Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.

ヘルスケア製品およびサービスの償還または支払いに使用される可能性のある金融商品。 保険と自己負担の両方が含まれる。

The Coverage resource contains the insurance card level information, which is customary to provide on claims and other communications between providers and insurers.

Coverageには、保険証レベルの情報が含まれている。これは、保険金請求やプロバイダーと保険会社間のその他の通信で提供するのが通例である。

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

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.

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.

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.

The base language in which the resource is written.

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).

このリソースのショートサマリーで人が読んでわかるテキスト表現

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.

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

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.

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.

• value @ url

"テキスト内容の全てがリソースのコンテンツから生成されたことを示す。 generated　固定値

本リソースの構造化情報から生成したテキスト表現をいれてもよい。\r\nXHTML形式。

The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, <a> elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.

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.

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.

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.

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.

• value @ url

健康保険における被保険者証記号を示す拡張

健康保険における被保険者証記号を示す拡張

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

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.

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.

• value @ url

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A stream of bytes, base64 encoded

【JP-CORE】 被保険者記号の文字列。

健康保険における被保険者証番号を示す拡張

健康保険における被保険者証番号を示す拡張

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

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.

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.

• value @ url

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A stream of bytes, base64 encoded

【JP-CORE】 被保険者番号

健康保険における被保険者証番号の枝番を示す拡張

健康保険における被保険者証番号の枝番を示す拡張

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

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.

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.

• value @ url

Source of the definition for the extension code - a logical name or a URL.

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

A stream of bytes, base64 encoded

【JP-CORE】 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。

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).

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.

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.

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。

Allows coverages to be distinguished and referenced.

カバレッジを区別して参照できるようにします。

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.

カバレッジのメイン（および場合によっては唯一の）識別子-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。 Coverage.SubscriberIDとCoverage.dependantの連結として構築できます

リソースインスタンスのステータス。固定値active。処方箋発行時に真に有効な保険かどうかは意味しない。

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」リソースはさらに編集される可能性があり、「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」に変更されるだけであ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。

This element is labeled as a modifier because the status contains the code entered-in-error that marks the coverage as not currently valid.

ステータスには、カバレッジが現在無効であることを示すエラー入力されたコードが含まれているため、この要素は修飾子としてラベル付けされます。

The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.

補償の種類：社会プログラム、医療計画、事故補償（労働者災害補償、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 order of application of coverages is dependent on the types of coverage.

カバレッジの適用順序は、カバレッジのタイプによって異なります。

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.

すべてのターミノロジーの使用がこの一般的なパターンに適合するわけではない。場合によっては、モデルはCodeableConceptを使用せず、コーディングを直接使用して、テキスト、コーディング、翻訳、および要素間の関係とpre-coordinationとpost-coordinationの用語関係を管理するための独自の構造を提供する必要がある。

【JP-CORE】 厚労省保険局の電子処方等で使用される保険種別コード（system=”urn:oid:1.2.392.100495.20.2.61”）として、https://www.mhlw.go.jp/content/10800000/000342368.pdf　の別表１１が使用できる。

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

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.

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.

• value @ url

A reference to a code defined by a terminology system.

Allows for alternative encodings within a code system, and translations to other code systems.

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.

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

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.

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.

• value @ url

保険種別コード　厚生労働省電子処方箋 CDA 記述仕様第１版　別表１１のOID

Need to be unambiguous about the source of the definition of the symbol.

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

The 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.

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.

保険種別コード　厚生労働省電子処方箋 CDA 記述仕様第１版　別表１１のコード表に従う。 8で固定。 1 医保 2 国保 3 労災 4 自賠責 5 公害 6 自費 7 後期高齢者 8 公費

Need to refer to a particular code in the system.

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

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.

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.

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.

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.

Very often the text is the same as a displayName of one of the codings.

The party who 'owns' the insurance policy.

保険証券を「所有する」当事者。

This provides employer information in the case of Worker's Compensation and other policies.

これは、労働者災害補償およびその他のポリシーの場合に雇用者情報を提供します。

For example: may be an individual, corporation or the subscriber's employer.

例：個人、企業、または加入者の雇用主である可能性があります。

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.

ポリシーにサインアップした、またはポリシーとの契約関係を「所有」している当事者、またはポリシーの利益が彼らまたはその家族に提供されることになっている当事者。

This is the party who is entitled to the benfits under the policy.

これは、ポリシーに基づいて給付を受ける権利を有する当事者です。

【JP-CORE】 公費情報で本リソースを使用する場合には、この要素に公費受給者番号を設定する。

May be self or a parent in the case of dependants.

扶養家族の場合、自己または親である可能性があります。

公費受給者番号。 医療券等に記載されている受給者番号７桁を半角数字で記録する。 受給者番号が７桁に満たない場合は、先頭から“0”を記録し、７桁で記録する。 医療観察法（法別３０）の場合は、記録を省略する。

The insurer requires this identifier on correspondance and claims (digital and otherwise).

保険者は、連絡や請求（デジタルおよびその他）でこの識別子を要求する。 保険会社は、通信および請求（デジタルおよびその他）でこの識別子を要求します。

-----SWG3コメント-------- 被保険者番号を全角で格納する

患者情報（Patientリソース）へのリテラル参照

This is the party who receives treatment for which the costs are reimbursed under the coverage.

これは、補償の下で費用が償還される治療を受ける側のことです。

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (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.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能（内容に到達可能）である必要がある（アクセス制御、一時的な使用不可などを考慮に入れる）。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。

【JP_CORE】 患者Patientリソースへの参照。

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

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.

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.

• value @ url

Budleリソースに記述されるPatientリソースのfullUrl要素に指定されるUUIDを指定

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

A unique identifier for a dependent under the coverage.

補償対象の被扶養者の一意の識別子。

For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary.

一部の補償では、単一の識別子が加入者に発行され、次に一意の従属番号が各受益者に発行される。 一部の保険では、単一の識別子が加入者に発行され、その後、各受益者に固有の扶養番号が発行される。

【JP-CORE】 医療保険で本リソースを使用する場合には、この要素に拡張 InsuredPersonSubNumberに設定した値と同じ、被保険者番号の枝番号2桁を設定する。

Periodically the member number is constructed from the subscriberId and the dependant number.

定期的に subscriberId と従属番号からメンバー番号を構築する。

The relationship of beneficiary (patient) to the subscriber.

受益者（患者）と加入者の関係。

To determine relationship between the patient and the subscriber to determine coordination of benefits.

患者と加入者の関係を決定し、給付の調整を決定する。

【JP-CORE】 厚労省保険局の電子処方等で使用される被保険者区分コード（system=”urn:oid:1.2.392.100495.20.2.62”）として、https://www.mhlw.go.jp/content/10800000/000342368.pdf　の別表１２が使用できる。 1　被保険者 2　被扶養者

Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others.

一般的に、個人は、他人が所有するポリシーよりも、自分のポリシー（relationship='self'）を使用します。

公費受給者証の有効期間。公費受給者証に明示的に記載がある場合、かつ、医療機関がその情報を把握している場合のみ記録する。

Some insurers require the submission of the coverage term.

保険会社によっては、補償期間の提出を義務付けているところもあります。

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.

Period（期間）は時間の範囲を指定します。使用状況は、範囲全体が適用されるか（たとえば、「患者はこの時間範囲で入院していた」）、範囲から1つの値が適用されるか（たとえば、「この2回の間に患者に投与する」）を指定する。 Period（期間）は、Duration（時間区間＝経過時間の測定値）には使用されない。 [Duration]（datatypes.html＃Duration）を参照のこと。 This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. 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"). If duration is required, specify the type as Interval|Duration.

これはDuration（時間区間）ではない-　Durationは時間の尺度（別のタイプ）だが、時間の固定値で発生する時間区間です。Period（期間）は時間の範囲を指定します。使用状況は、範囲全体が適用されるか（たとえば、「患者はこの時間範囲で入院していた」）、範囲から1つの値が適用されるか（たとえば、「この2回の間に患者に投与する」）を指定する。もし、Duration（時間区間）が必要な場合は、タイプをInterval | Durationとして指定する。 これは期間ではありません-これは時間の尺度（別のタイプ）ですが、時間の固定値で発生する期間です。期間は時間の範囲を指定します。使用状況は、範囲全体が適用されるか（たとえば、「患者はこの時間範囲で入院していた」）、または範囲から1つの値が適用されるか（たとえば、「これら2回の間に患者に与える」）を指定します。期間が必要な場合は、タイプをInterval | Durationとして指定します。

【JP-CORE】 医療保険、公費で本リソースを使用する場合には、保険証または公費の有効期間の開始日、終了日をstart とendに yyyy-mm-dd形式で設定する。

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

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.

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.

• value @ url

公費受給者証の有効期間の開始日。資格取得日。ISO8601に準拠してyyyy_mm_dd形式で指定する。

If the low element is missing, the meaning is that the low boundary is not known.

公費受給者証の有効期間の終了日。資格喪失日。ISO8601に準拠してyyyy_mm_dd形式で指定する。

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.

公費負担者を表すOrganizationリソースへの参照

Need to identify the issuer to target for claim processing and for coordination of benefit processing.

請求処理および給付処理の調整の対象となる発行者を特定する必要があります。

【JP-CORE】 医療保険で本リソースを使用する場合には、保険者組織Organizationリソースへの参照。自費の場合には、患者Patientリソースへの参照。公費の場合には、公費負担者組織Organizationリソースへの参照。

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.

保険会社の識別子や事業者の識別子（BIN番号）など、複数の識別子を提供してもよい。自己負担の場合は、複数の支払者および/または組織を提供してもよい。

A suite of underwriter specific classifiers.

保険事業者の分類子

The codes provided on the health card which identify or confirm the specific policy for the insurer.

健康カードに記載されているコードで、保険者の特定の保険契約を識別または確認するもの。

For example may be used to identify a class of coverage or employer group, Policy, Plan.

例えば、保険の種類または雇用者グループ、保険契約、Planを識別するために使用することができます。

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

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.

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.

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).

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.

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.

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.

保険者固有のクラスラベルまたは番号、任意の名前が提供されている分類のタイプを表す。例えば、保険のクラスまたは雇用者グループ、保険契約、Planを識別するために使用することができます。

The insurer issued label for a specific health card value.

保険者が発行した特定の健康カード番号のラベル。

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.

すべての用語の使用がこの一般的なパターンに適合するわけではない。いくつかのケースでは、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係、および前後の調整を管理するための独自の構造を提供することが望ましい。

The alphanumeric string value associated with the insurer issued label.

保険者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 insurer issued label and value are necessary to identify the specific policy.

保険者が発行したラベルと値は、特定の保険契約を識別するために必要なものです。

For example, the Group or Plan number.

例えば、グループ番号やプラン番号など。

A short description for the class.

保険種類の簡単な説明。

Used to provide a meaningful description in correspondence to the patient.

患者に対応するのに意味のある説明をするために使用します。

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.

現在適用されている他の保障と比較して、この保障の適用可能性が高い順に記載されています。なお、ナンバリングにギャップがある場合があり、カバーの具体的な位置づけはケアのエピソードに依存するため、一次、二次などを意味するものではありません。

Used in managing the coordination of benefits.

保険給付の調整管理に使用します。

【JP-CORE】 公費情報で本リソースを使用する場合で、複数の公費負担情報がある場合に、その適用順序番号を示す１，２，３．．．を設定する。

32 bit number; for values larger than this, use decimal

32 ビットの数値、これより大きい値の場合は 10 進数を使用します。

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.

保険者が定義したプロバイダーの保険者定義ネットワークの保険者固有の識別子で、被保険者が「ネットワーク内」の料金でカバーされる治療を受けることができるが、そうでなければ「ネットワーク外」の条件が適用される。

Used in referral for treatment and in claims processing.

治療のための紹介や請求処理の際に使用します。

保険の自己負担率。記録が可能な場合にのみ記録する。

ポリシーに詳細が記載されており、ヘルスカードに含まれている可能性の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。

Required by providers to manage financial transaction with the patient.

事業者が患者との金銭的な取引を管理するために必要となる。

For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment.

例えば、患者の訪問時の自己負担額を知ることで、医療提供者は治療を行う前にその金額を回収することができる。

【JP-CORE】 公費の場合には自己負担率。判明している場合のみ設定する。

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

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.

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.

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).

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.

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.

The category of patient centric costs associated with treatment.

治療に伴う患者中心の費用のカテゴリー。

Needed to identify the category associated with the amount for the patient.

患者さんの金額に関連するカテゴリーを特定する必要がありました。

For example visit, specialist visits, emergency, inpatient care, etc.

例えば、訪問診療、専門医の訪問診療、救急診療、入院診療など。

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

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.

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.

• value @ url

A reference to a code defined by a terminology system.

Allows for alternative encodings within a code system, and translations to other code systems.

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.

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

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.

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.

• value @ url

保険における自己負担の種別を識別するコードのコード体系を識別するURI。固定値。

Need to be unambiguous about the source of the definition of the symbol.

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.

【JP-CORE】 保険や公費における自己負担率の種別を識別するコード体系のコード。 "http://terminology.hl7.org/CodeSystem/coverage-copay-type"

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.

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.

固定値　copaypct

Need to refer to a particular code in the system.

Note that FHIR strings SHALL NOT exceed 1MB in size

【JP-CORE】 自己負担率を表すコード　"copaypct"

A representation of the meaning of the code in the system, following the rules of the system.

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

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.

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.

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.

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.

Very often the text is the same as a displayName of one of the codings.

自己負担割合

Needed to identify the amount for the patient associated with the category.

カテゴリーに関連する患者の支払い金額を特定する必要がありました。

The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.

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

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.

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.

• value @ url

自己負担割合を%で指定する。

Precision is handled implicitly in almost all cases of measurement.

The implicit precision in the value should always be honored. Monetary values have their own rules for handling precision (refer to standard accounting text books).

Not allowed to be used in this context

Need a framework for handling measures where the value is <5ug/L or >400mg/L due to the limitations of measuring methodology.

人が解釈可能な単位文字列。固定値

There are many representations for units of measure and in many contexts, particular representations are fixed and required. I.e. mcg for micrograms.

UCUMを識別するURI。

Need to know the system that defines the coded form of the unit.

固定値

Need a computable form of the unit that is fixed across all forms. UCUM provides this for quantities, but SNOMED CT provides many units of interest.

The preferred system is UCUM, but SNOMED CT can also be used (for customary units) or ISO 4217 for currency. The context of use may additionally require a code from a particular system.

A suite of codes indicating exceptions or reductions to patient costs and their effective periods.

患者費用の例外または削減を示すコードとその有効期間を示すコード群。

Required by providers to manage financial transaction with the patient.

事業者が患者との金銭的な取引を管理するために必要となる。

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

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.

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.

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).

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.

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.

The code for the specific exception.

特定の例外のコード。

Needed to identify the exception associated with the amount for the patient.

患者の金額に関連する例外を特定する必要があった。

The timeframe during when the exception is in force.

例外が発生している間の時間枠。

Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs.

患者の費用を正しく計算するための例外の適用時期を特定する必要があった。

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、保険者に費用回収のための詳細を提供するために含まれている。 (subrogation=代位、subrogation payment=代位納付)

See definition for when to be used.

使用時期については定義を参照してください。

Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims.

一般的に、自動車保険や労災保険では、医療費支払い者が事故請求に対して回収できるように、subrogation＝true というフラグが立てられている。

The policy(s) which constitute this insurance coverage.

この保険の適用範囲を構成するポリシー。

To reference the legally binding contract between the policy holder and the insurer.

契約者と保険者との間の法的拘束力のある契約を参照するため。

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (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.

参照は、実際のFHIRリソースへの参照である必要があり、解決可能（内容に到達可能）である必要がある（アクセス制御、一時的な使用不可などを考慮に入れる）。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。