EHDS Logical Information Models
0.1.0 - ci-build

EHDS Logical Information Models, published by Xt-EHR. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Xt-EHR/xt-ehr-common/tree/stakeholder-consultation-D6-2 and changes regularly. See the Directory of published versions

## Logical Model: Coverage model

Official URL: https://www.xt-ehr.eu/specifications/fhir/StructureDefinition/EHDSCoverage | Version: 0.1.0
Draft as of 2025-05-26 | Computable Name: EHDSCoverage

EHDS refined base model for Coverage

Usage:

- Use this Logical Model Profile: Hospital Discharge Report header model, Imaging report header model, Laboratory order header model and Laboratory report header model
- Refer to this Logical Model Profile: Service request model

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
EHDSCoverage |  | 0..* | Base | Coverage model Instances of this logical model can be the target of a Reference
identifier |  | 0..* | Identifier | usiness Identifier for the coverage
type |  | 0..1 | CodeableConcept | Type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. Binding Description (No ValueSet): (preferred): hl7:coverage-selfpay, hl7:v3-ActCoverageTypeCode
patient |  | 1..1 | EHDSPatient | Patient who benefits from the insurance coverage when products and/or services are provided.
payor |  | 1..* | Base | Payor including both insurance and non-insurance agreements, such as patient-pay agreements.
payorEntity[x] |  | 1..1 |  | Payor entity
payorEntityEHDSOrganization |  |  | EHDSOrganization |
payorEntityEHDSPatient |  |  | EHDSPatient |
subscriberId |  | 0..1 | Identifier | Number or code under which the insured person is registered at the insurance provider.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
EHDSCoverage.type | preferred |

This structure is derived from Base

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
EHDSCoverage |  | 0..* | Base | Coverage model Instances of this logical model can be the target of a Reference
identifier |  | 0..* | Identifier | usiness Identifier for the coverage
type |  | 0..1 | CodeableConcept | Type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. Binding Description (No ValueSet): (preferred): hl7:coverage-selfpay, hl7:v3-ActCoverageTypeCode
patient |  | 1..1 | EHDSPatient | Patient who benefits from the insurance coverage when products and/or services are provided.
payor |  | 1..* | Base | Payor including both insurance and non-insurance agreements, such as patient-pay agreements.
payorEntity[x] |  | 1..1 |  | Payor entity
payorEntityEHDSOrganization |  |  | EHDSOrganization |
payorEntityEHDSPatient |  |  | EHDSPatient |
subscriberId |  | 0..1 | Identifier | Number or code under which the insured person is registered at the insurance provider.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
EHDSCoverage.type | preferred |

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
EHDSCoverage |  | 0..* | Base | Coverage model Instances of this logical model can be the target of a Reference
identifier |  | 0..* | Identifier | usiness Identifier for the coverage
type |  | 0..1 | CodeableConcept | Type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. Binding Description (No ValueSet): (preferred): hl7:coverage-selfpay, hl7:v3-ActCoverageTypeCode
patient |  | 1..1 | EHDSPatient | Patient who benefits from the insurance coverage when products and/or services are provided.
payor |  | 1..* | Base | Payor including both insurance and non-insurance agreements, such as patient-pay agreements.
payorEntity[x] |  | 1..1 |  | Payor entity
payorEntityEHDSOrganization |  |  | EHDSOrganization |
payorEntityEHDSPatient |  |  | EHDSPatient |
subscriberId |  | 0..1 | Identifier | Number or code under which the insured person is registered at the insurance provider.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
EHDSCoverage.type | preferred |

This structure is derived from Base

Summary

Mandatory: 0 element(3 nested mandatory elements)

Key Elements View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
EHDSCoverage |  | 0..* | Base | Coverage model Instances of this logical model can be the target of a Reference
identifier |  | 0..* | Identifier | usiness Identifier for the coverage
type |  | 0..1 | CodeableConcept | Type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. Binding Description (No ValueSet): (preferred): hl7:coverage-selfpay, hl7:v3-ActCoverageTypeCode
patient |  | 1..1 | EHDSPatient | Patient who benefits from the insurance coverage when products and/or services are provided.
payor |  | 1..* | Base | Payor including both insurance and non-insurance agreements, such as patient-pay agreements.
payorEntity[x] |  | 1..1 |  | Payor entity
payorEntityEHDSOrganization |  |  | EHDSOrganization |
payorEntityEHDSPatient |  |  | EHDSPatient |
subscriberId |  | 0..1 | Identifier | Number or code under which the insured person is registered at the insurance provider.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
EHDSCoverage.type | preferred |

Differential View

This structure is derived from Base

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
EHDSCoverage |  | 0..* | Base | Coverage model Instances of this logical model can be the target of a Reference
identifier |  | 0..* | Identifier | usiness Identifier for the coverage
type |  | 0..1 | CodeableConcept | Type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. Binding Description (No ValueSet): (preferred): hl7:coverage-selfpay, hl7:v3-ActCoverageTypeCode
patient |  | 1..1 | EHDSPatient | Patient who benefits from the insurance coverage when products and/or services are provided.
payor |  | 1..* | Base | Payor including both insurance and non-insurance agreements, such as patient-pay agreements.
payorEntity[x] |  | 1..1 |  | Payor entity
payorEntityEHDSOrganization |  |  | EHDSOrganization |
payorEntityEHDSPatient |  |  | EHDSPatient |
subscriberId |  | 0..1 | Identifier | Number or code under which the insured person is registered at the insurance provider.
Documentation for this format

#### Terminology Bindings (Differential)

Path | Conformance | ValueSet | URI
EHDSCoverage.type | preferred |

Snapshot View

Name | Flags | Card. | Type | Description & Constraints
--- | --- | --- | --- | ---
EHDSCoverage |  | 0..* | Base | Coverage model Instances of this logical model can be the target of a Reference
identifier |  | 0..* | Identifier | usiness Identifier for the coverage
type |  | 0..1 | CodeableConcept | Type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization. Binding Description (No ValueSet): (preferred): hl7:coverage-selfpay, hl7:v3-ActCoverageTypeCode
patient |  | 1..1 | EHDSPatient | Patient who benefits from the insurance coverage when products and/or services are provided.
payor |  | 1..* | Base | Payor including both insurance and non-insurance agreements, such as patient-pay agreements.
payorEntity[x] |  | 1..1 |  | Payor entity
payorEntityEHDSOrganization |  |  | EHDSOrganization |
payorEntityEHDSPatient |  |  | EHDSPatient |
subscriberId |  | 0..1 | Identifier | Number or code under which the insured person is registered at the insurance provider.
Documentation for this format

#### Terminology Bindings

Path | Conformance | ValueSet | URI
EHDSCoverage.type | preferred |

This structure is derived from Base

Summary

Mandatory: 0 element(3 nested mandatory elements)

Other representations of profile: CSV, Excel