Health Card Eligibility Extension¶
| Canonical | ../StructureDefinition/health-card-eligibility |
|---|---|
| Status | draft · 1.26.0 |
| Base | Extension (constraint) |
| Context | Patient.identifier (element) |
| Source | FSH · 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 |