Coverage

Overview

The Coverage resource provides high-level information about an insurance plan for a specific person or patient or an encounter. Identifying coverage information would appear on an insurance card, and can be used to pay for health care services. The resource can also be used for “selfpay” where an individual takes responsibility for the cost of health care services, rather than a company or organization.

The following fields are returned if valued:

Terminology Bindings

Coverage.relationship
  • Description
    • Indicates the beneficiary relationship to the subscriber.
  • Details: Subscriber Relationship
    System: http://terminology.hl7.org/CodeSystem/subscriber-relationship

  • Details: Millennium Person Relationship
    System: https://fhir.cerner.com/<EHR source id>/codeSet/40

Extensions

Custom Extensions

All URLs for custom extensions are defined as https://fhir-ehr.cerner.com/r4/StructureDefinition/{id}

ID Value[x] Type Description
coverage-encounter Reference A reference to an Encounter.

Search for Patient-level or Encounter-level Coverages that meet supplied query parameters:

GET /Coverage?:parameters

Implementation Notes

Authorization Types

Parameters

Name Required? Type Description
patient This or -encounter reference Retrieve coverages for a patient. Example: 12345
-encounter This or patient reference Retrieve coverages for an encounter. Example: 143242

Headers

Accept: application/fhir+json
Authorization: <OAuth2 Bearer Token>

Example - Patient-level Private Coverage

Request

GET https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?patient=12724066

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "a8876443-c615-4244-9044-047dea2d92dd",
  "type": "searchset",
  "total": 1,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?patient=12724066"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/12724066-490016987-490016987",
      "resource": {
        "resourceType": "Coverage",
        "id": "12724066-490016987-490016987",
        "meta": {
          "versionId": "24-24",
          "lastUpdated": "2020-07-06T17:03:43.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Coverage</b></p><p><b>Status</b>: Active</p><p><b>Subscriber</b>: SMART, NANCY</p><p><b>Beneficiary</b>: SMART, NANCY</p><p><b>Coverage Start Date</b>: Aug 14, 2015  7:07 P.M. UTC</p><p><b>Payor</b>: SELF PAY</p><p><b>Class</b>: plan: Value: 2800235 Name: Self Pay</p></div>"
        },
        "status": "active",
        "subscriber": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "beneficiary": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self",
              "display": "Self",
              "userSelected": false
            }
          ],
          "text": "Self"
        },
        "period": {
          "start": "2015-08-14T19:07:56.000Z"
        },
        "payor": [
          {
            "reference": "Organization/589803",
            "display": "SELF PAY"
          }
        ],
        "class": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "plan"
                }
              ]
            },
            "value": "2800235",
            "name": "Self Pay"
          }
        ]
      }
    }
  ]
}

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Example - Patient-level Public Coverage

Request

GET https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?patient=12724066

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "8ff4481d-ce55-4b3f-ac2c-4d4fd3cad4c0",
  "type": "searchset",
  "total": 1,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?patient=12724066"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PHP-490218084-12724066",
      "resource": {
        "resourceType": "Coverage",
        "id": "PHP-490218084-12724066",
        "meta": {
          "versionId": "134-0",
          "lastUpdated": "2021-03-16T20:04:11.000Z"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\\"http://www.w3.org/1999/xhtml\\"><p><b>Coverage</b></p><p><b>Status</b>: Active</p><p><b>Beneficiary</b>: SMART, NANCY</p><p><b>Coverage Start Date</b>: Mar 16, 2021  8:04 P.M. UTC</p><p><b>Payor</b>: Government</p><p><b>Class</b>:</p><dl><dt>Charging Category</dt><dd><b>Value</b>:2572940471</dd><dd><b>Name</b>: 10-OPC, Class II</dd></dl><p><b>Type</b>: public healthcare</p></div>"
        },
        "status": "active",
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "PUBLICPOL",
              "display": "public healthcare"
            }
          ],
          "text": "public healthcare"
        },
        "beneficiary": {
          "reference": "Patient/12462008",
          "display": "TRAUMA SURGERY, TESTONE"
        },
        "period": {
          "start": "2021-03-16T20:04:11.000Z"
        },
        "payor": [
          {
            "display": "Government"
          }
        ],
        "class": [
          {
            "type": {
              "text": "Charging Category"
            },
            "value": "2572940471",
            "name": "10-OPC, Class II"
          }
        ]
      }
    }
  ]
}

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Example - Encounter-level Private Coverage

Request

GET https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?-encounter=97954095

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "d42baa44-1566-458c-8457-10fbfacfc3e5",
  "type": "searchset",
  "total": 1,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?-encounter=97954095"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-open.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/97954095-98320174",
      "resource": {
        "resourceType": "Coverage",
        "id": "97954095-98320174",
        "meta": {
          "versionId": "0",
          "lastUpdated": "2020-07-27T21:01:55.000Z"
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Coverage</b></p><p><b>Status</b>: Active</p><p><b>Subscriber</b>: SMART, NANCY</p><p><b>Subscriber Id</b>: 12345</p><p><b>Encounter</b>: 97954095</p><p><b>Beneficiary</b>: SMART, NANCY</p><p><b>Dependent Number</b>: 12345</p><p><b>Coverage Start Date</b>: Feb  2, 2020  6:00 A.M. UTC</p><p><b>Coverage End Date</b>: Feb  3, 2021  5:59 A.M. UTC</p><p><b>Payor</b>: Aetna</p><p><b>Class</b>: plan: Value: 2830233 Name: Aetna</p></div>"
        },
        "extension": [
          {
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter",
            "valueReference": {
              "reference": "Encounter/97954095"
            }
          }
        ],
        "status": "active",
        "subscriber": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "subscriberId": "12345",
        "beneficiary": {
          "reference": "Patient/12724066",
          "display": "SMART, NANCY"
        },
        "dependent": "12345",
        "relationship": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "self",
              "display": "Self",
              "userSelected": false
            }
          ],
          "text": "Self"
        },
        "period": {
          "start": "2020-02-02T06:00:00.000Z",
          "end": "2021-02-03T05:59:59.000Z"
        },
        "payor": [
          {
            "reference": "Organization/3064032",
            "display": "Aetna"
          }
        ],
        "class": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "plan"
                }
              ]
            },
            "value": "2830233",
            "name": "Aetna"
          }
        ]
      }
    }
  ]
}

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Example - Encounter-level Public Coverage

Request

GET https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?-encounter=97701467

Response

Status: 200 OK
{
  "resourceType": "Bundle",
  "id": "1714d1b5-cabf-4c4a-bb76-c1e2e4d76d64",
  "type": "searchset",
  "total": 1,
  "link": [
    {
      "relation": "self",
      "url": "https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage?-encounter=97701467"
    }
  ],
  "entry": [
    {
      "fullUrl": "https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PH-98371617-97701467",
      "resource": {
        "resourceType": "Coverage",
        "id": "PH-98371617-97701467",
        "meta": {
          "versionId": "2-0",
          "lastUpdated": "2020-09-24T17:11:10.000Z"
        },
        "text": {
          "status": "extensions",
          "div": "<div xmlns='http://www.w3.org/1999/xhtml'><p><b>Coverage</b></p><p><b>Status</b>: Active</p><p><b>Encounter</b>: 97701467</p><p><b>Beneficiary</b>: TRAUMA SURGERY, TESTONE</p><p><b>Coverage Start Date</b>: Jul  1, 2022  5:00 A.M. UTC</p><p><b>Coverage End Date</b>: Jul  1, 2025  5:00 A.M. UTC</p><p><b>Payor</b>: Government</p><p><b>Class</b>:</p><dl><dt>Class</dt><dd><b>Value</b>: 2572499881</dd><dd><b>Name</b>: Charging Category</dd></dl><p><b>Type</b>: public healthcare</p></div>"
        },
        "extension": [
          {
            "valueReference": {
              "reference": "Encounter/97701467"
            },
            "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter"
          }
        ],
        "status": "active",
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "PUBLICPOL",
              "display": "public healthcare"
            }
          ],
          "text": "public healthcare"
        },
        "beneficiary": {
          "reference": "Patient/12462008",
          "display": "TRAUMA SURGERY, TESTONE"
        },
        "period": {
          "start": "2022-07-01T05:00:00.000Z",
          "end": "2025-07-01T05:00:00.000Z"
        },
        "payor": [
          {
            "display": "Government"
          }
        ],
        "class": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                  "code": "class"
                }
              ]
            },
            "value": "2572499881",
            "name": "Charging Category"
          }
        ]
      }
    }
  ]
}

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.

Create

Create new Patient-level or Encounter-level Coverages.

POST /Coverage

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
Content-Type: application/fhir+json

Body Fields

Name Required Type
resourceType Yes string
  • Description
    • The type of the FHIR resource.
  • Example
    • {
        "resourceType": "Coverage"
      }
      
  • Notes
    • The resourceType must be Coverage.
Coverage Encounter Extension No Extension
  • Description
    • Reference to the Encounter associated to the Encounter-level Coverage.
  • Example
    • {
        "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter",
        "valueReference": {
          "reference": "Encounter/31363178"
        }
      }
      
  • Notes
      • The valueReference.reference must be an Encounter reference.
      • If provided, an Encounter-level Coverage will be created.
status Yes code
  • Description
    • The status of the coverage.
  • Example
    • {
        "status": "active"
      }
      
  • Notes
    • Currently supports only active.
subscriber Yes Reference (Patient)
  • Description
    • Subscriber to the policy.
  • Example
    • {
        "subscriber": {
          "reference": "Patient/1626016"
        }
      }
      
  • Notes
      • Currently supports only Patient references.
      • Not required for Public Healthcare Writes.
subscriberId No string
  • Description
    • ID assigned to the subscriber.
  • Example
    • {
        "subscriberId": "1626016"
      }
      
beneficiary Yes Reference (Patient)
  • Description
    • Plan beneficiary.
  • Example
    • {
        "beneficiary": {
          "reference": "Patient/1626016"
        }
      }
      
dependent No string
  • Description
    • Dependent number.
  • Example
    • {
        "dependent": "1626016"
      }
      
  • Notes
    • Not required for Public Healthcare Writes.
relationship No CodeableConcept
  • Description
    • Indicates the beneficiary relationship to the subscriber.
  • Example
    • {
        "relationship": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                "code": "child"
              }
            ]
          }
        ]
      }
      
  • Notes
    • Not required for Public Healthcare Writes.
period No Period
  • Description
    • Coverage start and end dates.
  • Example
    • {
        "period": {
          "start": "2014-09-05T14:30:12.000Z",
          "end": "2015-09-05T14:30:12.000Z"
        }
      }
      
  • Notes
    • Both period.start and period.end must contain date and time components.
payor Yes List of Reference (Organization)
  • Description
    • Issuer of the policy.
  • Example
    • {
        "payor": [
          {
            "reference": "Organization/643847",
            "display": "Aetna Missouri POS - Open"
          }
        ]
      }
      
  • Notes
    • For Public Coverages, payor[0].reference is not supported.
class No List of BackboneElement
  • Description
    • Additional coverage classifications.
  • Example
    • {
        "class": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/ValueSet/coverage-class",
                  "code": "plan"
                }
              ],
              "text": "plan"
            },
            "value": "729825",
            "name": "Aetna Missouri POS Open"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/ValueSet/coverage-class",
                  "code": "group"
                }
              ],
              "text": "group"
            },
            "value": "7298139",
            "name": "Aetna Missouri POS Open group"
          }
        ]
      }
      
class.type Yes CodeableConcept
  • Description
    • Type of class such as group or plan.
  • Example
    • {
        "type": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/ValueSet/coverage-class",
              "code": "group"
            }
          ],
          "text": "group"
        }
      }
      
  • Example
    • {
        "type": {
          "coding": [
            {
              "system": "http://hl7.org/fhir/ValueSet/coverage-class",
              "code": "plan"
            }
          ],
          "text": "plan"
        }
      }
      
class.value Yes string
  • Description
    • Value associated with type.
  • Example
    • {
        "value": "7298139"
      }
      
class.name No string
  • Description
    • Human readable description of the type and value.
  • Example
    • {
        "name": "Aetna Missouri POS Open group"
      }
      

Example - Patient-level Private Coverage

Request

POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage

Body

{
  "resourceType": "Coverage",
  "status": "active",
  "subscriber": {
    "reference": "Patient/589763"
  },
  "subscriberId": "123",
  "beneficiary": {
    "reference": "Patient/589763"
  },
  "relationship": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code": "other"
      }
    ]
  },
  "period": {
    "start": "2014-09-05T14:30:12.000Z",
    "end": "2015-09-05T14:30:12.000Z"
  },
  "payor": [
    {
      "reference": "Organization/643847",
      "display": "Aetna Missouri POS - Open"
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "plan"
          }
        ],
        "text": "plan"
      },
      "value": "729827",
      "name": "Aetna Missouri POS Open"
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "group"
          }
        ],
        "text": "group"
      },
      "value": "729839",
      "name": "Aetna Missouri POS Open group"
    }
  ]
}

Response

Status: 201 Created
Cache-Control: no-cache
Content-Length: 0
Content-Type: text/html
Date: Tue, 22 Oct 2019 15:59:33 GMT
Etag: W/"0$0"
Last-Modified: Tue, 22 Oct 2019 15:59:30 GMT
Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/589763-11500257-11500257
Vary: Origin
X-Request-Id: ef7c0ee60a8cf431403fe82d9009640b

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Example - Patient-level Public Coverage

Request

POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage

Body

{
  "resourceType": "Coverage",
  "status": "active",
  "beneficiary": {
    "reference": "Patient/1626016"
  },
  "period": {
    "start": "2021-01-18T14:30:20.000Z",
    "end": "2021-01-18T14:30:21.000Z"
  },
  "payor": [
    {
      "display": "Government"
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "plan"
          }
        ],
        "text": "Charging Category"
      },
      "value": "2572940471",
      "name": "10-OPC, Class II"
    }
  ]
}

Response

Status: 201 Created
Cache-Control: no-cache
Content-Length: 0
Content-Type: text/html
Date: Tue, 22 Oct 2019 15:59:33 GMT
Etag: W/"135-0"
Last-Modified: Tue, 22 Oct 2019 15:59:30 GMT
Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PHP-1626016-11500257
Vary: Origin
X-Request-Id: ef7c0ee60a8cf431403fe82d9009640b

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Example - Encounter-level Private Coverage

Request

POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage

Body

{
  "resourceType": "Coverage",
  "status": "active",
  "subscriber": {
    "reference": "Patient/1626016",
    "display": "WOLFE, STEPHANIE T"
  },
  "extension": [
    {
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter",
      "valueReference": {
        "reference": "Encounter/31363178"
      }
    }
  ],
  "subscriberId": "2461235",
  "dependent": "74965675",
  "beneficiary": {
    "reference": "Patient/1626016"
  },
  "relationship": {
    "coding": [
      {
        "system": "https://fhir.cerner.com/2c400054-42d8-4e74-87b7-80b5bd5fde9f/codeSet/40",
        "code": "156",
        "display": "child",
        "userSelected": true
      }
    ]
  },
  "period": {
    "start": "2014-09-05T14:30:12.000Z",
    "end": "2015-09-05T14:30:12.000Z"
  },
  "payor": [
    {
      "reference": "Organization/643847",
      "display": "Aetna Missouri POS - Open"
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "plan"
          }
        ],
        "text": "plan"
      },
      "value": "729825",
      "name": "Aetna Missouri POS Open"
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "group"
          }
        ],
        "text": "group"
      },
      "value": "8939999",
      "name": "Aetna Missouri POS Open group"
    }
  ]
}

Response

Status: 201 Created
Cache-Control: no-cache
Content-Length: 0
Content-Type: text/html
Date: Tue, 22 Oct 2019 15:59:33 GMT
Etag: W/"0"
Last-Modified: Tue, 22 Oct 2019 15:59:30 GMT
Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/31363178-11500257
Vary: Origin
X-Request-Id: ef7c0ee60a8cf431403fe82d9009640b

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Example - Encounter-level Public Coverage

Request

POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage

Body

{
  "resourceType": "Coverage",
  "status": "active",
  "beneficiary": {
    "reference": "Patient/1626016"
  },
  "period": {
    "start": "2021-01-18T14:30:20.000Z",
    "end": "2021-01-18T14:30:21.000Z"
  },
  "payor": [
    {
      "display": "Government"
    }
  ],
  "extension": [
    {
      "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter",
      "valueReference": {
        "reference": "Encounter/31363178"
      }
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "plan"
          }
        ],
        "text": "Charging Category"
      },
      "value": "2572940471",
      "name": "10-OPC, Class II"
    }
  ]
}

Response

Status: 201 Created
Cache-Control: no-cache
Content-Length: 0
Content-Type: text/html
Date: Tue, 22 Oct 2019 15:59:33 GMT
Etag: W/"42-0"
Last-Modified: Tue, 22 Oct 2019 15:59:30 GMT
Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PH-31363178-11500257
Vary: Origin
X-Request-Id: ef7c0ee60a8cf431403fe82d9009640b

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.

Patch

Patch an existing Encounter-level or Patient-level Coverage.

PATCH /Coverage/:id

Implementation Notes

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
Accept: application/fhir+json
Content-Type: application/json-patch+json
If-Match: W/"<Current version of the Coverage resource>"

Patch Operations

Path Operation Value Type
/class/0/value replace string
  • Description
    • The alphanumeric string value associated with the insurer issued label.
  • Example
    • {
        "op": "replace",
        "path": "/class/0/value",
        "value": "729825"
      }
      
  • Notes
      • For Private Coverages, the Coverage.class at index 0 represents the plan for the Coverage.
      • For Public Coverages, the Coverage.class at index 0 represents the charging category for the Coverage.
/class/1/value replace string
  • Description
    • The alphanumeric string value associated with the insurer issued label.
  • Example
    • {
        "op": "replace",
        "path": "/class/1/value",
        "value": "729825"
      }
      
  • Notes
      • This path should be used only to replace the policy group number.
      • The Coverage.class at index 1 represents the group for the Coverage.
      • When no value is provided for this patch operation, Coverage.class[1].value will be unset.
/class/1/name replace string
  • Description
    • A short description for the class.
  • Example
    • {
        "op": "replace",
        "path": "/class/1/name",
        "value": "name"
      }
      
  • Notes
      • The Coverage.class at index 1 represents the group for the Coverage.
      • When no value is provided for this patch operation, Coverage.class[1].name will be unset.
/dependent replace string
  • Description
    • A unique identifier for a dependent under the coverage.
  • Example
    • {
        "op": "replace",
        "path": "/dependent",
        "value": "9816564"
      }
      
  • Notes
      • When no value is provided for this patch operation, Coverage.dependent will be unset.
/period replace Period
  • Description
    • Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.
  • Example
    • {
        "op": "replace",
        "path": "/period",
        "value": {
          "start": "2014-09-05T14:30:12.000Z",
          "end": "2015-09-05T14:30:12.000Z"
        }
      }
      
  • Notes
      • When no start value is provided for this patch operation, Coverage.period.start will be unset.
      • When no end value is provided for this patch operation, Coverage.period.end will be unset.
      • When start or end values are provided, time components must be provided.
/relationship replace CodeableConcept
  • Description
    • The relationship of beneficiary (patient) to the subscriber.
  • Example
    • {
        "op": "replace",
        "path": "/relationship",
        "value": {
          "coding": [
            {
              "system": "https://terminology.hl7.org/CodeSystem/subscriber-relationship",
              "code": "parent"
            }
          ]
        }
      }
      
  • Notes
      • When no value is provided for this patch operation, Coverage.relationship will be unset.
/subscriberId replace string
  • Description
    • The insurer assigned ID for the Subscriber.
  • Example
    • {
        "op": "replace",
        "path": "/subscriberId",
        "value": "4655446"
      }
      
  • Notes
      • When no value is provided for this patch operation, Coverage.subscriberId will be unset.
/subscriber replace Reference
  • Description
    • The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.
  • Example
    • {
        "op": "replace",
        "path": "/subscriber",
        "value": {
          "reference": "Patient/1626016"
        }
      }
      
  • Notes
      • Coverage.subscriber supports only Patient references

Example

Request

PATCH https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/623884-674012

Body

[
  {
    "op": "replace",
    "path": "/class/0/value",
    "value": "729825"
  },
  {
    "op": "replace",
    "path": "/class/1/value",
    "value": "456"
  },
  {
    "op": "replace",
    "path": "/class/1/name",
    "value": "Miscellaneous Commercial Health Plan"
  },
  {
    "op": "replace",
    "path": "/dependent",
    "value": "9816564"
  },
  {
    "op": "replace",
    "path": "/period",
    "value": {
      "start": "2014-09-05T14:30:12.000Z",
      "end": "2015-09-05T14:30:12.000Z"
    }
  },
  {
    "op": "replace",
    "path": "/relationship",
    "value": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
          "code": "parent"
        }
      ]
    }
  },
  {
    "op": "replace",
    "path": "/subscriberId",
    "value": "4655446"
  },
  {
    "op": "replace",
    "path": "/subscriber",
    "value": {
      "reference": "Patient/1626016"
    }
  }
]

Response

Status: 200 OK
Cache-Control: no-cache
Content-Length: 0
Content-Type: text/html
Date: Tue, 26 Mar 2019 15:42:29 GMT
Etag: W/"10"
Last-Modified: Tue, 26 Mar 2019 15:42:27 GMT
Vary: Origin
X-Request-Id: 47306a14c8a2c3afd4ab85aa9594101d

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

The ETag response header indicates the current If-Match version to use on subsequent updates.

Errors

The common errors and OperationOutcomes may be returned.

Delete

Delete an existing Encounter-level or Patient-level Coverage.

DELETE /Coverage/:id

Authorization Types

Headers

Authorization: <OAuth2 Bearer Token>
If-Match: W/"<Current version of the Coverage resource>"

Example

Request

DELETE https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/623884-674012

Response

Status: 204 No Content
Cache-Control: no-cache
Date: Wed, 20 May 2020 18:55:23 GMT
Vary: Origin
X-Request-Id: 160d603d256dce10d510f7da2ca1780e

Note: The examples provided here are non-normative and replaying them in the public sandbox is not guaranteed to yield the results shown on the site.

Errors

The common errors and OperationOutcomes may be returned.