| COCT_HD510003UV06 A_Coverage contact |
(Link to Excel View) Derived from RMIM: COCT_RM510003UV06 |
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| CoverageRecord | |||||||||
| classCode [1..1] (M) FinancialContract (CS) {CNE:V:ActClassCoverage, root= "COV"} |
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| moodCode [1..1] (M) FinancialContract (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| id [0..*] FinancialContract (DSET<II>) |
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| statusCode [0..1] FinancialContract (CS) {CNE:V:ActStatus} |
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| component [0..*] (Component) | |||||||||
| Component | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipHasComponent, root= "COMP"} |
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| priorityNumber [0..1] ActRelationship (INT) |
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| policyOrProgram [1..1] (PolicyOrProgram) | |||||||||
| PolicyOrProgram | |||||||||
| classCode [1..1] (M) FinancialContract (CS) {CNE:V:ActClassCoverage, root= "COV"} |
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| moodCode [1..1] (M) FinancialContract (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| id [0..*] FinancialContract (DSET<II>) |
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| code [1..1] (M) FinancialContract (CD) {CWE:D:ActCoverageTypeCode} |
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| statusCode [0..1] FinancialContract (CS) {CNE:V:ActStatus} |
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| effectiveTime [0..1] FinancialContract (IVL<TS>) |
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| coveredParty [1..1] (CoveredParty2) | |||||||||
| primaryPerformer [0..1] (PrimaryPerformer) | |||||||||
| CoveredParty2 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationCoverageTarget, root= "COV"} |
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| negationInd [0..1] Participation (BL){default= "true"} |
Design Comments: If the optional negationInd is sent, the value should be "true". The receiving application will interpret this as meaning that the coverage participation is negated. If the optional negationInd is not sent, then the receiving application assumes the negationInd value is "false" meaning that the participation is correct. |
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| coveredParty [1..1] (CoveredParty) | |||||||||
| CoveredParty | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassCoveredParty, root= "COVPTY"} |
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| id [1..1] Role (II) |
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| addr [0..*] Role (COLL<AD>) |
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| telecom [0..*] Role (COLL<TEL>) |
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| effectiveTime [0..1] Role (IVL<TS>) |
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| coveredEntityChoiceSubject [0..1] (E_LivingSubjectInformational) | |||||||||
| PrimaryPerformer | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationPrimaryPerformer, root= "PPRF"} |
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| payor [1..1] (Payor) | |||||||||
| Payor | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassInvoicePayor, root= "PAYOR"} |
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| id [0..*] Role (DSET<II>) |
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| name [0..*] Role (COLL<ON>) |
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| addr [0..*] Role (COLL<AD>) |
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| telecom [0..*] Role (COLL<TEL>) |
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| effectiveTime [0..1] Role (IVL<TS>) |
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