Name	Flags	Card.	Type	Description & Constraints
Coverage	C	0..*	NzCoverage	Insurance or medical plan or a payment agreement dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management COVERAGE-STATUS-ALLOWED-CODES: draft status is not allowed COVERAGE-URL-ALLOWED-CHARS: character restrictions for URLs COVERAGE-SYSTEM-LENGTH: System URLs must be less than 1024 characters COVERAGE-SYSTEM-ALLOWED-CHARS: character restrictions for system url COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH: valueCodeableConcept.text must be less than 1024 characters COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS: character restrictions for valueCodeableConcept.text
id	Σ	0..1	id	Logical id of this artifact (The Entitlement.id)
Slices for contained		0..*	Resource	Contained, inline Resources Slice: Unordered, Closed by type:$this
contained:beneficiary		0..1	NesPatient	Information about an individual or animal receiving health care services
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	Σ	0..*	Identifier	Business Identifier for the Entitlement ele-1: All FHIR elements must have a @value or children
extension		0..0
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children Fixed Value: official
system	Σ	0..1	uri	The namespace for the identifier value Binding: NES Entitlement System Identifiers (required) ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
status	?!Σ	1..1	code	active | cancelled Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. ele-1: All FHIR elements must have a @value or children
type	Σ	0..1	CodeableConcept	Entitlement type such as CSC or HUHC. Binding: CoverageType (1.1.0) (required) ele-1: All FHIR elements must have a @value or children
beneficiary	Σ	1..1	Reference(NES Patient)	The Health service user's NHI. ele-1: All FHIR elements must have a @value or children
relationship		0..1	CodeableConcept	Used to identify a CSC dependent Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). ele-1: All FHIR elements must have a @value or children
period	Σ	0..1	Period	Entitlement Start and Expiry or End date ele-1: All FHIR elements must have a @value or children
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Organisation approving the entitlement. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Coverage.identifier.use	required	Fixed Value: official http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Coverage.identifier.system	required	Nes_Entitlement_Identifier https://nzhts.digital.health.nz/fhir/ValueSet/nes-entitlement-identifier-code
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
Coverage.type	required	CoverageType https://nzhts.digital.health.nz/fhir/ValueSet/coverage-type-code|1.1.0
Coverage.relationship	extensible	SubscriberRelationshipCodes http://hl7.org/fhir/ValueSet/subscriber-relationship from the FHIR Standard
Coverage.class.type	extensible	CoverageCategory https://nzhts.digital.health.nz/fhir/ValueSet/coverage-category-code

Constraints

Id	Grade	Path(s)	Details	Requirements
COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS	error	Coverage	character restrictions for valueCodeableConcept.text : Coverage.descendants().valueCodeableConcept.text.all(matches('^([-a-zA-Z0-9\' \t\r\n.\/,])*$'))
COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH	error	Coverage	valueCodeableConcept.text must be less than 1024 characters : Coverage.descendants().valueCodeableConcept.text.all(length()<1024)
COVERAGE-STATUS-ALLOWED-CODES	error	Coverage	draft status is not allowed : Coverage.status.all(matches('draft').not())
COVERAGE-SYSTEM-ALLOWED-CHARS	error	Coverage	character restrictions for system url : Coverage.descendants().system.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))
COVERAGE-SYSTEM-LENGTH	error	Coverage	System URLs must be less than 1024 characters : Coverage.descendants().system.all(length()<1024)
COVERAGE-URL-ALLOWED-CHARS	error	Coverage	character restrictions for URLs : Coverage.descendants().url.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))

Name	Flags	Card.	Type	Description & Constraints
Coverage	C	0..*	NzCoverage	Insurance or medical plan or a payment agreement COVERAGE-STATUS-ALLOWED-CODES: draft status is not allowed COVERAGE-URL-ALLOWED-CHARS: character restrictions for URLs COVERAGE-SYSTEM-LENGTH: System URLs must be less than 1024 characters COVERAGE-SYSTEM-ALLOWED-CHARS: character restrictions for system url COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH: valueCodeableConcept.text must be less than 1024 characters COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS: character restrictions for valueCodeableConcept.text
id		0..1	id	Logical id of this artifact (The Entitlement.id)
implicitRules		0..0
language		0..0
Slices for contained		0..*	Resource	Contained, inline Resources Slice: Unordered, Closed by type:$this
contained:beneficiary		0..1	NesPatient	Information about an individual or animal receiving health care services
identifier		0..*	Identifier	Business Identifier for the Entitlement
id		0..0
extension		0..0
use		0..1	code	usual | official | temp | secondary | old (If known) Fixed Value: official
type		0..0
system		0..1	uri	The namespace for the identifier value Binding: NES Entitlement System Identifiers (required)
period		0..0
assigner		0..0
status		1..1	code	active | cancelled
type		0..1	CodeableConcept	Entitlement type such as CSC or HUHC. Binding: CoverageType (1.1.0) (required)
policyHolder		0..0
subscriber		0..0
subscriberId		0..0
beneficiary		1..1	Reference(NES Patient)	The Health service user's NHI.
dependent		0..0
relationship		0..1	CodeableConcept	Used to identify a CSC dependent
period		0..1	Period	Entitlement Start and Expiry or End date
payor		1..*	Reference(Organization | Patient | RelatedPerson)	Organisation approving the entitlement.
class		0..0
order		0..0
network		0..0
costToBeneficiary		0..0
subrogation		0..0
contract		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Coverage.identifier.system	required	Nes_Entitlement_Identifier https://nzhts.digital.health.nz/fhir/ValueSet/nes-entitlement-identifier-code
Coverage.type	required	CoverageType https://nzhts.digital.health.nz/fhir/ValueSet/coverage-type-code|1.1.0

Constraints

Id	Grade	Path(s)	Details	Requirements
COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS	error	Coverage	character restrictions for valueCodeableConcept.text : Coverage.descendants().valueCodeableConcept.text.all(matches('^([-a-zA-Z0-9\' \t\r\n.\/,])*$'))
COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH	error	Coverage	valueCodeableConcept.text must be less than 1024 characters : Coverage.descendants().valueCodeableConcept.text.all(length()<1024)
COVERAGE-STATUS-ALLOWED-CODES	error	Coverage	draft status is not allowed : Coverage.status.all(matches('draft').not())
COVERAGE-SYSTEM-ALLOWED-CHARS	error	Coverage	character restrictions for system url : Coverage.descendants().system.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))
COVERAGE-SYSTEM-LENGTH	error	Coverage	System URLs must be less than 1024 characters : Coverage.descendants().system.all(length()<1024)
COVERAGE-URL-ALLOWED-CHARS	error	Coverage	character restrictions for URLs : Coverage.descendants().url.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))

Name	Flags	Card.	Type	Description & Constraints
Coverage	C	0..*	NzCoverage	Insurance or medical plan or a payment agreement COVERAGE-STATUS-ALLOWED-CODES: draft status is not allowed COVERAGE-URL-ALLOWED-CHARS: character restrictions for URLs COVERAGE-SYSTEM-LENGTH: System URLs must be less than 1024 characters COVERAGE-SYSTEM-ALLOWED-CHARS: character restrictions for system url COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH: valueCodeableConcept.text must be less than 1024 characters COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS: character restrictions for valueCodeableConcept.text
id	Σ	0..1	id	Logical id of this artifact (The Entitlement.id)
meta	Σ	0..1	Meta	Metadata about the resource
text		0..1	Narrative	Text summary of the resource, for human interpretation
Slices for contained		0..*	Resource	Contained, inline Resources Slice: Unordered, Closed by type:$this
contained:beneficiary		0..1	NesPatient	Information about an individual or animal receiving health care services
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for the Entitlement
extension		0..0
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official
system	Σ	0..1	uri	The namespace for the identifier value Binding: NES Entitlement System Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	The value that is unique Example General: 123456
status	?!Σ	1..1	code	active | cancelled Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	0..1	CodeableConcept	Entitlement type such as CSC or HUHC. Binding: CoverageType (1.1.0) (required)
beneficiary	Σ	1..1	Reference(NES Patient)	The Health service user's NHI.
relationship		0..1	CodeableConcept	Used to identify a CSC dependent Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Entitlement Start and Expiry or End date
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Organisation approving the entitlement.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Coverage.identifier.use	required	Fixed Value: official http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Coverage.identifier.system	required	Nes_Entitlement_Identifier https://nzhts.digital.health.nz/fhir/ValueSet/nes-entitlement-identifier-code
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
Coverage.type	required	CoverageType https://nzhts.digital.health.nz/fhir/ValueSet/coverage-type-code|1.1.0
Coverage.relationship	extensible	SubscriberRelationshipCodes http://hl7.org/fhir/ValueSet/subscriber-relationship from the FHIR Standard
Coverage.class.type	extensible	CoverageCategory https://nzhts.digital.health.nz/fhir/ValueSet/coverage-category-code
Coverage.costToBeneficiary.type	extensible	CoverageCopayTypeCodes http://hl7.org/fhir/ValueSet/coverage-copay-type from the FHIR Standard
Coverage.costToBeneficiary.exception.type	example	ExampleCoverageFinancialExceptionCodes http://hl7.org/fhir/ValueSet/coverage-financial-exception from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS	error	Coverage	character restrictions for valueCodeableConcept.text : Coverage.descendants().valueCodeableConcept.text.all(matches('^([-a-zA-Z0-9\' \t\r\n.\/,])*$'))
COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH	error	Coverage	valueCodeableConcept.text must be less than 1024 characters : Coverage.descendants().valueCodeableConcept.text.all(length()<1024)
COVERAGE-STATUS-ALLOWED-CODES	error	Coverage	draft status is not allowed : Coverage.status.all(matches('draft').not())
COVERAGE-SYSTEM-ALLOWED-CHARS	error	Coverage	character restrictions for system url : Coverage.descendants().system.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))
COVERAGE-SYSTEM-LENGTH	error	Coverage	System URLs must be less than 1024 characters : Coverage.descendants().system.all(length()<1024)
COVERAGE-URL-ALLOWED-CHARS	error	Coverage	character restrictions for URLs : Coverage.descendants().url.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))

Summary

Fixed: 1 element
Prohibited: 17 elements

Structures

This structure refers to these other structures:

• NES Patient (http://hl7.org.nz/fhir/StructureDefinition/NesPatient)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.contained (Closed)

Name	Flags	Card.	Type	Description & Constraints
Coverage	C	0..*	NzCoverage	Insurance or medical plan or a payment agreement dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management COVERAGE-STATUS-ALLOWED-CODES: draft status is not allowed COVERAGE-URL-ALLOWED-CHARS: character restrictions for URLs COVERAGE-SYSTEM-LENGTH: System URLs must be less than 1024 characters COVERAGE-SYSTEM-ALLOWED-CHARS: character restrictions for system url COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH: valueCodeableConcept.text must be less than 1024 characters COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS: character restrictions for valueCodeableConcept.text
id	Σ	0..1	id	Logical id of this artifact (The Entitlement.id)
Slices for contained		0..*	Resource	Contained, inline Resources Slice: Unordered, Closed by type:$this
contained:beneficiary		0..1	NesPatient	Information about an individual or animal receiving health care services
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	Σ	0..*	Identifier	Business Identifier for the Entitlement ele-1: All FHIR elements must have a @value or children
extension		0..0
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . ele-1: All FHIR elements must have a @value or children Fixed Value: official
system	Σ	0..1	uri	The namespace for the identifier value Binding: NES Entitlement System Identifiers (required) ele-1: All FHIR elements must have a @value or children Example General: http://www.acme.com/identifiers/patient
status	?!Σ	1..1	code	active | cancelled Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. ele-1: All FHIR elements must have a @value or children
type	Σ	0..1	CodeableConcept	Entitlement type such as CSC or HUHC. Binding: CoverageType (1.1.0) (required) ele-1: All FHIR elements must have a @value or children
beneficiary	Σ	1..1	Reference(NES Patient)	The Health service user's NHI. ele-1: All FHIR elements must have a @value or children
relationship		0..1	CodeableConcept	Used to identify a CSC dependent Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient). ele-1: All FHIR elements must have a @value or children
period	Σ	0..1	Period	Entitlement Start and Expiry or End date ele-1: All FHIR elements must have a @value or children
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Organisation approving the entitlement. ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Coverage.identifier.use	required	Fixed Value: official http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Coverage.identifier.system	required	Nes_Entitlement_Identifier https://nzhts.digital.health.nz/fhir/ValueSet/nes-entitlement-identifier-code
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
Coverage.type	required	CoverageType https://nzhts.digital.health.nz/fhir/ValueSet/coverage-type-code|1.1.0
Coverage.relationship	extensible	SubscriberRelationshipCodes http://hl7.org/fhir/ValueSet/subscriber-relationship from the FHIR Standard
Coverage.class.type	extensible	CoverageCategory https://nzhts.digital.health.nz/fhir/ValueSet/coverage-category-code

Constraints

Id	Grade	Path(s)	Details	Requirements
COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS	error	Coverage	character restrictions for valueCodeableConcept.text : Coverage.descendants().valueCodeableConcept.text.all(matches('^([-a-zA-Z0-9\' \t\r\n.\/,])*$'))
COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH	error	Coverage	valueCodeableConcept.text must be less than 1024 characters : Coverage.descendants().valueCodeableConcept.text.all(length()<1024)
COVERAGE-STATUS-ALLOWED-CODES	error	Coverage	draft status is not allowed : Coverage.status.all(matches('draft').not())
COVERAGE-SYSTEM-ALLOWED-CHARS	error	Coverage	character restrictions for system url : Coverage.descendants().system.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))
COVERAGE-SYSTEM-LENGTH	error	Coverage	System URLs must be less than 1024 characters : Coverage.descendants().system.all(length()<1024)
COVERAGE-URL-ALLOWED-CHARS	error	Coverage	character restrictions for URLs : Coverage.descendants().url.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))

Name	Flags	Card.	Type	Description & Constraints
Coverage	C	0..*	NzCoverage	Insurance or medical plan or a payment agreement COVERAGE-STATUS-ALLOWED-CODES: draft status is not allowed COVERAGE-URL-ALLOWED-CHARS: character restrictions for URLs COVERAGE-SYSTEM-LENGTH: System URLs must be less than 1024 characters COVERAGE-SYSTEM-ALLOWED-CHARS: character restrictions for system url COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH: valueCodeableConcept.text must be less than 1024 characters COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS: character restrictions for valueCodeableConcept.text
id		0..1	id	Logical id of this artifact (The Entitlement.id)
implicitRules		0..0
language		0..0
Slices for contained		0..*	Resource	Contained, inline Resources Slice: Unordered, Closed by type:$this
contained:beneficiary		0..1	NesPatient	Information about an individual or animal receiving health care services
identifier		0..*	Identifier	Business Identifier for the Entitlement
id		0..0
extension		0..0
use		0..1	code	usual | official | temp | secondary | old (If known) Fixed Value: official
type		0..0
system		0..1	uri	The namespace for the identifier value Binding: NES Entitlement System Identifiers (required)
period		0..0
assigner		0..0
status		1..1	code	active | cancelled
type		0..1	CodeableConcept	Entitlement type such as CSC or HUHC. Binding: CoverageType (1.1.0) (required)
policyHolder		0..0
subscriber		0..0
subscriberId		0..0
beneficiary		1..1	Reference(NES Patient)	The Health service user's NHI.
dependent		0..0
relationship		0..1	CodeableConcept	Used to identify a CSC dependent
period		0..1	Period	Entitlement Start and Expiry or End date
payor		1..*	Reference(Organization | Patient | RelatedPerson)	Organisation approving the entitlement.
class		0..0
order		0..0
network		0..0
costToBeneficiary		0..0
subrogation		0..0
contract		0..0
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Coverage.identifier.system	required	Nes_Entitlement_Identifier https://nzhts.digital.health.nz/fhir/ValueSet/nes-entitlement-identifier-code
Coverage.type	required	CoverageType https://nzhts.digital.health.nz/fhir/ValueSet/coverage-type-code|1.1.0

Constraints

Id	Grade	Path(s)	Details	Requirements
COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS	error	Coverage	character restrictions for valueCodeableConcept.text : Coverage.descendants().valueCodeableConcept.text.all(matches('^([-a-zA-Z0-9\' \t\r\n.\/,])*$'))
COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH	error	Coverage	valueCodeableConcept.text must be less than 1024 characters : Coverage.descendants().valueCodeableConcept.text.all(length()<1024)
COVERAGE-STATUS-ALLOWED-CODES	error	Coverage	draft status is not allowed : Coverage.status.all(matches('draft').not())
COVERAGE-SYSTEM-ALLOWED-CHARS	error	Coverage	character restrictions for system url : Coverage.descendants().system.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))
COVERAGE-SYSTEM-LENGTH	error	Coverage	System URLs must be less than 1024 characters : Coverage.descendants().system.all(length()<1024)
COVERAGE-URL-ALLOWED-CHARS	error	Coverage	character restrictions for URLs : Coverage.descendants().url.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))

Name	Flags	Card.	Type	Description & Constraints
Coverage	C	0..*	NzCoverage	Insurance or medical plan or a payment agreement COVERAGE-STATUS-ALLOWED-CODES: draft status is not allowed COVERAGE-URL-ALLOWED-CHARS: character restrictions for URLs COVERAGE-SYSTEM-LENGTH: System URLs must be less than 1024 characters COVERAGE-SYSTEM-ALLOWED-CHARS: character restrictions for system url COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH: valueCodeableConcept.text must be less than 1024 characters COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS: character restrictions for valueCodeableConcept.text
id	Σ	0..1	id	Logical id of this artifact (The Entitlement.id)
meta	Σ	0..1	Meta	Metadata about the resource
text		0..1	Narrative	Text summary of the resource, for human interpretation
Slices for contained		0..*	Resource	Contained, inline Resources Slice: Unordered, Closed by type:$this
contained:beneficiary		0..1	NesPatient	Information about an individual or animal receiving health care services
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	Σ	0..*	Identifier	Business Identifier for the Entitlement
extension		0..0
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known . Fixed Value: official
system	Σ	0..1	uri	The namespace for the identifier value Binding: NES Entitlement System Identifiers (required) Example General: http://www.acme.com/identifiers/patient
value	Σ	0..1	string	The value that is unique Example General: 123456
status	?!Σ	1..1	code	active | cancelled Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	Σ	0..1	CodeableConcept	Entitlement type such as CSC or HUHC. Binding: CoverageType (1.1.0) (required)
beneficiary	Σ	1..1	Reference(NES Patient)	The Health service user's NHI.
relationship		0..1	CodeableConcept	Used to identify a CSC dependent Binding: SubscriberRelationshipCodes (extensible): The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
period	Σ	0..1	Period	Entitlement Start and Expiry or End date
payor	Σ	1..*	Reference(Organization | Patient | RelatedPerson)	Organisation approving the entitlement.
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Coverage.identifier.use	required	Fixed Value: official http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 from the FHIR Standard
Coverage.identifier.system	required	Nes_Entitlement_Identifier https://nzhts.digital.health.nz/fhir/ValueSet/nes-entitlement-identifier-code
Coverage.status	required	FinancialResourceStatusCodes http://hl7.org/fhir/ValueSet/fm-status|4.0.1 from the FHIR Standard
Coverage.type	required	CoverageType https://nzhts.digital.health.nz/fhir/ValueSet/coverage-type-code|1.1.0
Coverage.relationship	extensible	SubscriberRelationshipCodes http://hl7.org/fhir/ValueSet/subscriber-relationship from the FHIR Standard
Coverage.class.type	extensible	CoverageCategory https://nzhts.digital.health.nz/fhir/ValueSet/coverage-category-code
Coverage.costToBeneficiary.type	extensible	CoverageCopayTypeCodes http://hl7.org/fhir/ValueSet/coverage-copay-type from the FHIR Standard
Coverage.costToBeneficiary.exception.type	example	ExampleCoverageFinancialExceptionCodes http://hl7.org/fhir/ValueSet/coverage-financial-exception from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
COVERAGE-CODEABLE-CONCEPT-TEXT-ALLOWED-CHARS	error	Coverage	character restrictions for valueCodeableConcept.text : Coverage.descendants().valueCodeableConcept.text.all(matches('^([-a-zA-Z0-9\' \t\r\n.\/,])*$'))
COVERAGE-CODEABLE-CONCEPT-TEXT-LENGTH	error	Coverage	valueCodeableConcept.text must be less than 1024 characters : Coverage.descendants().valueCodeableConcept.text.all(length()<1024)
COVERAGE-STATUS-ALLOWED-CODES	error	Coverage	draft status is not allowed : Coverage.status.all(matches('draft').not())
COVERAGE-SYSTEM-ALLOWED-CHARS	error	Coverage	character restrictions for system url : Coverage.descendants().system.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))
COVERAGE-SYSTEM-LENGTH	error	Coverage	System URLs must be less than 1024 characters : Coverage.descendants().system.all(length()<1024)
COVERAGE-URL-ALLOWED-CHARS	error	Coverage	character restrictions for URLs : Coverage.descendants().url.all(matches('^[-a-zA-Z0-9@:%._~#=?&\/]*$'))

Summary

Fixed: 1 element
Prohibited: 17 elements

Structures

This structure refers to these other structures:

• NES Patient (http://hl7.org.nz/fhir/StructureDefinition/NesPatient)

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the value of Coverage.contained (Closed)