diff --git a/content/millennium/r4/financial/support/coverage.md b/content/millennium/r4/financial/support/coverage.md index db466e013..3add1b80b 100644 --- a/content/millennium/r4/financial/support/coverage.md +++ b/content/millennium/r4/financial/support/coverage.md @@ -54,6 +54,8 @@ _Implementation Notes_ * Public Healthcare represents an insurance policy funded by a public health system such as a provincial or national health plan. If there are any public coverages, they will return with an id prefixed with 'PH' or 'PHP' and will be returned in the payload with the rest of the coverages (private coverages). +* Search with `_id` is not supported. + ### Authorization Types <%= authorization_types(provider: true, patient: false, system: true) %> @@ -125,6 +127,76 @@ _Implementation Notes_ The common [errors] and [OperationOutcomes] may be returned. +## Retrieve by id + +List an individual Coverage by its id: + + GET /Coverage/:id + +### Authorization Types + +<%= authorization_types(provider: true, patient: false, system: true) %> + +### Headers + +<%= headers fhir_json: true %> + +### Example - Patient-level Private Coverage + +#### Request + + GET https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/12724066-490016987-490016987 + +#### Response + +<%= headers status: 200 %> +<%= json(:r4_coverage_patient_bundle_entry) %> + +<%= disclaimer %> + +### Example - Patient-level Public Coverage + +#### Request + + GET https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PHP-490218084-12724066 + +#### Response + +<%= headers status: 200 %> +<%= json(:r4_coverage_patient_social_healthcare_bundle_entry) %> + +<%= disclaimer %> + +### Example - Encounter-level Private Coverage + +#### Request + + GET https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/97954095-98320174 + +#### Response + +<%= headers status: 200 %> +<%= json(:r4_coverage_encounter_bundle_entry) %> + +<%= disclaimer %> + +### Example - Encounter-level Public Coverage + +#### Request + + GET https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PH-98371617-97701467 + +#### Response + +<%= headers status: 200 %> +<%= json(:r4_coverage_encounter_social_healthcare_bundle_entry) %> + +<%= disclaimer %> + +### Errors + +The common [errors] and [OperationOutcomes] may be returned. + ## Create Create new Patient-level or Encounter-level Coverages. diff --git a/lib/resources/example_json/r4_examples_coverage.rb b/lib/resources/example_json/r4_examples_coverage.rb index 776bf22ac..1c9891f5c 100644 --- a/lib/resources/example_json/r4_examples_coverage.rb +++ b/lib/resources/example_json/r4_examples_coverage.rb @@ -3,6 +3,249 @@ module Cerner module Resources + R4_COVERAGE_PATIENT_BUNDLE_ENTRY ||= { + 'resourceType': 'Coverage', + 'id': '12724066-490016987-490016987', + 'meta': { + 'versionId': '24-24', + 'lastUpdated': '2020-07-06T17:03:43.000Z' + }, + 'text': { + 'status': 'generated', + 'div': '

Coverage

Status: '\ + 'Active

Subscriber: SMART, NANCY

Beneficiary: SMART, NANCY'\ + '

Coverage Start Date: Aug 14, 2015 7:07 P.M. UTC

Payor: '\ + 'SELF PAY

Class: plan: Value: 2800235 Name: Self Pay

' + }, + 'status': 'active', + 'subscriber': { + 'reference': 'Patient/12724066', + 'display': 'SMART, NANCY' + }, + 'beneficiary': { + 'reference': 'Patient/12724066', + 'display': 'SMART, NANCY' + }, + 'relationship': { + 'coding': [ + { + 'system': 'http://terminology.hl7.org/CodeSystem/subscriber-relationship', + 'code': 'self', + 'display': 'Self', + 'userSelected': false + } + ], + 'text': 'Self' + }, + 'period': { + 'start': '2015-08-14T19:07:56.000Z' + }, + 'payor': [ + { + 'reference': 'Organization/589803', + 'display': 'SELF PAY' + } + ], + 'class': [ + { + 'type': { + 'coding': [ + { + 'system': 'http://terminology.hl7.org/CodeSystem/coverage-class', + 'code': 'plan' + } + ] + }, + 'value': '2800235', + 'name': 'Self Pay' + } + ] + } + + R4_COVERAGE_ENCOUNTER_BUNDLE_ENTRY ||= { + 'resourceType': 'Coverage', + 'id': '97954095-98320174', + 'meta': { + 'versionId': '0', + 'lastUpdated': '2020-07-27T21:01:55.000Z' + }, + 'text': { + 'status': 'extensions', + 'div': '

Coverage

Status: Active

'\ + 'Subscriber: SMART, NANCY

Subscriber Id: 12345

Encounter: '\ + '97954095

Beneficiary: SMART, NANCY

Dependent Number: 12345

'\ + 'Coverage Start Date: Feb 2, 2020 6:00 A.M. UTC

Coverage End Date: Feb '\ + '3, 2021 5:59 A.M. UTC

Payor: Aetna

Class: plan: Value: 2830233 Name: '\ + 'Aetna

' + }, + 'extension': [ + { + 'url': 'https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter', + 'valueReference': { + 'reference': 'Encounter/97954095' + } + } + ], + 'status': 'active', + 'subscriber': { + 'reference': 'Patient/12724066', + 'display': 'SMART, NANCY' + }, + 'subscriberId': '12345', + 'beneficiary': { + 'reference': 'Patient/12724066', + 'display': 'SMART, NANCY' + }, + 'dependent': '12345', + 'relationship': { + 'coding': [ + { + 'system': 'http://terminology.hl7.org/CodeSystem/subscriber-relationship', + 'code': 'self', + 'display': 'Self', + 'userSelected': false + } + ], + 'text': 'Self' + }, + 'period': { + 'start': '2020-02-02T06:00:00.000Z', + 'end': '2021-02-03T05:59:59.000Z' + }, + 'payor': [ + { + 'reference': 'Organization/3064032', + 'display': 'Aetna' + } + ], + 'class': [ + { + 'type': { + 'coding': [ + { + 'system': 'http://terminology.hl7.org/CodeSystem/coverage-class', + 'code': 'plan' + } + ] + }, + 'value': '2830233', + 'name': 'Aetna' + } + ] + } + + R4_COVERAGE_ENCOUNTER_SOCIAL_HEALTHCARE_BUNDLE_ENTRY ||= { + 'resourceType': 'Coverage', + 'id': 'PH-98371617-97701467', + 'meta': { + 'versionId': '2-0', + 'lastUpdated': '2020-09-24T17:11:10.000Z' + }, + 'text': { + 'status': 'extensions', + 'div': '

Coverage

Status: Active

'\ + '

Encounter: 97701467

Beneficiary: TRAUMA SURGERY, TESTONE

'\ + '

Coverage Start Date: Jul 1, 2022 5:00 A.M. UTC

Coverage End Date'\ + ': Jul 1, 2025 5:00 A.M. UTC

Payor: Government

Class:

'\ + '
Class
Value: 2572499881
Name: Charging Category
'\ + '

Type: public healthcare

' + }, + 'extension': [ + { + 'valueReference': { + 'reference': 'Encounter/97701467' + }, + 'url': 'https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter' + } + ], + 'status': 'active', + 'type': { + 'coding': [ + { + 'system': 'http://terminology.hl7.org/CodeSystem/v3-ActCode', + 'code': 'PUBLICPOL', + 'display': 'public healthcare' + } + ], + 'text': 'public healthcare' + }, + 'beneficiary': { + 'reference': 'Patient/12462008', + 'display': 'TRAUMA SURGERY, TESTONE' + }, + 'period': { + 'start': '2022-07-01T05:00:00.000Z', + 'end': '2025-07-01T05:00:00.000Z' + }, + 'payor': [ + { + 'display': 'Government' + } + ], + 'class': [ + { + 'type': { + 'coding': [ + { + 'system': 'http://terminology.hl7.org/CodeSystem/coverage-class', + 'code': 'class' + } + ] + }, + 'value': '2572499881', + 'name': 'Charging Category' + } + ] + } + + R4_COVERAGE_PATIENT_SOCIAL_HEALTHCARE_BUNDLE_ENTRY ||= { + 'resourceType': 'Coverage', + 'id': 'PHP-490218084-12724066', + 'meta': { + 'versionId': '134-0', + 'lastUpdated': '2021-03-16T20:04:11.000Z' + }, + 'text': { + 'status': 'generated', + 'div': '

Coverage

Status: Active

'\ + '

Beneficiary: SMART, NANCY

Coverage Start Date: Mar 16, 2021 8:04 P.M. UTC

'\ + '

Payor: Government

Class:

Charging Category
Value:'\ + '2572940471
Name: 10-OPC, Class II

Type: public healthcare

' + }, + 'status': 'active', + 'type': { + 'coding': [ + { + 'system': 'http://terminology.hl7.org/CodeSystem/v3-ActCode', + 'code': 'PUBLICPOL', + 'display': 'public healthcare' + } + ], + 'text': 'public healthcare' + }, + 'beneficiary': { + 'reference': 'Patient/12462008', + 'display': 'TRAUMA SURGERY, TESTONE' + }, + 'period': { + 'start': '2021-03-16T20:04:11.000Z' + }, + 'payor': [ + { + 'display': 'Government' + } + ], + 'class': [ + { + 'type': { + 'text': 'Charging Category' + }, + 'value': '2572940471', + 'name': '10-OPC, Class II' + } + ] + } + R4_COVERAGE_BUNDLE ||= { 'resourceType': 'Bundle', 'id': 'a8876443-c615-4244-9044-047dea2d92dd', @@ -11,71 +254,14 @@ module Resources 'link': [ { 'relation': 'self', - 'url': 'https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?patient=12724066' + 'url': 'https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?patient=12724066' } ], 'entry': [ { - 'fullUrl': 'https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage'\ + 'fullUrl': 'https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage'\ '/12724066-490016987-490016987', - 'resource': { - 'resourceType': 'Coverage', - 'id': '12724066-490016987-490016987', - 'meta': { - 'versionId': '24-24', - 'lastUpdated': '2020-07-06T17:03:43.000Z' - }, - 'text': { - 'status': 'generated', - 'div': '

Coverage

Status: '\ - 'Active

Subscriber: SMART, NANCY

Beneficiary: SMART, NANCY'\ - '

Coverage Start Date: Aug 14, 2015 7:07 P.M. UTC

Payor: '\ - 'SELF PAY

Class: plan: Value: 2800235 Name: Self Pay

' - }, - 'status': 'active', - 'subscriber': { - 'reference': 'Patient/12724066', - 'display': 'SMART, NANCY' - }, - 'beneficiary': { - 'reference': 'Patient/12724066', - 'display': 'SMART, NANCY' - }, - 'relationship': { - 'coding': [ - { - 'system': 'http://terminology.hl7.org/CodeSystem/subscriber-relationship', - 'code': 'self', - 'display': 'Self', - 'userSelected': false - } - ], - 'text': 'Self' - }, - 'period': { - 'start': '2015-08-14T19:07:56.000Z' - }, - 'payor': [ - { - 'reference': 'Organization/589803', - 'display': 'SELF PAY' - } - ], - 'class': [ - { - 'type': { - 'coding': [ - { - 'system': 'http://terminology.hl7.org/CodeSystem/coverage-class', - 'code': 'plan' - } - ] - }, - 'value': '2800235', - 'name': 'Self Pay' - } - ] - } + 'resource': R4_COVERAGE_PATIENT_BUNDLE_ENTRY } ] }.freeze @@ -88,83 +274,13 @@ module Resources 'link': [ { 'relation': 'self', - 'url': 'https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?-encounter=97954095' + 'url': 'https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?-encounter=97954095' } ], 'entry': [ { - 'fullUrl': 'https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/97954095-98320174', - 'resource': { - 'resourceType': 'Coverage', - 'id': '97954095-98320174', - 'meta': { - 'versionId': '0', - 'lastUpdated': '2020-07-27T21:01:55.000Z' - }, - 'text': { - 'status': 'extensions', - 'div': '

Coverage

Status: Active

'\ - 'Subscriber: SMART, NANCY

Subscriber Id: 12345

Encounter: '\ - '97954095

Beneficiary: SMART, NANCY

Dependent Number: 12345

'\ - 'Coverage Start Date: Feb 2, 2020 6:00 A.M. UTC

Coverage End Date: Feb '\ - '3, 2021 5:59 A.M. UTC

Payor: Aetna

Class: plan: Value: 2830233 Name: '\ - 'Aetna

' - }, - 'extension': [ - { - 'url': 'https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter', - 'valueReference': { - 'reference': 'Encounter/97954095' - } - } - ], - 'status': 'active', - 'subscriber': { - 'reference': 'Patient/12724066', - 'display': 'SMART, NANCY' - }, - 'subscriberId': '12345', - 'beneficiary': { - 'reference': 'Patient/12724066', - 'display': 'SMART, NANCY' - }, - 'dependent': '12345', - 'relationship': { - 'coding': [ - { - 'system': 'http://terminology.hl7.org/CodeSystem/subscriber-relationship', - 'code': 'self', - 'display': 'Self', - 'userSelected': false - } - ], - 'text': 'Self' - }, - 'period': { - 'start': '2020-02-02T06:00:00.000Z', - 'end': '2021-02-03T05:59:59.000Z' - }, - 'payor': [ - { - 'reference': 'Organization/3064032', - 'display': 'Aetna' - } - ], - 'class': [ - { - 'type': { - 'coding': [ - { - 'system': 'http://terminology.hl7.org/CodeSystem/coverage-class', - 'code': 'plan' - } - ] - }, - 'value': '2830233', - 'name': 'Aetna' - } - ] - } + 'fullUrl': 'https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/97954095-98320174', + 'resource': R4_COVERAGE_ENCOUNTER_BUNDLE_ENTRY } ] }.freeze @@ -183,69 +299,7 @@ module Resources 'entry': [ { 'fullUrl': 'https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PH-98371617-97701467', - 'resource': { - 'resourceType': 'Coverage', - 'id': 'PH-98371617-97701467', - 'meta': { - 'versionId': '2-0', - 'lastUpdated': '2020-09-24T17:11:10.000Z' - }, - 'text': { - 'status': 'extensions', - 'div': '

Coverage

Status: Active

'\ - '

Encounter: 97701467

Beneficiary: TRAUMA SURGERY, TESTONE

'\ - '

Coverage Start Date: Jul 1, 2022 5:00 A.M. UTC

Coverage End Date'\ - ': Jul 1, 2025 5:00 A.M. UTC

Payor: Government

Class:

'\ - '
Class
Value: 2572499881
Name: Charging Category
'\ - '

Type: public healthcare

' - }, - 'extension': [ - { - 'valueReference': { - 'reference': 'Encounter/97701467' - }, - 'url': 'https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter' - } - ], - 'status': 'active', - 'type': { - 'coding': [ - { - 'system': 'http://terminology.hl7.org/CodeSystem/v3-ActCode', - 'code': 'PUBLICPOL', - 'display': 'public healthcare' - } - ], - 'text': 'public healthcare' - }, - 'beneficiary': { - 'reference': 'Patient/12462008', - 'display': 'TRAUMA SURGERY, TESTONE' - }, - 'period': { - 'start': '2022-07-01T05:00:00.000Z', - 'end': '2025-07-01T05:00:00.000Z' - }, - 'payor': [ - { - 'display': 'Government' - } - ], - 'class': [ - { - 'type': { - 'coding': [ - { - 'system': 'http://terminology.hl7.org/CodeSystem/coverage-class', - 'code': 'class' - } - ] - }, - 'value': '2572499881', - 'name': 'Charging Category' - } - ] - } + 'resource': R4_COVERAGE_ENCOUNTER_SOCIAL_HEALTHCARE_BUNDLE_ENTRY } ] }.freeze @@ -264,53 +318,7 @@ module Resources 'entry': [ { 'fullUrl': 'https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PHP-490218084-12724066', - 'resource': { - 'resourceType': 'Coverage', - 'id': 'PHP-490218084-12724066', - 'meta': { - 'versionId': '134-0', - 'lastUpdated': '2021-03-16T20:04:11.000Z' - }, - 'text': { - 'status': 'generated', - 'div': '

Coverage

Status: Active

'\ - '

Beneficiary: SMART, NANCY

Coverage Start Date: Mar 16, 2021 8:04 P.M. UTC

'\ - '

Payor: Government

Class:

Charging Category
Value:'\ - '2572940471
Name: 10-OPC, Class II

Type: public healthcare

' - }, - 'status': 'active', - 'type': { - 'coding': [ - { - 'system': 'http://terminology.hl7.org/CodeSystem/v3-ActCode', - 'code': 'PUBLICPOL', - 'display': 'public healthcare' - } - ], - 'text': 'public healthcare' - }, - 'beneficiary': { - 'reference': 'Patient/12462008', - 'display': 'TRAUMA SURGERY, TESTONE' - }, - 'period': { - 'start': '2021-03-16T20:04:11.000Z' - }, - 'payor': [ - { - 'display': 'Government' - } - ], - 'class': [ - { - 'type': { - 'text': 'Charging Category' - }, - 'value': '2572940471', - 'name': '10-OPC, Class II' - } - ] - } + 'resource': R4_COVERAGE_PATIENT_SOCIAL_HEALTHCARE_BUNDLE_ENTRY } ] }.freeze