coverage

Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment. See the HL7 FHIR R4 spec for full details.

Previous version: coverage

Tables in this resource:

• coverage – Main coverage record (this page)
• coverage_type_coding
• coverage_relationship_coding
• coverage_class – Backbone for class
• coverage_class_type_coding
• coverage_extension
• coverage_extension_vcc_coding
• coverage_references – Normalized references; see Reference Tables

Primary Keys:

• coverage_id

Foreign Keys:

• patient_id - links to the patient table (beneficiary)

_{† Metriport Platform added}

Column	Data Type	Description
coverage_id	varchar	Unique identifier for the coverage
patient_id	varchar	Unique identifier for the patient (beneficiary)
status	varchar	Status of the coverage (e.g. active, cancelled, draft, entered-in-error)
period_start	datetime	Start of the coverage period
period_end	datetime	End of the coverage period
type_text	varchar	Free-text coverage type
type_hl7_code†	varchar	Coverage type: HL7 ActCode (v3-ActCode)
type_hl7_display†	varchar	Coverage type: HL7 ActCode display
relationship_text	varchar	Free-text subscriber relationship
relationship_hl7_code†	varchar	Subscriber relationship: HL7 code (subscriber-relationship)
relationship_hl7_display†	varchar	Subscriber relationship: HL7 display
subscriberid	varchar	Subscriber identifier
dependent	varchar	Dependent number
meta_source	varchar	Source document filename from FHIR meta.source
data_source_ext†	varchar	Integration source of the data, derived from FHIR extension

Related Tables:

Parent:

• patient

Child:

• coverage_class
• coverage_extension
• coverage_relationship_coding
• coverage_type_coding

Version diff

Renamed

• subscriber_member_id → subscriberid
• data_source → meta_source

Moved to separate tables

• source_type_code → coverage_type_coding.code w/ code_rank = 1
• source_type_display → coverage_type_coding.display w/ code_rank = 1
• source_type_system → coverage_type_coding.system w/ code_rank = 1
• source_relationship_code → coverage_relationship_coding.code w/ code_rank = 1
• source_relationship_display → coverage_relationship_coding.display w/ code_rank = 1
• source_relationship_system → coverage_relationship_coding.system w/ code_rank = 1
• class_group_code, class_group_display, class_group_system → coverage_class w/ type_code = group
• class_plan_code, class_plan_display, class_plan_system → coverage_class w/ type_code = plan