Профиль Core Coverage ресурса Coverage отражает национальные требования к учету взаимоотношений между медицинской организацией и плательщиками при оплате медицинской помощи. • Использование справочников НСИ МЗ РФ для указания источника оплаты и документа-основания оплаты

Профиль может быть использован при передаче информации о медицинской помощи, которая предполагает оплату в рамках систем обязательного страхования, добровольного страхования, за счет средств пациента или иных физических или юридических лиц.

//пример требует исправления: у него идентификатор ОМСный, а плательщик – сам пациент

• 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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:OMS	Σ	0..1	Identifier	Полис ОМС- обязательного медицинского страхования
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS
identifier:DMS	Σ	0..1	Identifier	Полис ДМС - добровольного медицинского страхования
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS
identifier:Contract	Σ	0..1	Identifier	Договор на оказание платных медицинских услугя
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 3
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	0..1	CodeableConcept	Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи 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.
beneficiary	Σ	1..1	Reference(Пациент (Ru Core))	Ссылка на пациента
payor	Σ	1..*	Reference(Организация-плательщик (Ru Core) | Пациент - плательщик (Ru Core) | Лицо, имеющее связь с пациентом(Ru Core) | Лицо, имеющее связь с пациентом-плательщик(Ru Core))	Плательщик: пациент, родственник или организация
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.identifier:OMS.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:OMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:DMS.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:DMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:Contract.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:Contract.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.status	Base	required	Financial Resource Status Codes	📍4.3.0	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.exists() and ('#'+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(uri) = '#').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
Slices for identifier		0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:OMS		0..1	Identifier	Полис ОМС- обязательного медицинского страхования
type		1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
system		1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS
identifier:DMS		0..1	Identifier	Полис ДМС - добровольного медицинского страхования
type		1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 2
system		1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS
identifier:Contract		0..1	Identifier	Договор на оказание платных медицинских услугя
type		1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 3
system		1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract
type		0..1	CodeableConcept	Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи
beneficiary		1..1	Reference(Пациент (Ru Core))	Ссылка на пациента
payor		1..*	Reference(Организация-плательщик (Ru Core) | Пациент - плательщик (Ru Core) | Лицо, имеющее связь с пациентом(Ru Core) | Лицо, имеющее связь с пациентом-плательщик(Ru Core))	Плательщик: пациент, родственник или организация
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.identifier:OMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:DMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:Contract.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG

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
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): IETF language tag 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 Constraints: dom-r4b
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:OMS	Σ	0..1	Identifier	Полис ОМС- обязательного медицинского страхования
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:DMS	Σ	0..1	Identifier	Полис ДМС - добровольного медицинского страхования
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:Contract	Σ	0..1	Identifier	Договор на оказание платных медицинских услугя
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 3
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	0..1	CodeableConcept	Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи 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.
policyHolder	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
subscriber	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
subscriberId	Σ	0..1	string	ID assigned to the subscriber
beneficiary	Σ	1..1	Reference(Пациент (Ru Core))	Ссылка на пациента
dependent	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Coverage start and end dates
payor	Σ	1..*	Reference(Организация-плательщик (Ru Core) | Пациент - плательщик (Ru Core) | Лицо, имеющее связь с пациентом(Ru Core) | Лицо, имеющее связь с пациентом-плательщик(Ru Core))	Плательщик: пациент, родственник или организация
class		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
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
order	Σ	0..1	positiveInt	Relative order of the coverage
network	Σ	0..1	string	Insurer network
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
exception		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	Σ	0..1	Period	The effective period of the exception
subrogation		0..1	boolean	Reimbursement to insurer
contract		0..*	Reference(Contract)	Contract details
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
Coverage.identifier:OMS.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:OMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:DMS.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:DMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:Contract.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:Contract.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.status	Base	required	Financial Resource Status Codes	📍4.3.0	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.3.0	FHIR Std.
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📍4.3.0	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍4.3.0	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍4.3.0	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.exists() and ('#'+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(uri) = '#').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()
dom-r4b	warning	Coverage.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
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()

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
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:OMS	Σ	0..1	Identifier	Полис ОМС- обязательного медицинского страхования
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS
identifier:DMS	Σ	0..1	Identifier	Полис ДМС - добровольного медицинского страхования
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS
identifier:Contract	Σ	0..1	Identifier	Договор на оказание платных медицинских услугя
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 3
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	0..1	CodeableConcept	Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи 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.
beneficiary	Σ	1..1	Reference(Пациент (Ru Core))	Ссылка на пациента
payor	Σ	1..*	Reference(Организация-плательщик (Ru Core) | Пациент - плательщик (Ru Core) | Лицо, имеющее связь с пациентом(Ru Core) | Лицо, имеющее связь с пациентом-плательщик(Ru Core))	Плательщик: пациент, родственник или организация
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.identifier:OMS.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:OMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:DMS.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:DMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:Contract.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:Contract.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.status	Base	required	Financial Resource Status Codes	📍4.3.0	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.exists() and ('#'+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(uri) = '#').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
Slices for identifier		0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:OMS		0..1	Identifier	Полис ОМС- обязательного медицинского страхования
type		1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
system		1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS
identifier:DMS		0..1	Identifier	Полис ДМС - добровольного медицинского страхования
type		1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 2
system		1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS
identifier:Contract		0..1	Identifier	Договор на оказание платных медицинских услугя
type		1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 3
system		1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract
type		0..1	CodeableConcept	Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи
beneficiary		1..1	Reference(Пациент (Ru Core))	Ссылка на пациента
payor		1..*	Reference(Организация-плательщик (Ru Core) | Пациент - плательщик (Ru Core) | Лицо, имеющее связь с пациентом(Ru Core) | Лицо, имеющее связь с пациентом-плательщик(Ru Core))	Плательщик: пациент, родственник или организация
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
Coverage.identifier:OMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:DMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:Contract.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG

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
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): IETF language tag 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 Constraints: dom-r4b
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	Σ	0..*	Identifier	Business Identifier for the coverage Slice: Unordered, Open by value:system
identifier:OMS	Σ	0..1	Identifier	Полис ОМС- обязательного медицинского страхования
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 1
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/OMS
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:DMS	Σ	0..1	Identifier	Полис ДМС - добровольного медицинского страхования
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 2
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/DMS
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
identifier:Contract	Σ	0..1	Identifier	Договор на оказание платных медицинских услугя
id		0..1	id	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required)
type	Σ	1..1	CodeableConcept	Тип идентификатора, кодируется по НСИ Binding: документы-основания для оплаты медицинских услуг (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: https://fhir.ru/ig/core/CodeSystem/core-cs-nsi-coverage-document
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: 3
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Required Pattern: http://fhir.ru/core/systems/Contract
value	Σ	0..1	string	The value that is unique Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	0..1	CodeableConcept	Тип страхового покрытия. Binding: Core_Vs_Nsi_Sources_Of_Paymente(required) Справочник НСИ Минздрава Источники оплаты медицинской помощи 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.
policyHolder	Σ	0..1	Reference(Patient | RelatedPerson | Organization)	Owner of the policy
subscriber	Σ	0..1	Reference(Patient | RelatedPerson)	Subscriber to the policy
subscriberId	Σ	0..1	string	ID assigned to the subscriber
beneficiary	Σ	1..1	Reference(Пациент (Ru Core))	Ссылка на пациента
dependent	Σ	0..1	string	Dependent number
relationship		0..1	CodeableConcept	Beneficiary relationship to the subscriber Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Coverage start and end dates
payor	Σ	1..*	Reference(Организация-плательщик (Ru Core) | Пациент - плательщик (Ru Core) | Лицо, имеющее связь с пациентом(Ru Core) | Лицо, имеющее связь с пациентом-плательщик(Ru Core))	Плательщик: пациент, родственник или организация
class		0..*	BackboneElement	Additional coverage classifications
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
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
order	Σ	0..1	positiveInt	Relative order of the coverage
network	Σ	0..1	string	Insurer network
costToBeneficiary		0..*	BackboneElement	Patient payments for services/products
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	0..1	CodeableConcept	Cost category Binding: CoverageCopayTypeCodes (extensible): The types of services to which patient copayments are specified.
value[x]	Σ	1..1		The amount or percentage due from the beneficiary
valueQuantity			Quantity(SimpleQuantity)
valueMoney			Money
exception		0..*	BackboneElement	Exceptions for patient payments
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type	Σ	1..1	CodeableConcept	Exception category Binding: ExampleCoverageFinancialExceptionCodes (example): The types of exceptions from the part or full value of financial obligations such as copays.
period	Σ	0..1	Period	The effective period of the exception
subrogation		0..1	boolean	Reimbursement to insurer
contract		0..*	Reference(Contract)	Contract details
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Coverage.language	Base	preferred	Common Languages	📍4.3.0	FHIR Std.
Coverage.identifier:OMS.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:OMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:DMS.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:DMS.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.identifier:Contract.​use	Base	required	IdentifierUse	📍4.3.0	FHIR Std.
Coverage.identifier:Contract.​type	Base	required	документы-основания для оплаты медицинских услуг	📦1	This IG
Coverage.status	Base	required	Financial Resource Status Codes	📍4.3.0	FHIR Std.
Coverage.type	Base	preferred	Coverage Type and Self-Pay Codes	📍4.3.0	FHIR Std.
Coverage.relationship	Base	extensible	SubscriberPolicyholder Relationship Codes	📍4.3.0	FHIR Std.
Coverage.class.type	Base	extensible	Coverage Class Codes	📍4.3.0	FHIR Std.
Coverage.costToBeneficiary.​type	Base	extensible	Coverage Copay Type Codes	📍4.3.0	FHIR Std.
Coverage.costToBeneficiary.​exception.type	Base	example	Example Coverage Financial Exception Codes	📍4.3.0	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
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.exists() and ('#'+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(uri) = '#').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()
dom-r4b	warning	Coverage.contained	Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems	($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic)
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: 0 element(6 nested mandatory elements)

Structures

This structure refers to these other structures:

• Пациент (Ru Core) (https://fhir.ru/ig/core/StructureDefinition/core-patient)
• Организация-плательщик (Ru Core) (https://fhir.ru/ig/core/StructureDefinition/core-organization-payer)
• Пациент - плательщик (Ru Core) (https://fhir.ru/ig/core/StructureDefinition/core-patient-payer)
• Лицо, имеющее связь с пациентом(Ru Core) (https://fhir.ru/ig/core/StructureDefinition/core-related-person)
• Лицо, имеющее связь с пациентом-плательщик(Ru Core) (https://fhir.ru/ig/core/StructureDefinition/core-related-person-payer)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.identifier