HL7 FHIR JP Core ImplementationGuide
1.2.0-dev - ci-build
HL7 FHIR JP Core ImplementationGuide - Local Development build (v1.2.0-dev) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Active as of 2024-11-18 |
Definitions for the jp-coverage resource profile.
Guidance on how to interpret the contents of this table can be found here
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. |
2. Coverage.extension | |
Slicing | This element introduces a set of slices on Coverage.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
4. Coverage.extension:insuredPersonSymbol | |
Slice Name | insuredPersonSymbol |
Control | 0..* |
Type | Extension(JP Core Coverage InsuredPersonSymbol Extension) (Extension Type: string) |
6. Coverage.extension:insuredPersonNumber | |
Slice Name | insuredPersonNumber |
Control | 0..* |
Type | Extension(JP Core Coverage InsuredPersonNumber Extension) (Extension Type: string) |
8. Coverage.extension:insuredPersonSubNumber | |
Slice Name | insuredPersonSubNumber |
Control | 0..* |
Type | Extension(JP Core Coverage InsuredPersonSubNumber Extension) (Extension Type: string) |
10. Coverage.identifier | |
Definition | A unique identifier assigned to this coverage. このカバレッジに割り当てられた一意の識別子。 |
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 | A unique identifier assigned to this coverage. このカバレッジに割り当てられた一意の識別子。 |
Note | This is a business identifier, not a resource identifier (see discussion) |
Requirements | Allows coverages to be distinguished and referenced. |
Slicing | This element introduces a set of slices on Coverage.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
12. Coverage.identifier:insuranceIdentifier | |
Slice Name | insuranceIdentifier |
Definition | 被保険者個人識別子として、保険者情報と被保険者情報を以下の仕様で連結したひとつの文字列を使用する |
Short | 被保険者個人識別子 例)00012345:あいう:187:05 |
Comments | 「被保険者個人識別子」の文字列仕様を参照のこと |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1 |
14. Coverage.identifier:insuranceIdentifier.system | |
Control | 1..? |
Fixed Value | http://jpfhir.jp/fhir/clins/Idsystem/JP_Insurance_memberID |
16. Coverage.identifier:insuranceIdentifier.value | |
Definition | 被保険者個人識別子として、保険者情報と被保険者情報とを以下の仕様で連結したひとつの文字列を使用する。 |
Short | 被保険者個人識別子 例)00012345:あいう:187:05 |
Control | 1..? |
18. Coverage.identifier:insuranceIdentifier.assigner | |
Definition | 保険者情報としてJP_Organizationを設定する。 |
Short | 保険者情報を設定 |
Comments | 保険者情報としてJP_Organizationを設定する。 |
Type | Reference(JP Core Organization Profile) |
20. Coverage.identifier:insuranceCsvIdentifier | |
Slice Name | insuranceCsvIdentifier |
Definition | 被保険者識別子として、保険者情報と被保険者情報を囲み文字をダブルクォーテーション、区切りをカンマにて連結する |
Short | 被保険者識別子(CSV形式) "00012345","12-34","5678","00" |
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..1 |
22. Coverage.identifier:insuranceCsvIdentifier.system | |
Control | 1..? |
Fixed Value | http://jpfhir.jp/fhir/core/IdSystem/JP_Coverage_id |
24. Coverage.identifier:insuranceCsvIdentifier.value | |
Definition | 被保険者識別子として、保険者番号と被保険者記号と番号と枝番を全角にした上でダブルコーテーションで囲い、カンマ区切りで連結する。 |
Short | 被保険者識別子(CSV形式) "00012345","12-34","5678","00" |
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. |
Control | 1..? |
26. Coverage.identifier:insuranceCsvIdentifier.assigner | |
Definition | 健康保険等の保険者情報を設定する。JP_Organizationをリソースにて表現する |
Short | 保険者情報 |
Comments | 健康保険等の保険者情報を設定する。JP_Organizationをリソースにて表現する |
Type | Reference(JP Core Organization Profile) |
28. Coverage.status | |
Definition | The status of the resource instance. |
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. |
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'. |
30. 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 | Coverage category such as medical or accident 医療保険や事故補償のような分類 |
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. |
Requirements | The order of application of coverages is dependent on the types of coverage. |
32. 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. |
Type | Reference(JP Core Patient Profile, RelatedPerson, JP Core Organization Profile) |
Requirements | This provides employer information in the case of Worker's Compensation and other policies. |
34. 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. |
Type | Reference(JP Core Patient Profile, RelatedPerson) |
Requirements | This is the party who is entitled to the benefits under the policy. |
36. 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 |
Requirements | The insurer requires this identifier on correspondence and claims (digital and otherwise). |
38. Coverage.beneficiary | |
Definition | The party who benefits from the insurance coverage; the patient when products and/or services are provided. |
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. |
Type | Reference(JP Core Patient Profile) |
Requirements | This is the party who receives treatment for which the costs are reimbursed under the coverage. |
40. Coverage.dependent | |
Definition | A unique identifier for a dependent under the coverage. |
Short | 被保険者証 枝番 |
Comments | Periodically the member number is constructed from the subscriberId and the dependent number. |
Requirements | For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary. |
42. 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. |
Requirements | To determine relationship between the patient and the subscriber to determine coordination of benefits. |
44. Coverage.period | |
Definition | 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. |
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. |
Requirements | Some insurers require the submission of the coverage term. |
46. Coverage.payor | |
Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. |
Short | 支払者に関する情報 |
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. |
Type | Reference(JP Core Organization Profile, JP Core Patient Profile, RelatedPerson) |
Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. |
48. Coverage.class | |
Definition | A suite of underwriter specific classifiers. |
Comments | For example may be used to identify a class of coverage or employer group, Policy, Plan. |
Requirements | The codes provided on the health card which identify or confirm the specific policy for the insurer. |
50. Coverage.class.type | |
Definition | The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan. |
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. |
Requirements | The insurer issued label for a specific health card value. |
52. Coverage.class.value | |
Definition | The alphanumeric string value associated with the insurer issued label. |
Comments | For example, the Group or Plan number. |
Requirements | The insurer issued label and value are necessary to identify the specific policy. |
54. Coverage.class.name | |
Definition | A short description for the class. |
Requirements | Used to provide a meaningful description in correspondence to the patient. |
56. 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. |
Comments | 32 bit number; for values larger than this, use decimal |
Requirements | Used in managing the coordination of benefits. |
58. 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. |
Requirements | Used in referral for treatment and in claims processing. |
60. Coverage.costToBeneficiary | |
Definition | 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 | Patient payments for services/products サービスやプロダクトに対する患者支払い |
Comments | For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment. |
Requirements | Required by providers to manage financial transaction with the patient. |
62. Coverage.costToBeneficiary.type | |
Definition | The category of patient centric costs associated with treatment. |
Comments | For example visit, specialist visits, emergency, inpatient care, etc. |
Requirements | Needed to identify the category associated with the amount for the patient. |
64. Coverage.costToBeneficiary.type.coding | |
66. Coverage.costToBeneficiary.type.coding.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. |
68. Coverage.costToBeneficiary.type.coding.code | |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
70. Coverage.costToBeneficiary.value[x] | |
Definition | The amount due from the patient for the cost category. |
Comments | Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency. |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Requirements | Needed to identify the amount for the patient associated with the category. |
72. Coverage.costToBeneficiary.exception | |
Definition | A suite of codes indicating exceptions or reductions to patient costs and their effective periods. |
Requirements | Required by providers to manage financial transaction with the patient. |
74. Coverage.costToBeneficiary.exception.type | |
Definition | The code for the specific exception. |
Requirements | Needed to identify the exception associated with the amount for the patient. |
76. Coverage.costToBeneficiary.exception.period | |
Definition | The timeframe during when the exception is in force. |
Requirements | Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. |
78. 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. |
Requirements | See definition for when to be used. |
80. 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. |
Requirements | To reference the legally binding contract between the policy holder and the insurer. |
Guidance on how to interpret the contents of this table can be found here
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. ヘルスケア製品とサービスの払い戻しまたは支払いに使用できる金融商品。保険と自己支払いの両方が含まれています。 / 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保険または医療計画、または支払い契約 / Insurance or medical plan or a payment agreement |
Comments | The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers. 補償リソースには、保険カードレベルの情報が含まれています。これは、プロバイダーと保険会社間の請求やその他の通信を提供するのが慣習です。 / 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)が必要です / A resource should have narrative for robust management (text.`div`.exists()) |
2. 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())) |
4. Coverage.extension | |
Definition | An Extension 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 | Extension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: |
6. 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 | 健康保険における被保険者証記号 |
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..* This element is affected by the following invariants: ele-1 |
Type | Extension(JP Core Coverage InsuredPersonSymbol Extension) (Extension Type: string) |
Is Modifier | 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() )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()) |
8. Coverage.extension:insuredPersonNumber | |
Slice Name | insuredPersonNumber |
Definition | 健康保険における被保険者証番号を示す拡張 |
Short | 健康保険における被保険者証番号 |
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..* This element is affected by the following invariants: ele-1 |
Type | Extension(JP Core Coverage InsuredPersonNumber Extension) (Extension Type: string) |
Is Modifier | 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() )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()) |
10. Coverage.extension:insuredPersonSubNumber | |
Slice Name | insuredPersonSubNumber |
Definition | 健康保険における被保険者証番号の枝番を示す拡張 |
Short | 健康保険における被保険者証番号の枝番 |
Comments | 健康保険における被保険者証番号を示す拡張。2桁の半角数字文字列。一桁の場合には先頭に0をつけて2桁にする。 |
Control | 0..* This element is affected by the following invariants: ele-1 |
Type | Extension(JP Core Coverage InsuredPersonSubNumber Extension) (Extension Type: string) |
Is Modifier | 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() )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()) |
12. 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()) |
14. Coverage.identifier | |
Definition | A unique identifier assigned to this coverage. このカバレッジに割り当てられた一意の識別子。 このカバレッジに割り当てられた一意のidentifier。 / 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】カバレッジのビジネスidentifier / Business Identifier for the coverage |
Comments | A unique identifier assigned to this coverage. このカバレッジに割り当てられた一意の識別子。 カバレッジのメイン(およびおそらくみの)identifier - 多くの場合、メンバーID、証明書番号、個人の健康番号、またはケースIDと呼ばれます。カバレッジの連結として構築される場合があります。 / 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.dependant. |
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. カバレッジを区別し、参照することができます。 / 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())) |
Slicing | This element introduces a set of slices on Coverage.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: |
16. Coverage.identifier:insuranceIdentifier | |
Slice Name | insuranceIdentifier |
Definition | 被保険者個人識別子として、保険者情報と被保険者情報を以下の仕様で連結したひとつの文字列を使用する このカバレッジに割り当てられた一意のidentifier。 / A unique identifier assigned to this coverage. |
Short | 被保険者個人識別子 例)00012345:あいう:187:05カバレッジのビジネスidentifier / Business Identifier for the coverage |
Comments | 「被保険者個人識別子」の文字列仕様を参照のこと カバレッジのメイン(およびおそらくみの)identifier - 多くの場合、メンバーID、証明書番号、個人の健康番号、またはケースIDと呼ばれます。カバレッジの連結として構築される場合があります。 / 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.dependant. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1* |
Type | Identifier |
Is Modifier | false |
Summary | true |
Requirements | カバレッジを区別し、参照することができます。 / 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())) |
18. Coverage.identifier:insuranceIdentifier.use | |
Definition | このidentifierの目的。 / The purpose of this identifier. |
Short | 通常|公式|一時的|セカンダリ|古い(知られている場合) / usual | official | temp | secondary | old (If known) |
Comments | アプリケーションは、identifierが一時的なものであると明示的に言っていない限り、永続的であると想定できます。 / Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )既知の場合、このidentifierの目的を識別します。 / Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true because これは、アプリケーションが一時的なIDを永続的なIDと間違えてはならないため、「IS修飾子」とラベル付けされています。 / This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | 特定の使用のコンテキストが一連のidentifierの中から選択される適切なidentifierを許可します。 / Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
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())) |
20. Coverage.identifier:insuranceIdentifier.system | |
Definition | 値の名前空間、つまり一意のセット値を記述するURLを確立します。 / Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | identifier値の名前空間 / The namespace for the identifier value |
Comments | identifier。システムは常にケースに敏感です。 / Identifier.system is always case sensitive. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | identifierのセットがたくさんあります。2つのidentifierを一致させるには、どのセットを扱っているかを知る必要があります。システムは、特定の一意のidentifierセットを識別します。 / There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Fixed Value | http://jpfhir.jp/fhir/clins/Idsystem/JP_Insurance_memberID |
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())) |
22. Coverage.identifier:insuranceIdentifier.value | |
Definition | 被保険者個人識別子として、保険者情報と被保険者情報とを以下の仕様で連結したひとつの文字列を使用する。 通常、identifierの部分はユーザーに関連し、システムのコンテキスト内で一意のユーザーに関連しています。 / The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | 被保険者個人識別子 例)00012345:あいう:187:05一意の値 / The value that is unique |
Comments | 値が完全なURIの場合、システムはurn:ietf:rfc:3986でなければなりません。値の主な目的は、計算マッピングです。その結果、比較目的で正規化される可能性があります(例えば、有意でない白文字、ダッシュなどの削除)ヒューマンディスプレイ用の値は、[レンダリングされた値拡張](拡張レンダリングValue.html)を使用して伝達できます。identifier。価値は、identifierの知識を使用しない限り、ケースに敏感なものとして扱われます。システムにより、プロセッサーは、非セイズに固有の処理が安全であると確信できます。 / If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 10..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())) |
24. Coverage.identifier:insuranceIdentifier.assigner | |
Definition | 保険者情報としてJP_Organizationを設定する。 identifierを発行/管理する組織。 / Organization that issued/manages the identifier. |
Short | 保険者情報を設定IDを発行した組織(単なるテキストである可能性があります) / Organization that issued id (may be just text) |
Comments | 保険者情報としてJP_Organizationを設定する。 identifierは、.reference要素を省略し、割り当て組織に関する名前またはその他のテキスト情報を反映した.display要素のみを含む場合があります。 / The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
Control | 0..1 |
Type | Reference(JP Core Organization Profile, Organization) |
Is Modifier | false |
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())) |
26. Coverage.identifier:insuranceCsvIdentifier | |
Slice Name | insuranceCsvIdentifier |
Definition | 被保険者識別子として、保険者情報と被保険者情報を囲み文字をダブルクォーテーション、区切りをカンマにて連結する このカバレッジに割り当てられた一意のidentifier。 / A unique identifier assigned to this coverage. |
Short | 被保険者識別子(CSV形式) "00012345","12-34","5678","00"カバレッジのビジネスidentifier / Business Identifier for the coverage |
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. カバレッジのメイン(およびおそらくみの)identifier - 多くの場合、メンバーID、証明書番号、個人の健康番号、またはケースIDと呼ばれます。カバレッジの連結として構築される場合があります。 / 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.dependant. |
Note | This is a business identifier, not a resource identifier (see discussion) |
Control | 0..1* |
Type | Identifier |
Is Modifier | false |
Summary | true |
Requirements | カバレッジを区別し、参照することができます。 / 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())) |
28. Coverage.identifier:insuranceCsvIdentifier.use | |
Definition | このidentifierの目的。 / The purpose of this identifier. |
Short | 通常|公式|一時的|セカンダリ|古い(知られている場合) / usual | official | temp | secondary | old (If known) |
Comments | アプリケーションは、identifierが一時的なものであると明示的に言っていない限り、永続的であると想定できます。 / Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. |
Control | 0..1 |
Binding | The codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1 (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )既知の場合、このidentifierの目的を識別します。 / Identifies the purpose for this identifier, if known . |
Type | code |
Is Modifier | true because これは、アプリケーションが一時的なIDを永続的なIDと間違えてはならないため、「IS修飾子」とラベル付けされています。 / This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | 特定の使用のコンテキストが一連のidentifierの中から選択される適切なidentifierを許可します。 / Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. |
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())) |
30. Coverage.identifier:insuranceCsvIdentifier.system | |
Definition | 値の名前空間、つまり一意のセット値を記述するURLを確立します。 / Establishes the namespace for the value - that is, a URL that describes a set values that are unique. |
Short | identifier値の名前空間 / The namespace for the identifier value |
Comments | identifier。システムは常にケースに敏感です。 / Identifier.system is always case sensitive. |
Control | 10..1 |
Type | uri |
Is Modifier | false |
Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Summary | true |
Requirements | identifierのセットがたくさんあります。2つのidentifierを一致させるには、どのセットを扱っているかを知る必要があります。システムは、特定の一意のidentifierセットを識別します。 / There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. |
Fixed Value | http://jpfhir.jp/fhir/core/IdSystem/JP_Coverage_id |
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())) |
32. Coverage.identifier:insuranceCsvIdentifier.value | |
Definition | 被保険者識別子として、保険者番号と被保険者記号と番号と枝番を全角にした上でダブルコーテーションで囲い、カンマ区切りで連結する。 通常、identifierの部分はユーザーに関連し、システムのコンテキスト内で一意のユーザーに関連しています。 / The portion of the identifier typically relevant to the user and which is unique within the context of the system. |
Short | 被保険者識別子(CSV形式) "00012345","12-34","5678","00"一意の値 / The value that is unique |
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. 値が完全なURIの場合、システムはurn:ietf:rfc:3986でなければなりません。値の主な目的は、計算マッピングです。その結果、比較目的で正規化される可能性があります(例えば、有意でない白文字、ダッシュなどの削除)ヒューマンディスプレイ用の値は、[レンダリングされた値拡張](拡張レンダリングValue.html)を使用して伝達できます。identifier。価値は、identifierの知識を使用しない限り、ケースに敏感なものとして扱われます。システムにより、プロセッサーは、非セイズに固有の処理が安全であると確信できます。 / If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. |
Control | 10..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())) |
34. Coverage.identifier:insuranceCsvIdentifier.assigner | |
Definition | 健康保険等の保険者情報を設定する。JP_Organizationをリソースにて表現する identifierを発行/管理する組織。 / Organization that issued/manages the identifier. |
Short | 保険者情報IDを発行した組織(単なるテキストである可能性があります) / Organization that issued id (may be just text) |
Comments | 健康保険等の保険者情報を設定する。JP_Organizationをリソースにて表現する identifierは、.reference要素を省略し、割り当て組織に関する名前またはその他のテキスト情報を反映した.display要素のみを含む場合があります。 / The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. |
Control | 0..1 |
Type | Reference(JP Core Organization Profile, Organization) |
Is Modifier | false |
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())) |
36. Coverage.status | |
Definition | The status of the resource instance. リソースインスタンスのステータス。 / The status of the resource instance. |
Short | アクティブ|キャンセル|ドラフト|エラーに入った / 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. この要素には、ステータスが現在有効ではないとカバレッジをマークするコードが入力されたコードが含まれているため、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 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. |
Type | code |
Is Modifier | true because この要素は、リソースを有効として扱うべきではないことを意味するステータスに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ます。 / 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 |
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'. 「ドラフト」リソースがさらに編集される可能性があるため、リソースのステータスを追跡する必要がありますが、「アクティブ」リソースは不変であり、ステータスが「キャンセル」に変更される場合があります。 / 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'. |
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())) |
38. 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. カバレッジの種類:社会プログラム、医療計画、事故補償(労働者補償、自動車)、グループの健康または個人または組織による支払い。 / The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. |
Short | Coverage category such as medical or accident 医療保険や事故補償のような分類医療や事故などの補償カテゴリ / 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 | 0..1 |
Binding | The codes SHOULD be taken from CoverageTypeAndSelf-PayCodeshttp://hl7.org/fhir/ValueSet/coverage-type (preferred to http://hl7.org/fhir/ValueSet/coverage-type )保険の種類:公衆衛生、労働者補償。個人的な事故、自動車、民間の健康など)または個人または組織による直接支払い。 / The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | The order of application of coverages is dependent on the types of coverage. カバレッジの適用順序は、カバレッジの種類に依存します。 / 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())) |
40. Coverage.policyHolder | |
Definition | The party who 'owns' the insurance policy. 保険契約を「所有」する当事者。 / The party who 'owns' the insurance policy. |
Short | Owner of the policy ポリシの所有者ポリシーの所有者 / Owner of the policy |
Comments | For example: may be an individual, corporation or the subscriber's employer. たとえば、個人、企業、または加入者の雇用主である場合があります。 / For example: may be an individual, corporation or the subscriber's employer. |
Control | 0..1 |
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. これにより、労働者の補償およびその他のポリシーの場合、雇用主情報が提供されます。 / 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())) |
42. 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. ポリシーとの契約上の関係、または彼らまたはその家族に提供されたサービスのためのポリシーの利益の利益に契約上の関係にサインアップまたは「所有」した当事者。 / 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 被保険者ポリシーのサブスクライバー / Subscriber to the policy |
Comments | May be self or a parent in the case of dependents. 扶養家族の場合の自己または親である可能性があります。 / May be self or a parent in the case of dependants. |
Control | 0..1 |
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. これは、ポリシーに基づく利益を受ける権利がある当事者です。 / 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())) |
44. Coverage.subscriberId | |
Definition | The insurer assigned ID for the Subscriber. 保険会社は、サブスクライバーにIDを割り当てました。 / 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サブスクライバーに割り当てられたID / ID assigned to the subscriber |
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 | The insurer requires this identifier on correspondence and claims (digital and otherwise). 保険会社は、このidentifierが通信と請求(デジタルおよびその他)に関するものを要求します。 / 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())) |
46. Coverage.beneficiary | |
Definition | The party who benefits from the insurance coverage; the patient when products and/or services are provided. 保険補償の恩恵を受ける当事者。製品やサービスが提供されるときの患者。 / The party who benefits from the insurance coverage; the patient when products and/or services are provided. |
Short | 受益者を計画します / 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 |
Summary | true |
Requirements | This is the party who receives treatment for which the costs are reimbursed under the coverage. これは、補償の下で費用が払い戻される治療を受ける当事者です。 / 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())) |
48. Coverage.dependent | |
Definition | A unique identifier for a dependent under the coverage. カバレッジの下で依存者のための一意のidentifier。 / A unique identifier for a dependent under the coverage. |
Short | 被保険者証 枝番従属番号 / Dependent number |
Comments | Periodically the member number is constructed from the subscriberId and the dependent number. 定期的にメンバー番号は、サブクライベリッドおよび従属番号から構築されます。 / 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 |
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. 一部のカバレッジの場合、単一のidentifierがサブスクライバーに発行され、その後、各受益者に一意の依存番号が発行されます。 / 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())) |
50. Coverage.relationship | |
Definition | The relationship of beneficiary (patient) to the subscriber. 受益者(患者)とサブスクライバーとの関係。 / The relationship of beneficiary (patient) to the subscriber. |
Short | Beneficiary relationship to the subscriber 加入者との受益者関係加入者との受益者関係 / Beneficiary relationship to the subscriber |
Comments | Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others. 通常、個人は、他の人が所有するポリシーの前に自分のポリシー(関係= 'self')を使用します。 / Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others. |
Control | 0..1 |
Binding | Unless not suitable, these codes SHALL be taken from SubscriberRelationshipCodeshttp://hl7.org/fhir/ValueSet/subscriber-relationship (extensible to http://hl7.org/fhir/ValueSet/subscriber-relationship )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 |
Summary | false |
Requirements | To determine relationship between the patient and the subscriber to determine coordination of benefits. 患者とサブスクライバーの関係を決定して、利益の調整を決定します。 / 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())) |
52. Coverage.period | |
Definition | 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. カバレッジが有効な期間。開始日の欠落は、開始日がわからないことを示し、終了日が欠落しているということは、カバレッジが引き続き有効になっていることを意味します。 / 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 | カバレッジの開始日と終了日 / 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 |
Summary | true |
Requirements | Some insurers require the submission of the coverage term. 一部の保険会社は、補償期間の提出を要求しています。 / 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())) |
54. Coverage.payor | |
Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. 患者支払契約など、保険および非保険契約の両方を含むプログラムまたはプランの引受会社または支払人。 / The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. |
Short | 支払者に関する情報ポリシーの発行者 / 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. 保険会社のidentifierやビジネスidentifier(BIN番号)などの複数のidentifierを提供する場合があります。 自己支払いの場合、複数の支払い担当者や組織を提供する場合があります。 / 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..* |
Type | Reference(JP Core Organization Profile, JP Core Patient Profile, RelatedPerson, Organization, Patient) |
Is Modifier | false |
Summary | true |
Requirements | Need to identify the issuer to target for claim processing and for coordination of benefit processing. 請求処理と福利厚生処理の調整のためにターゲットにする発行者を特定する必要があります。 / 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())) |
56. Coverage.class | |
Definition | A suite of underwriter specific classifiers. アンダーライター固有の分類器のスイート。 / 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. たとえば、補償範囲のクラスまたは雇用主グループ、ポリシー、計画を特定するために使用できます。 / For example may be used to identify a class of coverage or employer group, Policy, Plan. |
Control | 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. 保険会社の特定のポリシーを識別または確認するヘルスカードに提供されるコード。 / 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())) |
58. Coverage.class.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()) |
60. Coverage.class.type | |
Definition | The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan. たとえば、保険会社固有のクラスラベルまたはオプション名とオプション名が提供される分類のタイプを使用して、補償範囲のクラスまたは雇用主グループ、ポリシー、計画を特定することができます。 / The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan. |
Short | 「グループ」や「計画」などのクラスのタイプ / Type of class such as 'group' or 'plan' |
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 | Unless not suitable, these codes SHALL be taken from CoverageClassCodeshttp://hl7.org/fhir/ValueSet/coverage-class (extensible to http://hl7.org/fhir/ValueSet/coverage-class )ポリシー分類、例。グループ、プラン、クラスなど / The policy classifications, eg. Group, Plan, Class, etc. |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | The insurer issued label for a specific health card value. 保険会社は、特定のヘルスカード価値のためにラベルを発行しました。 / The insurer issued label for a specific health card value. |
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.class.value | |
Definition | The alphanumeric string value associated with the insurer issued label. 保険会社が発行したラベルに関連付けられた英数字の文字列値。 / The alphanumeric string value associated with the insurer issued label. |
Short | タイプに関連付けられた値 / Value associated with the type |
Comments | For example, the Group or Plan number. たとえば、グループまたはプラン番号。 / For example, the Group or Plan number. |
Control | 1..1 |
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 issued label and value are necessary to identify the specific policy. 特定のポリシーを特定するには、保険会社が発行したラベルと価値が必要です。 / The insurer issued label and value are necessary to identify the specific 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())) |
64. Coverage.class.name | |
Definition | A short description for the class. クラスの簡単な説明。 / A short description for the class. |
Short | タイプと価値の人間の読み取り可能な説明 / Human readable description of the type and value |
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 | Used to provide a meaningful description in correspondence to the patient. 患者への対応で意味のある説明を提供するために使用されます。 / Used to provide a meaningful description in correspondence to 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())) |
66. 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. 現在施行されている他のカバレッジに対するこのカバレッジの適用可能性の順序。注意してください。番号付けにはギャップがあり、これはプライマリ、セカンダリなどを意味するものではありません。カバレッジの特定のポジショニングはケアのエピソードに依存するためです。 / 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..1 |
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. 利益の調整の管理に使用されます。 / 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())) |
68. 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. 受益者が「ネットワーク内」レートでカバーされる治療を求める可能性のあるプロバイダーの保険会社が定義したネットワークの保険会社固有のidentifier。 / 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..1 |
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. 治療および請求処理のための紹介で使用されます。 / 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())) |
70. Coverage.costToBeneficiary | |
Definition | 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. ポリシーで詳述され、ヘルスカードに含まれている可能性があるコストカテゴリと関連する金額を示す一連のコード。 / 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 | Patient payments for services/products サービスやプロダクトに対する患者支払いサービス/製品の患者の支払い / 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. たとえば、患者が共同支払いを訪問することを知ることにより、プロバイダーは治療を行う前に金額を収集できます。 / 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 |
Summary | false |
Requirements | Required by providers to manage financial transaction with the patient. 医療提供者は、患者との金融取引を管理することを要求します。 / 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())) |
72. 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()) |
74. Coverage.costToBeneficiary.type | |
Definition | The category of patient centric costs associated with treatment. 治療に関連する患者中心コストのカテゴリ。 / 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. たとえば、訪問、専門家訪問、緊急事態、入院患者ケアなど。 / For example visit, specialist visits, emergency, inpatient care, etc. |
Control | 0..1 |
Binding | Unless not suitable, these codes SHALL be taken from CoverageCopayTypeCodeshttp://hl7.org/fhir/ValueSet/coverage-copay-type (extensible to http://hl7.org/fhir/ValueSet/coverage-copay-type )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 |
Summary | true |
Requirements | Needed to identify the category associated with the amount for the patient. 患者の金額に関連するカテゴリを特定する必要がありました。 / 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())) |
76. Coverage.costToBeneficiary.value[x] | |
Definition | The amount due from the patient for the cost category. コストカテゴリの患者からの金額。 / The amount due from the patient for the cost category. |
Short | 受益者からの金額または割合 / 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. 金額は、サービス/製品コストの割合または固定金額の通貨として表現できます。 / Amount may be expressed as a percentage of the service/product cost or a fixed amount of currency. |
Control | 1..1 |
Type | Choice of: Quantity(SimpleQuantity), Money |
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] |
Is Modifier | false |
Summary | true |
Requirements | Needed to identify the amount for the patient associated with the category. カテゴリに関連する患者の金額を特定する必要がありました。 / 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())) |
78. Coverage.costToBeneficiary.exception | |
Definition | A suite of codes indicating exceptions or reductions to patient costs and their effective periods. 患者コストの例外または削減とその有効期間を示す一連のコード。 / 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..* |
Type | BackboneElement |
Is Modifier | false |
Summary | false |
Requirements | Required by providers to manage financial transaction with the patient. 医療提供者は、患者との金融取引を管理することを要求します。 / 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())) |
80. Coverage.costToBeneficiary.exception.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()) |
82. Coverage.costToBeneficiary.exception.type | |
Definition | The code for the specific exception. 特定の例外のコード。 / The code for the specific exception. |
Short | 例外カテゴリ / Exception category |
Control | 1..1 |
Binding | For example codes, see ExampleCoverageFinancialExceptionCodeshttp://hl7.org/fhir/ValueSet/coverage-financial-exception (example to http://hl7.org/fhir/ValueSet/coverage-financial-exception )部品からの例外の種類またはCopaysなどの財務義務の完全な価値。 / The types of exceptions from the part or full value of financial obligations such as copays. |
Type | CodeableConcept |
Is Modifier | false |
Summary | true |
Requirements | Needed to identify the exception associated with the amount for the patient. 患者の量に関連する例外を特定する必要がありました。 / Needed to identify the exception 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())) |
84. Coverage.costToBeneficiary.exception.period | |
Definition | The timeframe during when the exception is in force. 例外が有効になっている時の時間枠。 / The timeframe during when the exception is in force. |
Short | 例外の有効期間 / The effective period of the exception |
Control | 0..1 |
Type | Period |
Is Modifier | false |
Summary | true |
Requirements | Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. 患者コストの正しい計算のために例外のために該当する時間枠を特定する必要がありました。 / Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. |
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())) |
86. 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. 「Subrogation = true」の場合、この保険インスタンスは裁定のためではなく、保険会社にコストを回収するための詳細を提供するために含まれています。 / 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 保険者への償還保険会社への払い戻し / Reimbursement to insurer |
Comments | Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims. 通常、自動車および労働者の報酬ポリシーには、医療費が事故請求に対して収集できるようにするために、「代位=真」でフラグが付けられます。 / Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims. |
Control | 0..1 |
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. 使用する時期については定義を参照してください。 / 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())) |
88. Coverage.contract | |
Definition | The policy(s) which constitute this insurance coverage. この保険の補償を構成する保険。 / The policy(s) which constitute this insurance coverage. |
Short | Contract details 契約の詳細契約の詳細 / Contract details |
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..* |
Type | Reference(Contract) |
Is Modifier | false |
Summary | false |
Requirements | To reference the legally binding contract between the policy holder and the insurer. 保険契約者と保険会社の間の法的拘束力のある契約を参照する。 / 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())) |
Guidance on how to interpret the contents of this table can be found here
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)が必要です / 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 | 0..1 | ||||
Type | Meta | ||||
Is Modifier | false | ||||
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.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()) ) | ||||
8. 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 )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()) ) | ||||
10. 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()) ) | ||||
12. 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..* | ||||
Type | Resource | ||||
Is Modifier | false | ||||
Summary | false | ||||
Alternate Names | inline resources, anonymous resources, contained resources | ||||
14. Coverage.extension | |||||
Definition | An Extension | ||||
Short | Extension | ||||
Control | 0..* | ||||
Type | Extension | ||||
Is Modifier | false | ||||
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() ) | ||||
Slicing | This element introduces a set of slices on Coverage.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
16. 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 | 健康保険における被保険者証記号 | ||||
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..* This element is affected by the following invariants: ele-1 | ||||
Type | Extension(JP Core Coverage InsuredPersonSymbol Extension) (Extension Type: string) | ||||
Is Modifier | 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() ) | ||||
18. Coverage.extension:insuredPersonNumber | |||||
Slice Name | insuredPersonNumber | ||||
Definition | 健康保険における被保険者証番号を示す拡張 | ||||
Short | 健康保険における被保険者証番号 | ||||
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..* This element is affected by the following invariants: ele-1 | ||||
Type | Extension(JP Core Coverage InsuredPersonNumber Extension) (Extension Type: string) | ||||
Is Modifier | 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() ) | ||||
20. Coverage.extension:insuredPersonSubNumber | |||||
Slice Name | insuredPersonSubNumber | ||||
Definition | 健康保険における被保険者証番号の枝番を示す拡張 | ||||
Short | 健康保険における被保険者証番号の枝番 | ||||
Comments | 健康保険における被保険者証番号を示す拡張。2桁の半角数字文字列。一桁の場合には先頭に0をつけて2桁にする。 | ||||
Control | 0..* This element is affected by the following invariants: ele-1 | ||||
Type | Extension(JP Core Coverage InsuredPersonSubNumber Extension) (Extension Type: string) | ||||
Is Modifier | 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() ) | ||||
22. 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() ) | ||||
24. Coverage.identifier | |||||
Definition | A unique identifier assigned to this coverage. このカバレッジに割り当てられた一意の識別子。 | ||||
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 | A unique identifier assigned to this coverage. このカバレッジに割り当てられた一意の識別子。 | ||||
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()) ) | ||||
Slicing | This element introduces a set of slices on Coverage.identifier . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
26. Coverage.identifier:insuranceIdentifier | |||||
Slice Name | insuranceIdentifier | ||||
Definition | 被保険者個人識別子として、保険者情報と被保険者情報を以下の仕様で連結したひとつの文字列を使用する | ||||
Short | 被保険者個人識別子 例)00012345:あいう:187:05 | ||||
Comments | 「被保険者個人識別子」の文字列仕様を参照のこと | ||||
Note | This is a business identifier, not a resource identifier (see discussion) | ||||
Control | 0..1 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | カバレッジを区別し、参照することができます。 / 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()) ) | ||||
28. Coverage.identifier:insuranceIdentifier.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 | ||||
30. Coverage.identifier:insuranceIdentifier.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.identifier.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
32. Coverage.identifier:insuranceIdentifier.use | |||||
Definition | このidentifierの目的。 / The purpose of this identifier. | ||||
Short | 通常|公式|一時的|セカンダリ|古い(知られている場合) / usual | official | temp | secondary | old (If known) | ||||
Comments | アプリケーションは、identifierが一時的なものであると明示的に言っていない限り、永続的であると想定できます。 / Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from IdentifierUse (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )既知の場合、このidentifierの目的を識別します。 / Identifies the purpose for this identifier, if known . | ||||
Type | code | ||||
Is Modifier | true because これは、アプリケーションが一時的なIDを永続的なIDと間違えてはならないため、「IS修飾子」とラベル付けされています。 / This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | 特定の使用のコンテキストが一連のidentifierの中から選択される適切なidentifierを許可します。 / Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
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()) ) | ||||
34. Coverage.identifier:insuranceIdentifier.type | |||||
Definition | 特定の目的に使用するidentifierを決定するために使用できるidentifierのコード化されたタイプ。 / A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Short | identifierの説明 / Description of identifier | ||||
Comments | この要素は、identifierの一般的なカテゴリのみを扱います。identifier。システムに対応するコードに使用しないでください。一部のidentifierは、一般的な使用法により複数のカテゴリに分類される場合があります。システムがわかっている場合、タイプは常にシステム定義の一部であるため、タイプは不要です。ただし、システムが不明なidentifierを処理する必要があることがよくあります。多くの異なるシステムが同じタイプを持っているため、タイプとシステムの間に1:1の関係はありません。 / This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||||
Control | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type )特定の目的に使用するidentifierを決定するために使用できるidentifierのコード化されたタイプ。 / A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | identifierシステムが不明な場合、ユーザーはidentifierを使用できます。 / Allows users to make use of identifiers when the identifier system is not known. | ||||
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()) ) | ||||
36. Coverage.identifier:insuranceIdentifier.system | |||||
Definition | 値の名前空間、つまり一意のセット値を記述するURLを確立します。 / Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | identifier値の名前空間 / The namespace for the identifier value | ||||
Comments | identifier。システムは常にケースに敏感です。 / Identifier.system is always case sensitive. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | identifierのセットがたくさんあります。2つのidentifierを一致させるには、どのセットを扱っているかを知る必要があります。システムは、特定の一意のidentifierセットを識別します。 / There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||||
Fixed Value | http://jpfhir.jp/fhir/clins/Idsystem/JP_Insurance_memberID | ||||
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()) ) | ||||
38. Coverage.identifier:insuranceIdentifier.value | |||||
Definition | 被保険者個人識別子として、保険者情報と被保険者情報とを以下の仕様で連結したひとつの文字列を使用する。 | ||||
Short | 被保険者個人識別子 例)00012345:あいう:187:05 | ||||
Comments | 値が完全なURIの場合、システムはurn:ietf:rfc:3986でなければなりません。値の主な目的は、計算マッピングです。その結果、比較目的で正規化される可能性があります(例えば、有意でない白文字、ダッシュなどの削除)ヒューマンディスプレイ用の値は、[レンダリングされた値拡張](拡張レンダリングValue.html)を使用して伝達できます。identifier。価値は、identifierの知識を使用しない限り、ケースに敏感なものとして扱われます。システムにより、プロセッサーは、非セイズに固有の処理が安全であると確信できます。 / If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. | ||||
Control | 1..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()) ) | ||||
40. Coverage.identifier:insuranceIdentifier.period | |||||
Definition | identifierが使用される/有効な期間。 / Time period during which identifier is/was valid for use. | ||||
Short | IDが使用に有効だった時間期間 / Time period when id is/was valid for use | ||||
Control | 0..1 | ||||
Type | Period | ||||
Is Modifier | false | ||||
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()) ) | ||||
42. Coverage.identifier:insuranceIdentifier.assigner | |||||
Definition | 保険者情報としてJP_Organizationを設定する。 | ||||
Short | 保険者情報を設定 | ||||
Comments | 保険者情報としてJP_Organizationを設定する。 | ||||
Control | 0..1 | ||||
Type | Reference(JP Core Organization Profile) | ||||
Is Modifier | false | ||||
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()) ) | ||||
44. Coverage.identifier:insuranceCsvIdentifier | |||||
Slice Name | insuranceCsvIdentifier | ||||
Definition | 被保険者識別子として、保険者情報と被保険者情報を囲み文字をダブルクォーテーション、区切りをカンマにて連結する | ||||
Short | 被保険者識別子(CSV形式) "00012345","12-34","5678","00" | ||||
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..1 | ||||
Type | Identifier | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | カバレッジを区別し、参照することができます。 / 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()) ) | ||||
46. Coverage.identifier:insuranceCsvIdentifier.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 | ||||
48. Coverage.identifier:insuranceCsvIdentifier.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.identifier.extension . The slices areUnordered and Open, and can be differentiated using the following discriminators: | ||||
50. Coverage.identifier:insuranceCsvIdentifier.use | |||||
Definition | このidentifierの目的。 / The purpose of this identifier. | ||||
Short | 通常|公式|一時的|セカンダリ|古い(知られている場合) / usual | official | temp | secondary | old (If known) | ||||
Comments | アプリケーションは、identifierが一時的なものであると明示的に言っていない限り、永続的であると想定できます。 / Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. | ||||
Control | 0..1 | ||||
Binding | The codes SHALL be taken from IdentifierUse (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 )既知の場合、このidentifierの目的を識別します。 / Identifies the purpose for this identifier, if known . | ||||
Type | code | ||||
Is Modifier | true because これは、アプリケーションが一時的なIDを永続的なIDと間違えてはならないため、「IS修飾子」とラベル付けされています。 / This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one. | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | 特定の使用のコンテキストが一連のidentifierの中から選択される適切なidentifierを許可します。 / Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. | ||||
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.identifier:insuranceCsvIdentifier.type | |||||
Definition | 特定の目的に使用するidentifierを決定するために使用できるidentifierのコード化されたタイプ。 / A coded type for the identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Short | identifierの説明 / Description of identifier | ||||
Comments | この要素は、identifierの一般的なカテゴリのみを扱います。identifier。システムに対応するコードに使用しないでください。一部のidentifierは、一般的な使用法により複数のカテゴリに分類される場合があります。システムがわかっている場合、タイプは常にシステム定義の一部であるため、タイプは不要です。ただし、システムが不明なidentifierを処理する必要があることがよくあります。多くの異なるシステムが同じタイプを持っているため、タイプとシステムの間に1:1の関係はありません。 / This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. | ||||
Control | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from Identifier Type Codes (extensible to http://hl7.org/fhir/ValueSet/identifier-type )特定の目的に使用するidentifierを決定するために使用できるidentifierのコード化されたタイプ。 / A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | identifierシステムが不明な場合、ユーザーはidentifierを使用できます。 / Allows users to make use of identifiers when the identifier system is not known. | ||||
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()) ) | ||||
54. Coverage.identifier:insuranceCsvIdentifier.system | |||||
Definition | 値の名前空間、つまり一意のセット値を記述するURLを確立します。 / Establishes the namespace for the value - that is, a URL that describes a set values that are unique. | ||||
Short | identifier値の名前空間 / The namespace for the identifier value | ||||
Comments | identifier。システムは常にケースに敏感です。 / Identifier.system is always case sensitive. | ||||
Control | 1..1 | ||||
Type | uri | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
Summary | true | ||||
Requirements | identifierのセットがたくさんあります。2つのidentifierを一致させるには、どのセットを扱っているかを知る必要があります。システムは、特定の一意のidentifierセットを識別します。 / There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. | ||||
Fixed Value | http://jpfhir.jp/fhir/core/IdSystem/JP_Coverage_id | ||||
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()) ) | ||||
56. Coverage.identifier:insuranceCsvIdentifier.value | |||||
Definition | 被保険者識別子として、保険者番号と被保険者記号と番号と枝番を全角にした上でダブルコーテーションで囲い、カンマ区切りで連結する。 | ||||
Short | 被保険者識別子(CSV形式) "00012345","12-34","5678","00" | ||||
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. | ||||
Control | 1..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()) ) | ||||
58. Coverage.identifier:insuranceCsvIdentifier.period | |||||
Definition | identifierが使用される/有効な期間。 / Time period during which identifier is/was valid for use. | ||||
Short | IDが使用に有効だった時間期間 / Time period when id is/was valid for use | ||||
Control | 0..1 | ||||
Type | Period | ||||
Is Modifier | false | ||||
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()) ) | ||||
60. Coverage.identifier:insuranceCsvIdentifier.assigner | |||||
Definition | 健康保険等の保険者情報を設定する。JP_Organizationをリソースにて表現する | ||||
Short | 保険者情報 | ||||
Comments | 健康保険等の保険者情報を設定する。JP_Organizationをリソースにて表現する | ||||
Control | 0..1 | ||||
Type | Reference(JP Core Organization Profile) | ||||
Is Modifier | false | ||||
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()) ) | ||||
62. Coverage.status | |||||
Definition | The status of the resource instance. | ||||
Short | アクティブ|キャンセル|ドラフト|エラーに入った / 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. | ||||
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 この要素は、リソースを有効として扱うべきではないことを意味するステータスに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ます。 / 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 | ||||
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'. | ||||
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()) ) | ||||
64. 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 | Coverage category such as medical or accident 医療保険や事故補償のような分類 | ||||
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 | 0..1 | ||||
Binding | The codes SHOULD be taken from CoverageTypeAndSelf-PayCodes (preferred to http://hl7.org/fhir/ValueSet/coverage-type )保険の種類:公衆衛生、労働者補償。個人的な事故、自動車、民間の健康など)または個人または組織による直接支払い。 / The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
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()) ) | ||||
66. 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..1 | ||||
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()) ) | ||||
68. 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..1 | ||||
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()) ) | ||||
70. 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..1 | ||||
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()) ) | ||||
72. Coverage.beneficiary | |||||
Definition | The party who benefits from the insurance coverage; the patient when products and/or services are provided. | ||||
Short | 受益者を計画します / 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) | ||||
Is Modifier | false | ||||
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()) ) | ||||
74. Coverage.dependent | |||||
Definition | A unique identifier for a dependent under the coverage. | ||||
Short | 被保険者証 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 | ||||
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()) ) | ||||
76. 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 | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from SubscriberRelationshipCodes (extensible to http://hl7.org/fhir/ValueSet/subscriber-relationship )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 | ||||
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()) ) | ||||
78. Coverage.period | |||||
Definition | 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 | カバレッジの開始日と終了日 / 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 | ||||
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()) ) | ||||
80. Coverage.payor | |||||
Definition | The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements. | ||||
Short | 支払者に関する情報 | ||||
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 | 1..* | ||||
Type | Reference(JP Core Organization Profile, JP Core Patient Profile, RelatedPerson) | ||||
Is Modifier | false | ||||
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()) ) | ||||
82. 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..* | ||||
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()) ) | ||||
84. Coverage.class.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 | ||||
86. Coverage.class.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() ) | ||||
88. Coverage.class.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() ) | ||||
90. Coverage.class.type | |||||
Definition | The type of classification for which an insurer-specific class label or number and optional name is provided, for example may be used to identify a class of coverage or employer group, Policy, Plan. | ||||
Short | 「グループ」や「計画」などのクラスのタイプ / Type of class such as 'group' or 'plan' | ||||
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 | Unless not suitable, these codes SHALL be taken from CoverageClassCodes (extensible to http://hl7.org/fhir/ValueSet/coverage-class )ポリシー分類、例。グループ、プラン、クラスなど / The policy classifications, eg. Group, Plan, Class, etc. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | The insurer issued label for a specific health card value. | ||||
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()) ) | ||||
92. Coverage.class.value | |||||
Definition | The alphanumeric string value associated with the insurer issued label. | ||||
Short | タイプに関連付けられた値 / Value associated with the type | ||||
Comments | For example, the Group or Plan number. | ||||
Control | 1..1 | ||||
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 issued label and value are necessary to identify the specific 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()) ) | ||||
94. Coverage.class.name | |||||
Definition | A short description for the class. | ||||
Short | タイプと価値の人間の読み取り可能な説明 / Human readable description of the type and value | ||||
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 | Used to provide a meaningful description in correspondence to 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()) ) | ||||
96. 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..1 | ||||
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()) ) | ||||
98. 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..1 | ||||
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()) ) | ||||
100. Coverage.costToBeneficiary | |||||
Definition | 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 | Patient payments for services/products サービスやプロダクトに対する患者支払い | ||||
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 | ||||
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()) ) | ||||
102. 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 | ||||
104. 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() ) | ||||
106. 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() ) | ||||
108. 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 | 0..1 | ||||
Binding | Unless not suitable, these codes SHALL be taken from CoverageCopayTypeCodes (extensible to http://hl7.org/fhir/ValueSet/coverage-copay-type )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 | ||||
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()) ) | ||||
110. 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 | ||||
112. 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: | ||||
114. 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 | 0..* | ||||
Type | Coding | ||||
Is Modifier | false | ||||
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()) ) | ||||
116. 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 | ||||
118. 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: | ||||
120. Coverage.costToBeneficiary.type.coding.system | |||||
Definition | コード内のシンボルの意味を定義するコードシステムの識別。 / The identification of the code system that defines the meaning of the symbol in the code. | ||||
Short | 用語システムのアイデンティティ / Identity 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 | ||||
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. | ||||
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()) ) | ||||
122. 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()) ) | ||||
124. Coverage.costToBeneficiary.type.coding.code | |||||
Definition | システムによって定義された構文のシンボル。シンボルは、定義されたコードまたはコーディングシステムによって定義された構文の式(例:調整後)である場合があります。 / 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 | システムによって定義された構文のシンボル / Symbol in syntax defined by the system | ||||
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size | ||||
Control | 0..1 | ||||
Type | code | ||||
Is Modifier | false | ||||
Primitive Value | This primitive element may be present, or absent, or replaced by an extension | ||||
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. | ||||
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()) ) | ||||
126. 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 | システムによって定義された表現 / 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 | 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. | ||||
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()) ) | ||||
128. 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()) ) | ||||
130. 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..1 | ||||
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()) ) | ||||
132. Coverage.costToBeneficiary.value[x] | |||||
Definition | The amount due from the patient for the cost category. | ||||
Short | 受益者からの金額または割合 / 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. | ||||
Control | 1..1 | ||||
Type | Choice of: Quantity(SimpleQuantity), Money | ||||
[x] Note | SeeChoice of Data Typesfor further information about how to use [x] | ||||
Is Modifier | false | ||||
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()) ) | ||||
134. 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..* | ||||
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()) ) | ||||
136. Coverage.costToBeneficiary.exception.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 | ||||
138. Coverage.costToBeneficiary.exception.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() ) | ||||
140. Coverage.costToBeneficiary.exception.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() ) | ||||
142. Coverage.costToBeneficiary.exception.type | |||||
Definition | The code for the specific exception. | ||||
Short | 例外カテゴリ / Exception category | ||||
Control | 1..1 | ||||
Binding | For example codes, see ExampleCoverageFinancialExceptionCodes (example to http://hl7.org/fhir/ValueSet/coverage-financial-exception )部品からの例外の種類またはCopaysなどの財務義務の完全な価値。 / The types of exceptions from the part or full value of financial obligations such as copays. | ||||
Type | CodeableConcept | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Needed to identify the exception 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()) ) | ||||
144. Coverage.costToBeneficiary.exception.period | |||||
Definition | The timeframe during when the exception is in force. | ||||
Short | 例外の有効期間 / The effective period of the exception | ||||
Control | 0..1 | ||||
Type | Period | ||||
Is Modifier | false | ||||
Summary | true | ||||
Requirements | Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. | ||||
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()) ) | ||||
146. 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..1 | ||||
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()) ) | ||||
148. 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..* | ||||
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()) ) |