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Specification:

FHIR Core (FHIR)
Raised in Version:

STU3
Work Group:

Financial Mgmt
Related Artifact(s):

Coverage
Resolution Description:

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FM has altered the structure based on a prior input as shown in the resource in the ballot to replace 'grouping' with 'class' which closely resembles your Option 2 but uses a string rather then an identifier to hod the value of the 'group' or 'plan' given that it would be a code-like thing but where the system is never expressed.

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FM has altered the structure based on a prior input as shown in the resource in the ballot to replace 'grouping' with 'class' which closely resembles your Option 2 but uses a string rather then an identifier to hod the value of the 'group' or 'plan' given that it would be a code-like thing but where the system is never expressed.
Resolution Vote:
Lou Bedor/Andy Stechishin: 5-0-0
Change Category:
Enhancement

Coverage.grouping is very un FHIR-like. Since these are identifiers use the Identifier datatype mapping the elements as follows:

Option A:

grouping.group --> group 0..1 Identifier

+ add new code for 'Payor Group Number' to http://hl7.org/fhir/ValueSet/identifier-type for Idenfiier.type

grouping.groupDisplay --> Idenfiier.assigner.display

+ add new code for 'Payor SubGroup Number' to http://hl7.org/fhir/ValueSet/identifier-type for Idenfiier.type

grouping.subgroup --> subgroup 0..1 Identifier

etc..

Option B:

.grouping --> .plan 0..* BackboneElement

plan.type 1..1 type codeableConcept ( valueset of 'plan', 'group', 'subplan', 'subgroup', etc. and allows for display)

plan.identifier 1..1 type Identifier ( add code for payor plan number to type)

e.g., grouping.group --> plan.type.coding.code = "plan" + plan.identifiier.value = [id]

e.g.,grouping.groupDisplay --> plan.type.text = "Kaiser Bronze Plan"

is voted on by

BALLOT-3650 Negative - Eric Haas : 2018-Jan-FHIR R1