Guía de Implmentación FHIR ADRES (Core) - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Resource Profile: Cobertura de Salud (Coverage) ADRES

Perfil FHIR para la representación estandarizada de la información de cobertura (Plan Obligatorio de Salud) de las personas que desempeñan el rol de pacientes en el contexto de las siguientes bases de datos administradas por la Administradora de los Recursos del Sistema General de Seguridad Social en Salud (ADRES):

• Base de Datos Única de Afiliados (BDUA)
• Base de Datos de los Regímenes de Excepción y Especial (BDEX).
• Base de Datos de los Planes Voluntarios de Salud (PVS).
• Base de Datos del Instituto Nacional Penitenciario y Carcelario (BDINPEC).

Incluye los datos de cobertura de salud de los pacientes, como el tipo de cobertura, el estado de la cobertura, el período de cobertura, la clase de régimen y tipo de afiliado, así como referencias a los recursos relacionados, como el paciente y la organización administradora del plan de beneficios.

Usages:

• Examples for this Profile: Coverage/CoverageADRES-ejemplo-3e1cd8b0-1, Coverage/CoverageADRES-ejemplo-3e1cd8b0-2, Coverage/CoverageADRES-ejemplo-6d9f20d5-1, Coverage/CoverageADRES-ejemplo-6d9f20d5-2... Show 4 more, Coverage/CoverageADRES-ejemplo-a45f98f4-1, Coverage/CoverageADRES-ejemplo-a45f98f4-2, Coverage/CoverageADRES-ejemplo-d82c245c-1 and Coverage/CoverageADRES-ejemplo-d82c245c-2

Formal Views of Profile Content

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

• Key Elements Table
• Differential Table
• Snapshot Table
• Statistics/References
• All

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
status	?!SΣ	1..1	code	active | cancelled Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Tipo de cobertura de salud del paciente en el sistema de salud colombiano Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageTypeAndSelf-PayCodes (required)
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-ActCode
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: MANDPOL
display	Σ	1..1	string	Representation defined by the system Required Pattern: mandatory health program
text	Σ	1..1	string	Plain text representation of the concept Fixed Value: Plan Obligatorio de Salud
subscriber	Σ	1..1	Reference(Paciente (Patient) ADRES)	Cotizante
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
subscriberId	SΣ	1..1	string	Tipo y número de documento de identificación del cotizante
beneficiary	Σ	1..1	Reference(Paciente (Patient) ADRES)	Plan beneficiary
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
period	Σ	1..1	Period	Fecha de inicio y fin de la cobertura de salud del paciente en el sistema de salud colombiano
start	SΣC	1..1	dateTime	Fecha de inicio de la cobertura de salud del paciente en el sistema de salud colombiano
end	SΣC	0..1	dateTime	Fecha de fin de la cobertura de salud del paciente en el sistema de salud colombiano
payor	Σ	1..1	Reference(Entidad Administradora de Planes de Beneficios en Salud - EAPBS (Organization))	Organización administradora del plan de beneficios
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for class		2..2	BackboneElement	Clase de régimen y tipo de afiliado del paciente en el sistema de salud colombiano Slice: Unordered, Closed by value:id
class:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type
class:Regimen		1..1	BackboneElement	Clase de régimen del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: Regimen
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: group
display	Σ	1..1	string	Representation defined by the system Required Pattern: Group
value	SΣC	1..1	string	Contributivo | Subsidiado Constraints: Cov-inv-0
class:TipoAfiliado		1..1	BackboneElement	Clase de tipo de afiliado del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: TipoAfiliado
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: class
display	Σ	1..1	string	Representation defined by the system Required Pattern: Class
value	SΣC	1..1	string	Cotizante | Beneficiario | Adicional Constraints: Cov-inv-1
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 From the FHIR Standard
Coverage.type	preferred	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.type.coding	required	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:Regimen.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:Regimen.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
Cov-inv-0	error	Coverage.class:Regimen.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem SGDRegimenNum : value in ('Contributivo' | 'Subsidiado' | 'Excepción' | 'Especial')
Cov-inv-1	error	Coverage.class:TipoAfiliado.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem RIBATipoAfiliado : class.where(type.coding.code = 'Regimen').value in ('Cotizante' | 'Beneficiario' | 'Adicional')
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Coverage	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	error	Coverage	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	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Coverage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
meta
profile		1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to Fixed Value: https://fhir.adres.gov.co/core/StructureDefinition/CoverageADRES
extension		0..0
modifierExtension		0..0
identifier		0..0
status	S	1..1	code	active | cancelled
type		1..1	CodeableConcept	Tipo de cobertura de salud del paciente en el sistema de salud colombiano
coding		1..1	Coding	Code defined by a terminology system Binding: CoverageTypeAndSelf-PayCodes (required)
system		1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-ActCode
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MANDPOL
display		1..1	string	Representation defined by the system Required Pattern: mandatory health program
text		1..1	string	Plain text representation of the concept Fixed Value: Plan Obligatorio de Salud
policyHolder		0..0
subscriber		1..1	Reference(Paciente (Patient) ADRES)	Cotizante
extension		0..0
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
type		0..0
display		0..0
subscriberId	S	1..1	string	Tipo y número de documento de identificación del cotizante
beneficiary		1..1	Reference(Paciente (Patient) ADRES)	Plan beneficiary
extension		0..0
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
type		0..0
identifier		0..0
display		0..0
dependent		0..0
relationship		0..0
period		1..1	Period	Fecha de inicio y fin de la cobertura de salud del paciente en el sistema de salud colombiano
start	S	1..1	dateTime	Fecha de inicio de la cobertura de salud del paciente en el sistema de salud colombiano
end	S	0..1	dateTime	Fecha de fin de la cobertura de salud del paciente en el sistema de salud colombiano
payor		1..1	Reference(Entidad Administradora de Planes de Beneficios en Salud - EAPBS (Organization))	Organización administradora del plan de beneficios
extension		0..0
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
type		0..0
identifier		0..0
display		0..0
Slices for class		2..2	BackboneElement	Clase de régimen y tipo de afiliado del paciente en el sistema de salud colombiano Slice: Unordered, Closed by value:id
class:All Slices				Content/Rules for all slices
extension		0..0
class:Regimen		1..1	BackboneElement	Clase de régimen del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: Regimen
extension		0..0
type
coding		1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
system		1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
code		1..1	code	Symbol in syntax defined by the system Fixed Value: group
display		1..1	string	Representation defined by the system Required Pattern: Group
value	SC	1..1	string	Contributivo | Subsidiado Constraints: Cov-inv-0
class:TipoAfiliado		1..1	BackboneElement	Clase de tipo de afiliado del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: TipoAfiliado
extension		0..0
type
coding		1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
system		1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
code		1..1	code	Symbol in syntax defined by the system Fixed Value: class
display		1..1	string	Representation defined by the system Required Pattern: Class
value	SC	1..1	string	Cotizante | Beneficiario | Adicional Constraints: Cov-inv-1
order		0..0
network		0..0
costToBeneficiary		0..0
subrogation		0..0
contract		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Coverage.type.coding	required	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.class:Regimen.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
Cov-inv-0	error	Coverage.class:Regimen.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem SGDRegimenNum : value in ('Contributivo' | 'Subsidiado' | 'Excepción' | 'Especial')
Cov-inv-1	error	Coverage.class:TipoAfiliado.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem RIBATipoAfiliado : class.where(type.coding.code = 'Regimen').value in ('Cotizante' | 'Beneficiario' | 'Adicional')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to Fixed Value: https://fhir.adres.gov.co/core/StructureDefinition/CoverageADRES
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
status	?!SΣ	1..1	code	active | cancelled Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Tipo de cobertura de salud del paciente en el sistema de salud colombiano Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageTypeAndSelf-PayCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-ActCode
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: MANDPOL
display	Σ	1..1	string	Representation defined by the system Required Pattern: mandatory health program
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	1..1	string	Plain text representation of the concept Fixed Value: Plan Obligatorio de Salud
subscriber	Σ	1..1	Reference(Paciente (Patient) ADRES)	Cotizante
id		0..1	string	Unique id for inter-element referencing
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
subscriberId	SΣ	1..1	string	Tipo y número de documento de identificación del cotizante
beneficiary	Σ	1..1	Reference(Paciente (Patient) ADRES)	Plan beneficiary
id		0..1	string	Unique id for inter-element referencing
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
period	Σ	1..1	Period	Fecha de inicio y fin de la cobertura de salud del paciente en el sistema de salud colombiano
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Fecha de inicio de la cobertura de salud del paciente en el sistema de salud colombiano
end	SΣC	0..1	dateTime	Fecha de fin de la cobertura de salud del paciente en el sistema de salud colombiano
payor	Σ	1..1	Reference(Entidad Administradora de Planes de Beneficios en Salud - EAPBS (Organization))	Organización administradora del plan de beneficios
id		0..1	string	Unique id for inter-element referencing
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for class		2..2	BackboneElement	Clase de régimen y tipo de afiliado del paciente en el sistema de salud colombiano Slice: Unordered, Closed by value:id
class:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value
class:Regimen		1..1	BackboneElement	Clase de régimen del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: Regimen
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: group
display	Σ	1..1	string	Representation defined by the system Required Pattern: Group
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value	SΣC	1..1	string	Contributivo | Subsidiado Constraints: Cov-inv-0
name	Σ	0..1	string	Human readable description of the type and value
class:TipoAfiliado		1..1	BackboneElement	Clase de tipo de afiliado del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: TipoAfiliado
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: class
display	Σ	1..1	string	Representation defined by the system Required Pattern: Class
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value	SΣC	1..1	string	Cotizante | Beneficiario | Adicional Constraints: Cov-inv-1
name	Σ	0..1	string	Human readable description of the type and value
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Coverage.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
Coverage.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags From the FHIR Standard
Coverage.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 From the FHIR Standard
Coverage.type	preferred	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.type.coding	required	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:Regimen.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:Regimen.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.costToBeneficiary.type	extensible	CoverageCopayTypeCodes http://hl7.org/fhir/ValueSet/coverage-copay-type From the FHIR Standard
Coverage.costToBeneficiary.exception.type	example	ExampleCoverageFinancialExceptionCodes http://hl7.org/fhir/ValueSet/coverage-financial-exception From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
Cov-inv-0	error	Coverage.class:Regimen.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem SGDRegimenNum : value in ('Contributivo' | 'Subsidiado' | 'Excepción' | 'Especial')
Cov-inv-1	error	Coverage.class:TipoAfiliado.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem RIBATipoAfiliado : class.where(type.coding.code = 'Regimen').value in ('Cotizante' | 'Beneficiario' | 'Adicional')
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Coverage	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	error	Coverage	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	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Coverage

Summary

Mandatory: 25 elements(1 nested mandatory element)
Must-Support: 9 elements
Fixed: 5 elements
Prohibited: 25 elements

Structures

This structure refers to these other structures:

• Paciente (Patient) ADRES (https://fhir.adres.gov.co/core/StructureDefinition/PatientADRES)
• Entidad Administradora de Planes de Beneficios en Salud - EAPBS (Organization) (https://fhir.adres.gov.co/core/StructureDefinition/HealthBenefitPlanAdminOrganizationADRES)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.class (Closed)

Key Elements View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
status	?!SΣ	1..1	code	active | cancelled Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Tipo de cobertura de salud del paciente en el sistema de salud colombiano Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageTypeAndSelf-PayCodes (required)
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-ActCode
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: MANDPOL
display	Σ	1..1	string	Representation defined by the system Required Pattern: mandatory health program
text	Σ	1..1	string	Plain text representation of the concept Fixed Value: Plan Obligatorio de Salud
subscriber	Σ	1..1	Reference(Paciente (Patient) ADRES)	Cotizante
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
subscriberId	SΣ	1..1	string	Tipo y número de documento de identificación del cotizante
beneficiary	Σ	1..1	Reference(Paciente (Patient) ADRES)	Plan beneficiary
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
period	Σ	1..1	Period	Fecha de inicio y fin de la cobertura de salud del paciente en el sistema de salud colombiano
start	SΣC	1..1	dateTime	Fecha de inicio de la cobertura de salud del paciente en el sistema de salud colombiano
end	SΣC	0..1	dateTime	Fecha de fin de la cobertura de salud del paciente en el sistema de salud colombiano
payor	Σ	1..1	Reference(Entidad Administradora de Planes de Beneficios en Salud - EAPBS (Organization))	Organización administradora del plan de beneficios
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for class		2..2	BackboneElement	Clase de régimen y tipo de afiliado del paciente en el sistema de salud colombiano Slice: Unordered, Closed by value:id
class:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type
class:Regimen		1..1	BackboneElement	Clase de régimen del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: Regimen
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: group
display	Σ	1..1	string	Representation defined by the system Required Pattern: Group
value	SΣC	1..1	string	Contributivo | Subsidiado Constraints: Cov-inv-0
class:TipoAfiliado		1..1	BackboneElement	Clase de tipo de afiliado del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: TipoAfiliado
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: class
display	Σ	1..1	string	Representation defined by the system Required Pattern: Class
value	SΣC	1..1	string	Cotizante | Beneficiario | Adicional Constraints: Cov-inv-1
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 From the FHIR Standard
Coverage.type	preferred	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.type.coding	required	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:Regimen.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:Regimen.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
Cov-inv-0	error	Coverage.class:Regimen.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem SGDRegimenNum : value in ('Contributivo' | 'Subsidiado' | 'Excepción' | 'Especial')
Cov-inv-1	error	Coverage.class:TipoAfiliado.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem RIBATipoAfiliado : class.where(type.coding.code = 'Regimen').value in ('Cotizante' | 'Beneficiario' | 'Adicional')
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Coverage	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	error	Coverage	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	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from Coverage

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
meta
profile		1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to Fixed Value: https://fhir.adres.gov.co/core/StructureDefinition/CoverageADRES
extension		0..0
modifierExtension		0..0
identifier		0..0
status	S	1..1	code	active | cancelled
type		1..1	CodeableConcept	Tipo de cobertura de salud del paciente en el sistema de salud colombiano
coding		1..1	Coding	Code defined by a terminology system Binding: CoverageTypeAndSelf-PayCodes (required)
system		1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-ActCode
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MANDPOL
display		1..1	string	Representation defined by the system Required Pattern: mandatory health program
text		1..1	string	Plain text representation of the concept Fixed Value: Plan Obligatorio de Salud
policyHolder		0..0
subscriber		1..1	Reference(Paciente (Patient) ADRES)	Cotizante
extension		0..0
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
type		0..0
display		0..0
subscriberId	S	1..1	string	Tipo y número de documento de identificación del cotizante
beneficiary		1..1	Reference(Paciente (Patient) ADRES)	Plan beneficiary
extension		0..0
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
type		0..0
identifier		0..0
display		0..0
dependent		0..0
relationship		0..0
period		1..1	Period	Fecha de inicio y fin de la cobertura de salud del paciente en el sistema de salud colombiano
start	S	1..1	dateTime	Fecha de inicio de la cobertura de salud del paciente en el sistema de salud colombiano
end	S	0..1	dateTime	Fecha de fin de la cobertura de salud del paciente en el sistema de salud colombiano
payor		1..1	Reference(Entidad Administradora de Planes de Beneficios en Salud - EAPBS (Organization))	Organización administradora del plan de beneficios
extension		0..0
reference	S	1..1	string	Literal reference, Relative, internal or absolute URL
type		0..0
identifier		0..0
display		0..0
Slices for class		2..2	BackboneElement	Clase de régimen y tipo de afiliado del paciente en el sistema de salud colombiano Slice: Unordered, Closed by value:id
class:All Slices				Content/Rules for all slices
extension		0..0
class:Regimen		1..1	BackboneElement	Clase de régimen del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: Regimen
extension		0..0
type
coding		1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
system		1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
code		1..1	code	Symbol in syntax defined by the system Fixed Value: group
display		1..1	string	Representation defined by the system Required Pattern: Group
value	SC	1..1	string	Contributivo | Subsidiado Constraints: Cov-inv-0
class:TipoAfiliado		1..1	BackboneElement	Clase de tipo de afiliado del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: TipoAfiliado
extension		0..0
type
coding		1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
system		1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
code		1..1	code	Symbol in syntax defined by the system Fixed Value: class
display		1..1	string	Representation defined by the system Required Pattern: Class
value	SC	1..1	string	Cotizante | Beneficiario | Adicional Constraints: Cov-inv-1
order		0..0
network		0..0
costToBeneficiary		0..0
subrogation		0..0
contract		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Coverage.type.coding	required	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.class:Regimen.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
Cov-inv-0	error	Coverage.class:Regimen.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem SGDRegimenNum : value in ('Contributivo' | 'Subsidiado' | 'Excepción' | 'Especial')
Cov-inv-1	error	Coverage.class:TipoAfiliado.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem RIBATipoAfiliado : class.where(type.coding.code = 'Regimen').value in ('Cotizante' | 'Beneficiario' | 'Adicional')

Snapshot View

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Coverage		0..*	Coverage	Insurance or medical plan or a payment agreement
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	1..*	canonical(StructureDefinition)	Profiles this resource claims to conform to Fixed Value: https://fhir.adres.gov.co/core/StructureDefinition/CoverageADRES
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
status	?!SΣ	1..1	code	active | cancelled Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	1..1	CodeableConcept	Tipo de cobertura de salud del paciente en el sistema de salud colombiano Binding: CoverageTypeAndSelf-PayCodes (preferred): The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageTypeAndSelf-PayCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/v3-ActCode
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: MANDPOL
display	Σ	1..1	string	Representation defined by the system Required Pattern: mandatory health program
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	1..1	string	Plain text representation of the concept Fixed Value: Plan Obligatorio de Salud
subscriber	Σ	1..1	Reference(Paciente (Patient) ADRES)	Cotizante
id		0..1	string	Unique id for inter-element referencing
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
identifier	Σ	0..1	Identifier	Logical reference, when literal reference is not known
subscriberId	SΣ	1..1	string	Tipo y número de documento de identificación del cotizante
beneficiary	Σ	1..1	Reference(Paciente (Patient) ADRES)	Plan beneficiary
id		0..1	string	Unique id for inter-element referencing
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
period	Σ	1..1	Period	Fecha de inicio y fin de la cobertura de salud del paciente en el sistema de salud colombiano
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
start	SΣC	1..1	dateTime	Fecha de inicio de la cobertura de salud del paciente en el sistema de salud colombiano
end	SΣC	0..1	dateTime	Fecha de fin de la cobertura de salud del paciente en el sistema de salud colombiano
payor	Σ	1..1	Reference(Entidad Administradora de Planes de Beneficios en Salud - EAPBS (Organization))	Organización administradora del plan de beneficios
id		0..1	string	Unique id for inter-element referencing
extension		0..0
reference	SΣC	1..1	string	Literal reference, Relative, internal or absolute URL
Slices for class		2..2	BackboneElement	Clase de régimen y tipo de afiliado del paciente en el sistema de salud colombiano Slice: Unordered, Closed by value:id
class:All Slices				Content/Rules for all slices
id		0..1	string	Unique id for inter-element referencing
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
value	Σ	1..1	string	Value associated with the type
name	Σ	0..1	string	Human readable description of the type and value
class:Regimen		1..1	BackboneElement	Clase de régimen del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: Regimen
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: group
display	Σ	1..1	string	Representation defined by the system Required Pattern: Group
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value	SΣC	1..1	string	Contributivo | Subsidiado Constraints: Cov-inv-0
name	Σ	0..1	string	Human readable description of the type and value
class:TipoAfiliado		1..1	BackboneElement	Clase de tipo de afiliado del paciente en el sistema de salud colombiano
id		1..1	string	Unique id for inter-element referencing Required Pattern: TipoAfiliado
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Type of class such as 'group' or 'plan' Binding: CoverageClassCodes (extensible): The policy classifications, eg. Group, Plan, Class, etc.
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
coding	Σ	1..1	Coding	Code defined by a terminology system Binding: CoverageClassCodes (required)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
system	Σ	1..1	uri	Identity of the terminology system Required Pattern: http://terminology.hl7.org/CodeSystem/coverage-class
version	Σ	0..1	string	Version of the system - if relevant
code	Σ	1..1	code	Symbol in syntax defined by the system Fixed Value: class
display	Σ	1..1	string	Representation defined by the system Required Pattern: Class
userSelected	Σ	0..1	boolean	If this coding was chosen directly by the user
text	Σ	0..1	string	Plain text representation of the concept
value	SΣC	1..1	string	Cotizante | Beneficiario | Adicional Constraints: Cov-inv-1
name	Σ	0..1	string	Human readable description of the type and value
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
Coverage.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
Coverage.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags From the FHIR Standard
Coverage.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 From the FHIR Standard
Coverage.type	preferred	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.type.coding	required	CoverageTypeAndSelf-PayCodes http://hl7.org/fhir/ValueSet/coverage-type From the FHIR Standard
Coverage.class.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:Regimen.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:Regimen.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type	extensible	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.class:TipoAfiliado.type.coding	required	CoverageClassCodes http://hl7.org/fhir/ValueSet/coverage-class From the FHIR Standard
Coverage.costToBeneficiary.type	extensible	CoverageCopayTypeCodes http://hl7.org/fhir/ValueSet/coverage-copay-type From the FHIR Standard
Coverage.costToBeneficiary.exception.type	example	ExampleCoverageFinancialExceptionCodes http://hl7.org/fhir/ValueSet/coverage-financial-exception From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
Cov-inv-0	error	Coverage.class:Regimen.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem SGDRegimenNum : value in ('Contributivo' | 'Subsidiado' | 'Excepción' | 'Especial')
Cov-inv-1	error	Coverage.class:TipoAfiliado.value	El valor de Coverage.class[Regimen].value debe corresponder a uno de los valores definidos en CodeSystem.concept.display del CodeSystem RIBATipoAfiliado : class.where(type.coding.code = 'Regimen').value in ('Cotizante' | 'Beneficiario' | 'Adicional')
dom-2	error	Coverage	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Coverage	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	error	Coverage	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	error	Coverage	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Coverage	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from Coverage

Summary

Mandatory: 25 elements(1 nested mandatory element)
Must-Support: 9 elements
Fixed: 5 elements
Prohibited: 25 elements

Structures

This structure refers to these other structures:

• Paciente (Patient) ADRES (https://fhir.adres.gov.co/core/StructureDefinition/PatientADRES)
• Entidad Administradora de Planes de Beneficios en Salud - EAPBS (Organization) (https://fhir.adres.gov.co/core/StructureDefinition/HealthBenefitPlanAdminOrganizationADRES)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.class (Closed)

Other representations of profile: CSV, Excel, Schematron