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Health Card Eligibility Extension

Canonical../StructureDefinition/health-card-eligibility
Statusdraft · 1.26.0
BaseExtension (constraint)
ContextPatient.identifier (element)
SourceFSH · JSON

The payer's settled answer about one provincial health card, carried on the card's own Identifier, together with a marker for a check that could not reach the payer.

Elements / Details

Every element this profile touches, with its full definition. Element names in the tables link here.

Extension

Short Settled payer eligibility answer for this health card
Definition The payer's settled answer about one provincial health card, carried on the card's own Identifier, together with a marker for a check that could not reach the payer. It belongs to one exact card. A card is a province, a number and a version code together, and an answer given for one card says nothing about a card that has since changed. Carried here, the answer is discarded with the card it was about rather than outliving it on the patient. It belongs on the health card and on nothing else. Patient.identifier also carries the medical record number, the legacy paper chart number and whatever identifiers a source system contributed, and a payer eligibility answer means nothing on any of them. The extension's contextInvariant requires the identifier it rides to carry the HL7 v2-0203 type JHN (jurisdictional health number), which is the same discriminator the Patient profile uses to recognise a provincial health number. An eligibility answer stamped on an MRN or a chart number is not merely unhelpful; it is invalid. answeredAt is when the payer gave THIS answer, not when the patient was last checked. The answer is rewritten only when it changes, so a check that confirms an existing answer leaves the moment alone. Nothing may infer freshness from it: an answer dated months ago may have been reconfirmed this morning. A failed attempt is not an answer. attemptFailedAt records that a check could not reach the payer. It never touches the answer children, so the last real answer survives an outage, and it dates the failure rather than the answer, so freshness cannot be inferred from it either. It is cleared by the next check that reaches the payer. An extension carrying only attemptFailedAt carries no answer at all. Read the answer whole or not at all. eligible and answeredAt are both required, and a malformed coverageExpiry invalidates the whole answer rather than being dropped -- dropping it would hand back an answer that reads as covered indefinitely. An unreadable attemptFailedAt is the one child held to a softer rule: it reads as no marker, because a corrupt display-only child must not be able to hide a real answer. Absence of coverageExpiry is not an unlimited entitlement. It means the payer delivered no expiry with this answer. coverageExpiry is DEPRECATED. Write the expiry to Identifier.period.end instead. R4 defines Identifier.period as the time period during which the identifier is or was valid for use, which is exactly what a card's coverage expiry is, and this guide already records the Indian status card's expiry there on the same resource. A child duplicating a base element gives a reader two places to look and no rule for which wins when they disagree. The child stays defined because answers already stored carry it and must keep reading back; a producer that has not moved yet is not thereby nonconformant. Readers SHOULD read Identifier.period.end first and fall back to coverageExpiry, and SHOULD NOT treat a disagreement between them as an error -- prefer Identifier.period.end. MIGRATION. Nexus EMR writes this extension today at http://services.well.com/fhir/identifier/eligibility (FHIR-381): that address is live in stored patient records and in code, and is under migration to the canonical declared here. Write the canonical; when reading, match both addresses exactly. The final segments differ (eligibility against health-card-eligibility), so a suffix rule does not reach the pre-migration one and a reader built on it misses every answer stored before the writer moves.
Cardinality 0..*
Invariants ele-1, ext-1

Extension.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension

Short Additional content defined by implementations
Definition May be used to represent additional information that is not part of the basic definition of the element. 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.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..*
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:eligible

Short The payer's answer; required for the answer to be readable
Definition May be used to represent additional information that is not part of the basic definition of the element. 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.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:eligible.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:eligible.extension

Short Additional content defined by implementations
Definition May be used to represent additional information that is not part of the basic definition of the element. 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.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:eligible.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value eligible

Extension.extension:eligible.value[x]

Short Value of extension
Definition The payer's settled answer for this card. Present with answeredAt or the extension carries no readable answer.
Cardinality 1..1
Type boolean
Must Support yes
Invariants ele-1

Extension.extension:answeredAt

Short When the payer gave THIS answer; required for the answer to be readable
Definition May be used to represent additional information that is not part of the basic definition of the element. 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.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:answeredAt.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:answeredAt.extension

Short Additional content defined by implementations
Definition May be used to represent additional information that is not part of the basic definition of the element. 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.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:answeredAt.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value answeredAt

Extension.extension:answeredAt.value[x]

Short Value of extension
Definition When the payer gave the answer stored here -- NOT when the patient was last checked. The answer is rewritten only on change, so a re-check that agrees leaves this moment untouched and no freshness may be inferred from it.
Cardinality 1..1
Type instant
Must Support yes
Invariants ele-1

Extension.extension:coverageExpiry

Short DEPRECATED -- write Identifier.period.end instead
Definition Deprecated. Write the coverage expiry to Identifier.period.end and not here. R4 defines Identifier.period as the time period during which the identifier is or was valid for use, which is what a card's coverage expiry is, and this guide already records the Indian status card's expiry there on the same resource; a child duplicating a base element leaves a reader with two places to look and no rule for which wins. This child remains defined, and must keep reading back, because answers stored before the move carry it. Readers SHOULD prefer Identifier.period.end and fall back to this.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:coverageExpiry.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:coverageExpiry.extension

Short Additional content defined by implementations
Definition May be used to represent additional information that is not part of the basic definition of the element. 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.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:coverageExpiry.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value coverageExpiry

Extension.extension:coverageExpiry.value[x]

Short Value of extension
Definition The coverage expiry the payer delivered alongside the answer. Absent means the payer delivered none, NOT that coverage is unlimited. Deprecated: Identifier.period.end is the element to write. Still must-support, because stored answers carry it and a reader has to be able to read one back.
Cardinality 1..1
Type date
Must Support yes
Invariants ele-1

Extension.extension:attemptFailedAt

Short When a check last failed to reach the payer; not part of the answer
Definition May be used to represent additional information that is not part of the basic definition of the element. 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.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..1
Type Extension
Must Support yes
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:attemptFailedAt.id

Short Unique id for inter-element referencing
Definition Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality 0..1
Type http://hl7.org/fhirpath/System.String

Extension.extension:attemptFailedAt.extension

Short Additional content defined by implementations
Definition May be used to represent additional information that is not part of the basic definition of the element. 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.
Comments There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Cardinality 0..0
Type Extension
Invariants ele-1, ext-1
Also called extensions, user content

Extension.extension:attemptFailedAt.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value attemptFailedAt

Extension.extension:attemptFailedAt.value[x]

Short Value of extension
Definition When a check last failed to reach the payer. It carries no answer, gates nothing, and dates the failure rather than the answer. Written once for a run of failures -- it names when the failures began -- and cleared by the next check that reaches the payer.
Cardinality 1..1
Type instant
Must Support yes
Invariants ele-1

Extension.url

Short identifies the meaning of the extension
Definition Source of the definition for the extension code - a logical name or a URL.
Comments The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Cardinality 1..1
Type http://hl7.org/fhirpath/System.String
Fixed value ../StructureDefinition/health-card-eligibility

Extension.value[x]

Short Value of extension
Definition Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Cardinality 0..0
Type base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
Invariants ele-1