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Coverage Profile

Canonical../StructureDefinition/nexus-emr-core-coverage
Statusdraft (experimental) · 1.26.0
BaseCoverage (constraint)
SourceFSH · JSON

Nexus EMR profile for Coverage -- the payor context for billing and the demo dataset. First pass: the Ontario-GP shape (public plan keyed by the patient's health-card number, payor as a logical Organization reference). Private/extended plans and coordination of benefits are deliberately unmodelled. Closed to SMART apps pending an exposure decision.

Elements / Differential

What this profile constrains beyond Coverage. Anything not listed is unchanged from the base; muted type/cardinality values are the base's, shown for context.

Element Flags Card. Type Description & Constraints
Coverage Nexus EMR Coverage Core i
status S 1..1 code i
type S 0..1 CodeableConcept Kind of coverage (public provincial plan, private, ...) i
subscriberId S 0..1 string The patient's identifier with the insurance plan i
beneficiary S 1..1 Reference(Patient Profile) The patient covered
period S 0..1 Period Coverage validity period, when the source records one
payor S 1..* Reference(Organization | Patient | RelatedPerson) Who pays -- typically a LOGICAL Organization reference (e.g. OHIP) i