coverages

Create Coverage

post
/organizations/{organizationId}/fhir/4/Coverage

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

Request

Headers

content-type*stringapplication/json|application/json+fhirapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug

Body

resourceType*This is a Coverage resource
ididThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
metaMetaThe 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.
implicitRulesuriA 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.
languagecodeThe base language in which the resource is written.
textNarrativeA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
containedarray(ResourceList)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.
extensionarray(Extension)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.
modifierExtensionarray(Extension)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).
identifierarray(Identifier)A unique identifier assigned to this coverage.
statuscodeThe status of the resource instance.
typeCodeableConceptThe type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
policyHolderReferenceThe party who 'owns' the insurance policy.
subscriberReferenceThe 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.
subscriberIdstringThe insurer assigned ID for the Subscriber.
beneficiary*ReferenceThe party who benefits from the insurance coverage; the patient when products and/or services are provided.
dependentstringA unique identifier for a dependent under the coverage.
relationshipCodeableConceptThe relationship of beneficiary (patient) to the subscriber.
periodPeriodTime period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
payor*array(Reference)The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.
classarray(Coverage_Class)A suite of underwriter specific classifiers.
orderpositiveIntThe 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.
networkstringThe 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.
costToBeneficiaryarray(Coverage_CostToBeneficiary)A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
subrogationbooleanWhen 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
contractarray(Reference)The policy(s) which constitute this insurance coverage.

Response

Patch Coverage

patch
/organizations/{organizationId}/fhir/4/Coverage/{resourceId}

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

Request

Headers

content-type*stringapplication/json-patch+jsonapplication/json-patch+json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*

Body

resourceType*This is a Coverage resource
ididThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
metaMetaThe 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.
implicitRulesuriA 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.
languagecodeThe base language in which the resource is written.
textNarrativeA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
containedarray(ResourceList)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.
extensionarray(Extension)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.
modifierExtensionarray(Extension)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).
identifierarray(Identifier)A unique identifier assigned to this coverage.
statuscodeThe status of the resource instance.
typeCodeableConceptThe type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
policyHolderReferenceThe party who 'owns' the insurance policy.
subscriberReferenceThe 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.
subscriberIdstringThe insurer assigned ID for the Subscriber.
beneficiary*ReferenceThe party who benefits from the insurance coverage; the patient when products and/or services are provided.
dependentstringA unique identifier for a dependent under the coverage.
relationshipCodeableConceptThe relationship of beneficiary (patient) to the subscriber.
periodPeriodTime period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
payor*array(Reference)The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.
classarray(Coverage_Class)A suite of underwriter specific classifiers.
orderpositiveIntThe 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.
networkstringThe 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.
costToBeneficiaryarray(Coverage_CostToBeneficiary)A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
subrogationbooleanWhen 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
contractarray(Reference)The policy(s) which constitute this insurance coverage.

Response

Read Coverage

get
/organizations/{organizationId}/fhir/4/Coverage/{resourceId}

Request

Headers

content-type*stringapplication/json|application/json+fhirapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*

Response

Read History Coverage

get
/organizations/{organizationId}/fhir/4/Coverage/{resourceId}/_history

Request

Headers

content-type*stringapplication/json|application/json+fhirapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Query params

_countstring
_sincestring

Params

organizationId*string|stringid|slug
resourceId*

Response

Read Version Coverage

get
/organizations/{organizationId}/fhir/4/Coverage/{resourceId}/_history/{versionId}

Request

Headers

content-type*stringapplication/json|application/json+fhirapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*
versionId*

Response

Remove Coverage

delete
/organizations/{organizationId}/fhir/4/Coverage/{resourceId}

Request

Headers

content-type*stringapplication/json|application/json+fhirapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*

Response

Search Get Coverage

get
/organizations/{organizationId}/fhir/4/Coverage

Request

Headers

content-type*stringapplication/json|application/json+fhirapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Query params

_idstring
_languagestring
beneficiarystring
class-typestring
class-valuestring
dependentstring
identifierstring
patientstring
payorstring
policy-holderstring
statusstring
subscriberstring
typestring

Params

organizationId*string|stringid|slug

Response

Search History Coverage

get
/organizations/{organizationId}/fhir/4/Coverage/_history

Request

Headers

content-type*stringapplication/json|application/json+fhirapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Query params

_countstring
_sincestring

Params

organizationId*string|stringid|slug

Response

Search Post Coverage

post
/organizations/{organizationId}/fhir/4/Coverage/_search

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

Request

Headers

content-type*stringapplication/json|application/x-www-form-urlencodedapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Query params

_idstring
_languagestring
beneficiarystring
class-typestring
class-valuestring
dependentstring
identifierstring
patientstring
payorstring
policy-holderstring
statusstring
subscriberstring
typestring

Params

organizationId*string|stringid|slug

Body

resourceType*This is a Coverage resource
ididThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
metaMetaThe 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.
implicitRulesuriA 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.
languagecodeThe base language in which the resource is written.
textNarrativeA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
containedarray(ResourceList)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.
extensionarray(Extension)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.
modifierExtensionarray(Extension)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).
identifierarray(Identifier)A unique identifier assigned to this coverage.
statuscodeThe status of the resource instance.
typeCodeableConceptThe type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
policyHolderReferenceThe party who 'owns' the insurance policy.
subscriberReferenceThe 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.
subscriberIdstringThe insurer assigned ID for the Subscriber.
beneficiary*ReferenceThe party who benefits from the insurance coverage; the patient when products and/or services are provided.
dependentstringA unique identifier for a dependent under the coverage.
relationshipCodeableConceptThe relationship of beneficiary (patient) to the subscriber.
periodPeriodTime period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
payor*array(Reference)The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.
classarray(Coverage_Class)A suite of underwriter specific classifiers.
orderpositiveIntThe 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.
networkstringThe 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.
costToBeneficiaryarray(Coverage_CostToBeneficiary)A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
subrogationbooleanWhen 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
contractarray(Reference)The policy(s) which constitute this insurance coverage.

Response

Update Coverage

put
/organizations/{organizationId}/fhir/4/Coverage/{resourceId}

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

Request

Headers

content-type*stringapplication/json|application/json+fhirapplication/json
log-cdatastring
log-cdata-formatstringkv|jsonkv
AuthorizationstringBearer <token>

Params

organizationId*string|stringid|slug
resourceId*

Body

resourceType*This is a Coverage resource
ididThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
metaMetaThe 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.
implicitRulesuriA 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.
languagecodeThe base language in which the resource is written.
textNarrativeA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
containedarray(ResourceList)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.
extensionarray(Extension)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.
modifierExtensionarray(Extension)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).
identifierarray(Identifier)A unique identifier assigned to this coverage.
statuscodeThe status of the resource instance.
typeCodeableConceptThe type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.
policyHolderReferenceThe party who 'owns' the insurance policy.
subscriberReferenceThe 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.
subscriberIdstringThe insurer assigned ID for the Subscriber.
beneficiary*ReferenceThe party who benefits from the insurance coverage; the patient when products and/or services are provided.
dependentstringA unique identifier for a dependent under the coverage.
relationshipCodeableConceptThe relationship of beneficiary (patient) to the subscriber.
periodPeriodTime period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
payor*array(Reference)The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements.
classarray(Coverage_Class)A suite of underwriter specific classifiers.
orderpositiveIntThe 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.
networkstringThe 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.
costToBeneficiaryarray(Coverage_CostToBeneficiary)A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.
subrogationbooleanWhen 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.
contractarray(Reference)The policy(s) which constitute this insurance coverage.

Response