the following invariants: ref-1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 106. Coverage.beneficiary.type | |||||
| Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). | ||||
| Short | Type the reference refers to (e.g. "Patient") | ||||
| Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. | ||||
| Control | 0..1 | ||||
| Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)Aa resource (or, for logical models, the URI of the logical model). | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 108. Coverage.beneficiary.identifier | |||||
| Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. | ||||
| Short | Logical reference, when literal reference is not known | ||||
| Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||
| Note | This is a business identifier, not a resource identifier (see discussion) | ||||
| Control | 0..1 | ||||
| Type | Identifier | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 110. Coverage.beneficiary.display | |||||
| Definition | Plain text narrative that identifies the resource in addition to the resource reference. | ||||
| Short | Text alternative for the resource | ||||
| Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 112. Coverage.dependent | |||||
| Definition | 被保険者証記号・番号に対する個人単位被保険者番号(枝番)。 被保険者番号の枝番を記述する拡張要素と同一の値を記述すること。 | ||||
| Short | 被保険者番号(枝番) | ||||
| Comments | Periodically the member number is constructed from the subscriberId and the dependent number. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 114. Coverage.relationship | |||||
| Definition | The relationship of beneficiary (patient) to the subscriber. | ||||
| Short | Beneficiary relationship to the subscriber 加入者との受益者関係 | ||||
| Comments | Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others. | ||||
| Control | 1..1 | ||||
| Binding | Unless not suitable, these codes SHALL be taken from SubscriberRelationshipCodes (extensible to http://hl7.org/fhir/ValueSet/subscriber-relationship|4.0.1)加入者と受益者(被保険者/対象当事者/患者)の関係。 / The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Requirements | To determine relationship between the patient and the subscriber to determine coordination of benefits. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 116. Coverage.relationship.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 118. Coverage.relationship.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.relationship.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 120. Coverage.relationship.coding | |||||
| Definition | A reference to a code defined by a terminology system. | ||||
| Short | Code defined by a terminology system | ||||
| Comments | Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
| Control | 1..1 | ||||
| Type | Coding | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Allows for alternative encodings within a code system, and translations to other code systems. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 122. Coverage.relationship.coding.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 124. Coverage.relationship.coding.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.relationship.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 126. Coverage.relationship.coding.system | |||||
| Definition | 被保険者区分コードのコード体系を識別するURI。厚生労働省電子処方箋等の医療文書 CDA 記述仕様第1版 別表12のOID | ||||
| Short | コード体系を識別するURI | ||||
| Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
| Control | 0..1 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need to be unambiguous about the source of the definition of the symbol. | ||||
| Fixed Value | http://jpfhir.jp/fhir/core/mhlw/CodeSystem/InsuredPersonCategory | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 128. Coverage.relationship.coding.version | |||||
| Definition | The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
| Short | Version of the system - if relevant | ||||
| Comments | Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
| Note | This is a business version Id, not a resource version Id (see discussion) | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 130. Coverage.relationship.coding.code | |||||
| Definition | 被保険者区分コード。厚生労働省電子処方箋 CDA 記述仕様第1版 別表12に従う。 1 被保険者 2 被扶養者 | ||||
| Short | 被保険者区分コード | ||||
| Control | 0..1 | ||||
| Type | code | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need to refer to a particular code in the system. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 132. Coverage.relationship.coding.display | |||||
| Definition | 以下の文字列のいずれかを設定するが、省略可能。 コード1 文字列: "被保険者" コード2 文字列:"被扶養者" | ||||
| Short | コードに対応する表示文字列 | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 134. Coverage.relationship.coding.userSelected | |||||
| Definition | Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
| Short | If this coding was chosen directly by the user | ||||
| Comments | Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
| Control | 0..0 | ||||
| Type | boolean | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 136. Coverage.relationship.text | |||||
| Definition | A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
| Short | Plain text representation of the concept | ||||
| Comments | Very often the text is the same as a displayName of one of the codings. | ||||
| Control | 0..0 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 138. Coverage.period | |||||
| Definition | 保険証の有効期間。保険証に明示的に記載がある場合、かつ、医療機関がその情報を把握している場合のみ記録する。 | ||||
| Short | 保険証の有効期間 | ||||
| Comments | A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times").
Period is not used for a duration (a measure of elapsed time). See Duration. | ||||
| Control | 0..1 | ||||
| Type | Period | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Some insurers require the submission of the coverage term. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 140. Coverage.period.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 142. Coverage.period.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.period.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 144. Coverage.period.start | |||||
| Definition | 保険証の有効期間の開始日。資格取得日。ISO8601に準拠してyyyy_mm_dd形式で指定する。 | ||||
| Short | 保険証の有効期間の開始日 | ||||
| Comments | If the low element is missing, the meaning is that the low boundary is not known. | ||||
| Control | 0..1 This element is affected by the following invariants: per-1 | ||||
| Type | dateTime | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 146. Coverage.period.end | |||||
| Definition | 保険証の有効期間の終了日。資格喪失日。ISO8601に準拠してyyyy_mm_dd形式で指定する。 | ||||
| Short | 保険証の有効期間の終了日 | ||||
| Comments | The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03. | ||||
| Control | 0..1 This element is affected by the following invariants: per-1 | ||||
| Type | dateTime | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Meaning if Missing | If the end of the period is missing, it means that the period is ongoing | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 148. Coverage.payor | |||||
| Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. | ||||
| Short | ポリシーの発行者 / Issuer of the policy | ||||
| Comments | May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
For selfpay it may provide multiple paying persons and/or organizations. | ||||
| Control | 1..1 | ||||
| Type | Reference(JP Core Organization Profile, JP Core Patient Profile, RelatedPerson) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Must Support Types | No must-support rules about the choice of types/profiles | ||||
| Summary | true | ||||
| Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| Slicing | This element introduces a set of slices on Coverage.payor. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 150. Coverage.payor:insurer | |||||
| Slice Name | insurer | ||||
| Definition | 保険者を表すOrganizationリソースへの参照 | ||||
| Short | 保険者情報 | ||||
| Comments | May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
For selfpay it may provide multiple paying persons and/or organizations. | ||||
| Control | 0..1 | ||||
| Type | Reference(JP_Organization_eCS_coveragePayer) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 152. Coverage.payor:insurer.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 154. Coverage.payor:insurer.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.payor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 156. Coverage.payor:insurer.reference | |||||
| Definition | Bundleリソースに記述される保険者を表すOrganizationリソースのfullUrl要素に指定されるUUIDを指定。 自費以外の場合に使用する。 | ||||
| Short | OrganizationリソースのfullUrl要素に指定されるUUIDを指定 | ||||
| Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. | ||||
| Control | 0..1 This element is affected by the following invariants: ref-1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 158. Coverage.payor:insurer.type | |||||
| Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). | ||||
| Short | Type the reference refers to (e.g. "Patient") | ||||
| Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. | ||||
| Control | 0..1 | ||||
| Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)Aa resource (or, for logical models, the URI of the logical model). | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 160. Coverage.payor:insurer.identifier | |||||
| Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. | ||||
| Short | Logical reference, when literal reference is not known | ||||
| Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||
| Note | This is a business identifier, not a resource identifier (see discussion) | ||||
| Control | 0..1 | ||||
| Type | Identifier | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 162. Coverage.payor:insurer.display | |||||
| Definition | Plain text narrative that identifies the resource in addition to the resource reference. | ||||
| Short | Text alternative for the resource | ||||
| Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 164. Coverage.payor:selfPayment | |||||
| Slice Name | selfPayment | ||||
| Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. | ||||
| Short | ポリシーの発行者 / Issuer of the policy | ||||
| Comments | May provide multiple identifiers such as insurance company identifier or business identifier (BIN number).
For selfpay it may provide multiple paying persons and/or organizations. | ||||
| Control | 0..1 | ||||
| Type | Reference(JP_Patient_eCS) | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 166. Coverage.payor:selfPayment.id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 168. Coverage.payor:selfPayment.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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.payor.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 170. Coverage.payor:selfPayment.reference | |||||
| Definition | Bundleリソースに記述される受給者本人(患者)を表すPatientリソースのfullUrl要素に指定されるUUIDを指定。 自費の場合に使用する。 | ||||
| Short | PatientリソースのfullUrl要素に指定されるUUIDを指定 | ||||
| Comments | Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server. | ||||
| Control | 0..1 This element is affected by the following invariants: ref-1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 172. Coverage.payor:selfPayment.type | |||||
| Definition | The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources). | ||||
| Short | Type the reference refers to (e.g. "Patient") | ||||
| Comments | This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified. | ||||
| Control | 0..1 | ||||
| Binding | Unless not suitable, these codes SHALL be taken from ResourceType (extensible to http://hl7.org/fhir/ValueSet/resource-types|4.0.1)Aa resource (or, for logical models, the URI of the logical model). | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 174. Coverage.payor:selfPayment.identifier | |||||
| Definition | An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. | ||||
| Short | Logical reference, when literal reference is not known | ||||
| Comments | When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any). | ||||
| Note | This is a business identifier, not a resource identifier (see discussion) | ||||
| Control | 0..1 | ||||
| Type | Identifier | ||||
| Is Modifier | false | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 176. Coverage.payor:selfPayment.display | |||||
| Definition | Plain text narrative that identifies the resource in addition to the resource reference. | ||||
| Short | Text alternative for the resource | ||||
| Comments | This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it. | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 178. Coverage.class | |||||
| Definition | A suite of underwriter specific classifiers. | ||||
| Short | 追加のカバレッジ分類 / Additional coverage classifications | ||||
| Comments | For example may be used to identify a class of coverage or employer group, Policy, Plan. | ||||
| Control | 0..0 | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Requirements | The codes provided on the health card which identify or confirm the specific policy for the insurer. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 186. Coverage.order | |||||
| Definition | The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care. | ||||
| Short | カバレッジの相対順序 / Relative order of the coverage | ||||
| Comments | 32 bit number; for values larger than this, use decimal | ||||
| Control | 0..0 | ||||
| Type | positiveInt | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | Used in managing the coordination of benefits. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 188. Coverage.network | |||||
| Definition | 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. | ||||
| Short | 保険会社ネットワーク / Insurer network | ||||
| Control | 0..0 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | Used in referral for treatment and in claims processing. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 190. Coverage.costToBeneficiary | |||||
| Definition | 自己負担率。記録が可能な場合にのみ記録する。 | ||||
| Short | 自己負担率 | ||||
| Comments | For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment. | ||||
| Control | 0..* | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | false | ||||
| Requirements | Required by providers to manage financial transaction with the patient. | ||||
| Alternate Names | CoPay, Deductible, Exceptions | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 192. Coverage.costToBeneficiary.id | |||||
| Definition | リソース内の要素の一意のID(内部参照用)。これは、スペースを含まない文字列値である場合があります。 / Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | 要素間参照のための一意のID / Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 194. Coverage.costToBeneficiary.extension | |||||
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. | ||||
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementations | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 196. Coverage.costToBeneficiary.modifierExtension | |||||
| Definition | 要素の基本的な定義の一部ではなく、それが含まれている要素の理解、および/または含まれる要素の子孫の理解を変更するために使用される場合があります。通常、修飾子要素は否定または資格を提供します。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。アプリケーションの処理リソースは、修飾子拡張機能をチェックする必要があります。 モディファイア拡張は、リソースまたはdomainResource上の要素の意味を変更してはなりません(修飾軸自体の意味を変更することはできません)。 / 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). | ||||
| Short | 認識されていなくても無視できない拡張機能 / Extensions that cannot be ignored even if unrecognized | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | true because 修飾子拡張は、それらを含む要素の意味または解釈を変更することが期待されています / Modifier extensions are expected to modify the meaning or interpretation of the element that contains them | ||||
| Summary | true | ||||
| Requirements | 修飾子拡張機能により、安全に無視できる大部分の拡張機能と明確に区別できるように、安全に無視できない拡張機能が可能になります。これにより、実装者が拡張の存在を禁止する必要性を排除することにより、相互運用性が促進されます。詳細については、[修飾子拡張の定義](拡張性.html#modifierextension)を参照してください。 / 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 Names | extensions, user content, modifiers | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| 198. Coverage.costToBeneficiary.type | |||||
| Definition | The category of patient centric costs associated with treatment. | ||||
| Short | コストカテゴリ / Cost category | ||||
| Comments | For example visit, specialist visits, emergency, inpatient care, etc. | ||||
| Control | 1..1 | ||||
| Binding | Unless not suitable, these codes SHALL be taken from CoverageCopayTypeCodes (extensible to http://hl7.org/fhir/ValueSet/coverage-copay-type|4.0.1)患者の自己負担が指定されているサービスの種類。 / The types of services to which patient copayments are specified. | ||||
| Type | CodeableConcept | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Needed to identify the category associated with the amount for the patient. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 200. Coverage.costToBeneficiary.type.id | |||||
| Definition | リソース内の要素の一意のID(内部参照用)。これは、スペースを含まない文字列値である場合があります。 / Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | 要素間参照のための一意のID / Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 202. Coverage.costToBeneficiary.type.extension | |||||
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. | ||||
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementations | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.costToBeneficiary.type.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 204. Coverage.costToBeneficiary.type.coding | |||||
| Definition | 用語システムによって定義されたコードへの参照。 / A reference to a code defined by a terminology system. | ||||
| Short | 用語システムによって定義されたコード / Code defined by a terminology system | ||||
| Comments | コードは、列挙されたCTなどの非常に正式な定義まで、列挙またはコードリストで非常にさりげなく定義される場合があります。詳細については、HL7 V3コアプリンシップを参照してください。コーディングの順序付けは未定義であり、意味を推測するために使用されません。一般に、せいぜい、コーディング値の1つのみがuserselected = trueとしてラベル付けされます。 / Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. | ||||
| Control | 1..1 | ||||
| Type | Coding | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | コードシステム内の代替エンコーディング、および他のコードシステムへの翻訳が可能になります。 / Allows for alternative encodings within a code system, and translations to other code systems. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 206. Coverage.costToBeneficiary.type.coding.id | |||||
| Definition | リソース内の要素の一意のID(内部参照用)。これは、スペースを含まない文字列値である場合があります。 / Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | 要素間参照のための一意のID / Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 208. Coverage.costToBeneficiary.type.coding.extension | |||||
| Definition | 要素の基本的な定義の一部ではない追加情報を表すために使用できます。拡張機能を安全で管理しやすくするために、拡張機能の定義と使用に適用される厳格なガバナンスセットがあります。実装者は拡張機能を定義できますが、拡張機能の定義の一部として満たされる一連の要件があります。 / 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. | ||||
| Short | 実装で定義された追加のコンテンツ / Additional content defined by implementations | ||||
| Comments | 拡張機能を使用または定義する機関や管轄権に関係なく、アプリケーション、プロジェクト、または標準による拡張機能の使用に関連するスティグマはありません。拡張機能の使用は、FHIR仕様がすべての人にコアレベルのシンプルさを保持できるようにするものです。 / 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: 両方ではなく、拡張または値[x]が必要です / Must have either extensions or value[x], not both ( extension.exists() != value.exists()) | ||||
| Slicing | This element introduces a set of slices on Coverage.costToBeneficiary.type.coding.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 210. Coverage.costToBeneficiary.type.coding.system | |||||
| Definition | 自己負担の種別を識別するコードのコード体系を識別するURI。固定値。 | ||||
| Short | 自己負担の種別を識別するコードのコード体系を識別するURI | ||||
| Comments | The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. | ||||
| Control | 1..1 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | シンボルの定義のソースについて明確である必要があります。 / Need to be unambiguous about the source of the definition of the symbol. | ||||
| Fixed Value | http://terminology.hl7.org/CodeSystem/coverage-copay-type | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 212. Coverage.costToBeneficiary.type.coding.version | |||||
| Definition | このコードを選択するときに使用されたコードシステムのバージョン。コードの意味がバージョン全体で一貫しているため、適切にメンテナンスしたコードシステムでは報告されたバージョンを必要としないことに注意してください。ただし、これは一貫して保証することはできず、意味が一貫していることが保証されていない場合、バージョンを交換する必要があります。 / The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. | ||||
| Short | システムのバージョン - 関連する場合 / Version of the system - if relevant | ||||
| Comments | 用語がコードシステムバージョンを識別するために使用する文字列を明確に定義していない場合、推奨は、そのバージョンがバージョンの日付として公式に公開された日付(FHIR日付形式で表現)を使用することです。 / Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date. | ||||
| Note | This is a business version Id, not a resource version Id (see discussion) | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 214. Coverage.costToBeneficiary.type.coding.code | |||||
| Definition | 固定値 copaypct | ||||
| Short | 自己負担率を表すコード | ||||
| Comments | Note that FHIR strings SHALL NOT exceed 1MB in size | ||||
| Control | 1..1 | ||||
| Type | code | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | システム内の特定のコードを参照する必要があります。 / Need to refer to a particular code in the system. | ||||
| Fixed Value | copaypct | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 216. Coverage.costToBeneficiary.type.coding.display | |||||
| Definition | システムのルールに従って、システム内のコードの意味の表現。 / A representation of the meaning of the code in the system, following the rules of the system. | ||||
| Short | コードの表示名 | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | システムを知らない読者のために、コードの人間の読み取り可能な意味を持ち込むことができる必要があります。 / Need to be able to carry a human-readable meaning of the code for readers that do not know the system. | ||||
| Fixed Value | 負担率 | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 218. Coverage.costToBeneficiary.type.coding.userSelected | |||||
| Definition | このコーディングがユーザーによって直接選択されたことを示します。利用可能なアイテムのピックリスト(コードまたはディスプレイ)。 / Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays). | ||||
| Short | このコーディングがユーザーによって直接選択された場合 / If this coding was chosen directly by the user | ||||
| Comments | 一連の代替案の中で、直接選択されたコードが新しい翻訳の最も適切な出発点です。この要素の使用とその結果をより完全に明確にするためには、「直接選択された」ことについては曖昧さがあり、取引パートナー契約が必要になる場合があります。 / Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely. | ||||
| Control | 0..1 | ||||
| Type | boolean | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | これは、臨床安全基準として特定されています - この正確なシステム/コードペアは、いくつかのルールまたは言語処理に基づいてシステムによって推測されるのではなく、明示的に選択されたことです。 / This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 220. Coverage.costToBeneficiary.type.text | |||||
| Definition | データを入力したユーザー、および/またはユーザーの意図された意味を表すユーザーによって見られる/選択/発言された概念の人間の言語表現。 / A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. | ||||
| Short | コンセプトの単純なテキスト表現 / Plain text representation of the concept | ||||
| Comments | 多くの場合、テキストはコーディングの1つの表示名と同じです。 / Very often the text is the same as a displayName of one of the codings. | ||||
| Control | 0..0 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | 用語からのコードは、それらを使用する人間のすべてのニュアンスを使用して、常に正しい意味をキャプチャするとは限りません。または、適切なコードがまったくない場合があります。これらの場合、テキストはソースの完全な意味をキャプチャするために使用されます。 / The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 222. Coverage.costToBeneficiary.value[x] | |||||
| Definition | 自己負担割合 | ||||
| Short | 自己負担割合 | ||||
| Comments | Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency. | ||||
| Control | 1..1 | ||||
| Type | Quantity(SimpleQuantity) | ||||
| [x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
| Is Modifier | false | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Needed to identify the amount for the patient associated with the category. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 224. Coverage.costToBeneficiary.value[x].id | |||||
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. | ||||
| Short | Unique id for inter-element referencing | ||||
| Control | 0..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| XML Format | In the XML format, this property is represented as an attribute. | ||||
| Summary | false | ||||
| 226. Coverage.costToBeneficiary.value[x].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. | ||||
| Short | Additional 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. | ||||
| Control | 0..* | ||||
| Type | Extension | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Alternate Names | extensions, user content | ||||
| Invariants | ele-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()) | ||||
| Slicing | This element introduces a set of slices on Coverage.costToBeneficiary.value[x].extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
| 228. Coverage.costToBeneficiary.value[x].value | |||||
| Definition | 自己負担割合を%で指定する。 例)数値で 10 | ||||
| Short | 自己負担割合 | ||||
| Comments | The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books). | ||||
| Control | 1..1 | ||||
| Type | decimal | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Precision is handled implicitly in almost all cases of measurement. | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 230. Coverage.costToBeneficiary.value[x].comparator | |||||
| Definition | Not allowed to be used in this context | ||||
| Short | < | <= | >= | > - how to understand the value | ||||
| Control | 0..0 | ||||
| Binding | The codes SHALL be taken from QuantityComparator (required to http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1)How the Quantity should be understood and represented. | ||||
| Type | code | ||||
| Is Modifier | true because This is labeled as "Is Modifier" because the comparator modifies the interpretation of the value significantly. If there is no comparator, then there is no modification of the value | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | true | ||||
| Requirements | Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology. | ||||
| Meaning if Missing | If there is no comparator, then there is no modification of the value | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 232. Coverage.costToBeneficiary.value[x].unit | |||||
| Definition | 人が解釈可能な単位文字列。固定値 | ||||
| Short | 単位 | ||||
| Control | 1..1 | ||||
| Type | string | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms. | ||||
| Fixed Value | % | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 234. Coverage.costToBeneficiary.value[x].system | |||||
| Definition | UCUMを識別するURI。 | ||||
| Short | 単位コード | ||||
| Control | 1..1 This element is affected by the following invariants: qty-3 | ||||
| Type | uri | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need to know the system that defines the coded form of the unit. | ||||
| Fixed Value | http://unitsofmeasure.org | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 236. Coverage.costToBeneficiary.value[x].code | |||||
| Definition | 固定値 | ||||
| Short | パーセントを表すUCUMコード | ||||
| Comments | The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system. | ||||
| Control | 1..1 | ||||
| Type | code | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Must Support | true | ||||
| Summary | true | ||||
| Requirements | Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest. | ||||
| Fixed Value | % | ||||
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 238. Coverage.costToBeneficiary.exception | |||||
| Definition | A suite of codes indicating exceptions or reductions to patient costs and their effective periods. | ||||
| Short | 患者の支払いの例外 / Exceptions for patient payments | ||||
| Control | 0..0 | ||||
| Type | BackboneElement | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Requirements | Required by providers to manage financial transaction with the patient. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 245. Coverage.subrogation | |||||
| Definition | When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs. | ||||
| Short | Reimbursement to insurer 保険者への償還 | ||||
| Comments | Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims. | ||||
| Control | 0..0 | ||||
| Type | boolean | ||||
| Is Modifier | false | ||||
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
| Summary | false | ||||
| Requirements | See definition for when to be used. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||
| 247. Coverage.contract | |||||
| Definition | The policy(s) which constitute this insurance coverage. | ||||
| Short | Contract details 契約の詳細 | ||||
| Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolvable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. | ||||
| Control | 0..0 | ||||
| Type | Reference(Contract) | ||||
| Is Modifier | false | ||||
| Summary | false | ||||
| Requirements | To reference the legally binding contract between the policy holder and the insurer. | ||||
| Invariants | ele-1: すべてのFHIR要素には、@valueまたは子要素が必要です / All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) | ||||