Stream: implementers
Topic: Linking Coverage to InsurancePlan
David Riddle (Sep 05 2019 at 15:55):
@Lloyd McKenzie , @Paul Knapp , @MaryKay McDaniel and @Brian Postlethwaite,
Can any of you speak to whether or not there is an expectation that the Coverage associated with an individual can be linked to an instance of InsurancePlan?
Currently the Coverage resource has the Coverage.class.value attribute described as 'For example, the Group or Plan number' and the InsurancePlan resource has both the InsurancePlan.identifier and InsurancePlan.plan.identifier attributes, which both have the same 'Business Identifier for Product' description (typo/copy-paste error?) listed here [1]. *NOTE: The detailed description for InsurancePlan.plan.identifier [2] does indicate that these represent 'identifiers assigned to this health insurance plan' vs 'product'.
That said, the mechanism for linking instances of the Coverage resource to the corresponding InsurancePlan tied to that Coverage (i.e., linking to the 'plan' the Coverage is associated with) is not clear. Is there an expectation that this sort of connection between Coverage resource instances and InsurancePlan instances can be made? If so, what attributes should be used to perform this 'join'/make this connection?
[1] http://hl7.org/fhir/insuranceplan.html
[2] http://hl7.org/fhir/insuranceplan-definitions.html#InsurancePlan.plan.identifier
cc @Michelle (Moseman) Miller
Paul Knapp (Sep 05 2019 at 19:31):
@David Riddle Currently there isn't currently a reference element linking the resources. I'll add this to the list of topics for the joint FM & PA session in Atlanta on the morning of Sept 19. I expect we would discuss whether there is a logical linkage, e.g. based on Coverage.payor and Coverage.class (plan) to InsurancePlan. We could consider and extension for R4 and prior and whether that should be an extension or first order element in R5.
David Riddle (Sep 06 2019 at 19:00):
@Paul Knapp Understood and thank you. Hopefully @Michelle (Moseman) Miller will be able to join the joint FM & PM session the morning of Sept. 19th. I won't be in Atlanta.
Samantha Mater (Feb 20 2020 at 21:42):
Hi -- I am working on implementing these resources and was wondering what was the outcome of the Sept 19th discussion? I am also looking for a mechanism to link Coverage to InsurancePlan.
Thanks!
Lloyd McKenzie (Feb 20 2020 at 21:44):
@Paul Knapp
Last updated: Apr 12 2022 at 19:14 UTC
