Nictiz FHIR NL STU3 Zib2017
1.3.15 - CI Build

Nictiz FHIR NL STU3 Zib2017 - Local Development build (v1.3.15) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: HCIM Payer

Official URL: http://nictiz.nl/fhir/StructureDefinition/zib-Payer Version: 1.3.15
Active as of 2024-04-09 Computable Name: Zib Payer

Copyright/Legal: CC0

Payer as defined by the Dutch Health and Care Information models (Dutch: Zorginformatiebouwsteen or ZIB) version 3.1, release 2017.

Recording the information of the paying authorities and people serves to simplify payment of the fees for the supplied care and to provide insight in advance on how these fees are to be paid, especially when it comes to non-insured healthcare.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Coverage
... type 0..1 CodeableConcept InsuranceType
Binding: VerzekeringssoortCodelijst (extensible): InsuranceTypeCodelist

... policyHolder 0..1 Reference(nl-core-patient | nl-core-relatedperson | nl-core-organization) Owner of the policy
... subscriber 0..1 Reference(nl-core-patient | nl-core-relatedperson) Subscriber to the policy
... beneficiary 0..1 Reference(nl-core-patient) Plan Beneficiary
... period 0..1 Period Coverage start and end dates
.... start 0..1 dateTime StartDateTime
.... end 1..1 dateTime EndDateTime
... payor 1..* Reference(nl-core-organization | nl-core-patient | nl-core-relatedperson) InsuranceCompany / PayerPerson
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bankInformation 0..* (Complex) BankInformation
URL: http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation
..... extension:BankName 0..1 Extension BankName
..... extension:AccountNumber 1..1 Extension AccountNumber
..... extension:Bankcode 0..1 Extension Bankcode

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Coverage.typeextensibleVerzekeringssoortCodelijst
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.1.1.1--20171231000000
from this IG
NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Coverage
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 0..1 code active | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.

... policyHolder Σ 0..1 Reference(nl-core-patient | nl-core-relatedperson | nl-core-organization) Owner of the policy
... subscriber Σ 0..1 Reference(nl-core-patient | nl-core-relatedperson) Subscriber to the policy
... subscriberId Σ 0..1 string InsurantNumber
... beneficiary Σ 0..1 Reference(nl-core-patient) Plan Beneficiary
... period Σ 0..1 Period Coverage start and end dates
.... start ΣC 0..1 dateTime StartDateTime
.... end ΣC 1..1 dateTime EndDateTime
... payor Σ 1..* Reference(nl-core-organization | nl-core-patient | nl-core-relatedperson) InsuranceCompany / PayerPerson
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bankInformation 0..* (Complex) BankInformation
URL: http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:BankName 0..1 Extension BankName
...... url 1..1 uri "BankName"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string BankName
..... extension:AccountNumber 1..1 Extension AccountNumber
...... url 1..1 uri "AccountNumber"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string AccountNumber
..... extension:Bankcode 0..1 Extension Bankcode
...... url 1..1 uri "Bankcode"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string Bankcode
..... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation"

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Coverage.statusrequiredFinancial Resource Status Codes
http://hl7.org/fhir/ValueSet/fm-status
from the FHIR Standard
Coverage.typeextensibleVerzekeringssoortCodelijst
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.1.1.1--20171231000000
from this IG

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorCoverageIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorCoverageIf 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()
NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Coverage
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional Content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier The primary coverage ID
... status ?!Σ 0..1 code active | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.

... type Σ 0..1 CodeableConcept InsuranceType
Binding: VerzekeringssoortCodelijst (extensible): InsuranceTypeCodelist

... policyHolder Σ 0..1 Reference(nl-core-patient | nl-core-relatedperson | nl-core-organization) Owner of the policy
... subscriber Σ 0..1 Reference(nl-core-patient | nl-core-relatedperson) Subscriber to the policy
... subscriberId Σ 0..1 string InsurantNumber
... beneficiary Σ 0..1 Reference(nl-core-patient) Plan Beneficiary
... relationship 0..1 CodeableConcept Beneficiary relationship to the Subscriber
Binding: Policyholder Relationship Codes (example): The relationship between the Policyholder and the Beneficiary (insured/covered party/patient).

... period Σ 0..1 Period Coverage start and end dates
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
.... start ΣC 0..1 dateTime StartDateTime
.... end ΣC 1..1 dateTime EndDateTime
... payor Σ 1..* Reference(nl-core-organization | nl-core-patient | nl-core-relatedperson) InsuranceCompany / PayerPerson
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bankInformation 0..* (Complex) BankInformation
URL: http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation
..... id 0..1 string xml:id (or equivalent in JSON)
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:BankName 0..1 Extension BankName
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... url 1..1 uri "BankName"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string BankName
..... extension:AccountNumber 1..1 Extension AccountNumber
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... url 1..1 uri "AccountNumber"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string AccountNumber
..... extension:Bankcode 0..1 Extension Bankcode
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... url 1..1 uri "Bankcode"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string Bankcode
..... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation"
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... grouping 0..1 BackboneElement Additional coverage classifications
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... group Σ 0..1 string An identifier for the group
.... groupDisplay Σ 0..1 string Display text for an identifier for the group
.... subGroup Σ 0..1 string An identifier for the subsection of the group
.... subGroupDisplay Σ 0..1 string Display text for the subsection of the group
.... plan Σ 0..1 string An identifier for the plan
.... planDisplay Σ 0..1 string Display text for the plan
.... subPlan Σ 0..1 string An identifier for the subsection of the plan
.... subPlanDisplay Σ 0..1 string Display text for the subsection of the plan
.... class Σ 0..1 string An identifier for the class
.... classDisplay Σ 0..1 string Display text for the class
.... subClass Σ 0..1 string An identifier for the subsection of the class
.... subClassDisplay Σ 0..1 string Display text for the subsection of the subclass
... dependent Σ 0..1 string Dependent number
... sequence Σ 0..1 string The plan instance or sequence counter
... order Σ 0..1 positiveInt Relative order of the coverage
... network Σ 0..1 string Insurer network
... contract 0..* Reference(Contract) Contract details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Coverage.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Coverage.statusrequiredFinancial Resource Status Codes
http://hl7.org/fhir/ValueSet/fm-status
from the FHIR Standard
Coverage.typeextensibleVerzekeringssoortCodelijst
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.1.1.1--20171231000000
from this IG
Coverage.relationshipexamplePolicyholder Relationship Codes
http://hl7.org/fhir/ValueSet/policyholder-relationship
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorCoverageIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorCoverageIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())

Differential View

This structure is derived from Coverage

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Coverage
... type 0..1 CodeableConcept InsuranceType
Binding: VerzekeringssoortCodelijst (extensible): InsuranceTypeCodelist

... policyHolder 0..1 Reference(nl-core-patient | nl-core-relatedperson | nl-core-organization) Owner of the policy
... subscriber 0..1 Reference(nl-core-patient | nl-core-relatedperson) Subscriber to the policy
... beneficiary 0..1 Reference(nl-core-patient) Plan Beneficiary
... period 0..1 Period Coverage start and end dates
.... start 0..1 dateTime StartDateTime
.... end 1..1 dateTime EndDateTime
... payor 1..* Reference(nl-core-organization | nl-core-patient | nl-core-relatedperson) InsuranceCompany / PayerPerson
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bankInformation 0..* (Complex) BankInformation
URL: http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation
..... extension:BankName 0..1 Extension BankName
..... extension:AccountNumber 1..1 Extension AccountNumber
..... extension:Bankcode 0..1 Extension Bankcode

doco Documentation for this format

Terminology Bindings (Differential)

PathConformanceValueSetURI
Coverage.typeextensibleVerzekeringssoortCodelijst
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.1.1.1--20171231000000
from this IG

Key Elements View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Coverage
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 0..1 code active | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.

... policyHolder Σ 0..1 Reference(nl-core-patient | nl-core-relatedperson | nl-core-organization) Owner of the policy
... subscriber Σ 0..1 Reference(nl-core-patient | nl-core-relatedperson) Subscriber to the policy
... subscriberId Σ 0..1 string InsurantNumber
... beneficiary Σ 0..1 Reference(nl-core-patient) Plan Beneficiary
... period Σ 0..1 Period Coverage start and end dates
.... start ΣC 0..1 dateTime StartDateTime
.... end ΣC 1..1 dateTime EndDateTime
... payor Σ 1..* Reference(nl-core-organization | nl-core-patient | nl-core-relatedperson) InsuranceCompany / PayerPerson
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bankInformation 0..* (Complex) BankInformation
URL: http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:BankName 0..1 Extension BankName
...... url 1..1 uri "BankName"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string BankName
..... extension:AccountNumber 1..1 Extension AccountNumber
...... url 1..1 uri "AccountNumber"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string AccountNumber
..... extension:Bankcode 0..1 Extension Bankcode
...... url 1..1 uri "Bankcode"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string Bankcode
..... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation"

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Coverage.statusrequiredFinancial Resource Status Codes
http://hl7.org/fhir/ValueSet/fm-status
from the FHIR Standard
Coverage.typeextensibleVerzekeringssoortCodelijst
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.1.1.1--20171231000000
from this IG

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorCoverageIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorCoverageIf 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()

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Coverage 0..* Coverage Coverage
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... text 0..1 Narrative Text summary of the resource, for human interpretation
... contained 0..* Resource Contained, inline Resources
... extension 0..* Extension Additional Content defined by implementations
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier Σ 0..* Identifier The primary coverage ID
... status ?!Σ 0..1 code active | cancelled | draft | entered-in-error
Binding: Financial Resource Status Codes (required): A code specifying the state of the resource instance.

... type Σ 0..1 CodeableConcept InsuranceType
Binding: VerzekeringssoortCodelijst (extensible): InsuranceTypeCodelist

... policyHolder Σ 0..1 Reference(nl-core-patient | nl-core-relatedperson | nl-core-organization) Owner of the policy
... subscriber Σ 0..1 Reference(nl-core-patient | nl-core-relatedperson) Subscriber to the policy
... subscriberId Σ 0..1 string InsurantNumber
... beneficiary Σ 0..1 Reference(nl-core-patient) Plan Beneficiary
... relationship 0..1 CodeableConcept Beneficiary relationship to the Subscriber
Binding: Policyholder Relationship Codes (example): The relationship between the Policyholder and the Beneficiary (insured/covered party/patient).

... period Σ 0..1 Period Coverage start and end dates
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
.... start ΣC 0..1 dateTime StartDateTime
.... end ΣC 1..1 dateTime EndDateTime
... payor Σ 1..* Reference(nl-core-organization | nl-core-patient | nl-core-relatedperson) InsuranceCompany / PayerPerson
.... id 0..1 string xml:id (or equivalent in JSON)
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... bankInformation 0..* (Complex) BankInformation
URL: http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation
..... id 0..1 string xml:id (or equivalent in JSON)
..... Slices for extension 1..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:BankName 0..1 Extension BankName
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... url 1..1 uri "BankName"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string BankName
..... extension:AccountNumber 1..1 Extension AccountNumber
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... url 1..1 uri "AccountNumber"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string AccountNumber
..... extension:Bankcode 0..1 Extension Bankcode
...... id 0..1 string xml:id (or equivalent in JSON)
...... extension 0..* Extension Additional Content defined by implementations
Slice: Unordered, Open by value:url
...... url 1..1 uri "Bankcode"
...... Slices for value[x] 0..1 string Value of extension
Slice: Unordered, Closed by type:$this
....... value[x]:valueString 0..1 string Bankcode
..... url 1..1 uri "http://nictiz.nl/fhir/StructureDefinition/zib-Payer-BankInformation"
.... reference ΣC 0..1 string Literal reference, Relative, internal or absolute URL
.... identifier Σ 0..1 Identifier Logical reference, when literal reference is not known
.... display Σ 0..1 string Text alternative for the resource
... grouping 0..1 BackboneElement Additional coverage classifications
.... id 0..1 string xml:id (or equivalent in JSON)
.... extension 0..* Extension Additional Content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
.... group Σ 0..1 string An identifier for the group
.... groupDisplay Σ 0..1 string Display text for an identifier for the group
.... subGroup Σ 0..1 string An identifier for the subsection of the group
.... subGroupDisplay Σ 0..1 string Display text for the subsection of the group
.... plan Σ 0..1 string An identifier for the plan
.... planDisplay Σ 0..1 string Display text for the plan
.... subPlan Σ 0..1 string An identifier for the subsection of the plan
.... subPlanDisplay Σ 0..1 string Display text for the subsection of the plan
.... class Σ 0..1 string An identifier for the class
.... classDisplay Σ 0..1 string Display text for the class
.... subClass Σ 0..1 string An identifier for the subsection of the class
.... subClassDisplay Σ 0..1 string Display text for the subsection of the subclass
... dependent Σ 0..1 string Dependent number
... sequence Σ 0..1 string The plan instance or sequence counter
... order Σ 0..1 positiveInt Relative order of the coverage
... network Σ 0..1 string Insurer network
... contract 0..* Reference(Contract) Contract details

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Coverage.languageextensibleCommon Languages
Additional Bindings Purpose
AllLanguages Max Binding
http://hl7.org/fhir/ValueSet/languages
from the FHIR Standard
Coverage.statusrequiredFinancial Resource Status Codes
http://hl7.org/fhir/ValueSet/fm-status
from the FHIR Standard
Coverage.typeextensibleVerzekeringssoortCodelijst
http://decor.nictiz.nl/fhir/ValueSet/2.16.840.1.113883.2.4.3.11.60.40.2.1.1.1--20171231000000
from this IG
Coverage.relationshipexamplePolicyholder Relationship Codes
http://hl7.org/fhir/ValueSet/policyholder-relationship
from the FHIR Standard

Constraints

IdGradePath(s)DetailsRequirements
dom-1errorCoverageIf the resource is contained in another resource, it SHALL NOT contain any narrative
: contained.text.empty()
dom-2errorCoverageIf the resource is contained in another resource, it SHALL NOT contain nested Resources
: contained.contained.empty()
dom-3errorCoverageIf the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
: contained.where(('#'+id in %resource.descendants().reference).not()).empty()
dom-4errorCoverageIf 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()
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() | (children().count() > id.count())

 

Other representations of profile: CSV, Excel, Schematron