| COCT_MT510000UV06 A_Coverage universal |
Derived from RMIM: COCT_RM510000UV06 and HMD: COCT_HD510000UV06 |
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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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| effectiveTime [0..1] FinancialContract (IVL<TS>) |
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| confidentialityCode [0..*] FinancialContract (DSET<CD>) {CWE:D:Confidentiality} |
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| beneficiary [0..1] (Beneficiary2) | |||||||||
| component [0..*] (Component) | |||||||||
| Beneficiary2 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationBeneficiary, root= "BEN"} |
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| negationInd [0..1] Participation (BL) |
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| beneficiaryChoice [1..1] (BeneficiaryChoice) | |||||||||
| BeneficiaryChoice | |||||||||
| choice of R_PatientUniversal | |||||||||
| or Beneficiary | |||||||||
| Beneficiary | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassMember, root= "MBR"} |
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| id [0..*] Role (DSET<II>) |
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| code [0..1] Role (CD) {CWE:D:MemberRoleType} |
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| statusCode [0..1] Role (CS) {CNE:V:RoleStatus} |
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| memberBeneficiary-CoveredPartyChoice [0..1] (Beneficiary-CoveredPartyChoice) | |||||||||
| groupOrganization [0..1] (Organization) | |||||||||
| Beneficiary-CoveredPartyChoice | |||||||||
| choice of E_OrganizationUniversal | |||||||||
| or E_LivingSubjectInformational | |||||||||
| Organization | |||||||||
| classCode [1..1] (M) Organization (CS) {CNE:V:EntityClassOrganization, root= "ORG"} |
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| determinerCode [1..1] (M) Organization (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"} |
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| name [1..*] Organization (COLL<ON>) |
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| telecom [0..*] Organization (COLL<TEL>) |
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| addr [0..1] Organization (AD) |
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| 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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| confidentialityCode [0..*] FinancialContract (DSET<CD>) {CWE:D:Confidentiality} |
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| coveredParty [1..1] (CoveredParty2) | |||||||||
| holder [0..1] (Holder) | |||||||||
| responsibleParty [0..1] (ResponsibleParty2) | |||||||||
| primaryPerformer [0..*] (PrimaryPerformer) | |||||||||
| author [0..*] (Author2) | |||||||||
| definition [0..1] (Definition3) | |||||||||
| replacementOf [0..1] (ReplacementOf) | |||||||||
| limitation1 [0..*] (Limitation3) | |||||||||
| limitation2 [0..*] (Limitation) | |||||||||
| coverageOf [0..*] (Coverage2) | |||||||||
| CoveredParty2 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationCoverageTarget, root= "COV"} |
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| negationInd [0..1] Participation (BL){default= "true"} |
UsageNotes: ERROR - Business name from Visio is too long and was truncated. Full businessName follows. (Means that a P/P is not applicable under the circumstances, e.g., the patient has workers comp coverage but the encounter is not work-related |
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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..*] Role (DSET<II>) |
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| code [0..1] Role (CD) {CWE:V:CoverageRoleType} |
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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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| coveredBeneficiary-CoveredPartyChoice [0..1] (Beneficiary-CoveredPartyChoice) | |||||||||
| underwritingOrganization [0..1] (E_OrganizationUniversal) | |||||||||
| subjectOf1 [0..*] (Subject) | |||||||||
| subjectOf2 [0..*] (Subject3) | |||||||||
| part [0..*] (Part) | |||||||||
| indirectAuthority1 [0..*] (IndirectAuthorithyOver) | |||||||||
| indirectAuthority2 [0..1] (IndirectAuthorithyOver2) | |||||||||
| Subject | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationTargetSubject, root= "SBJ"} |
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| eligibilityStatusObservation [1..1] (EligibilityStatusObservation) | |||||||||
| EligibilityStatusObservation | |||||||||
| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassObservation, root= "OBS"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"} |
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| id [0..*] Observation (DSET<II>) |
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| code [0..1] Observation (CD) {CWE:D:ObservationEligibilityIndicatorType} |
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| effectiveTime [0..1] Observation (IVL<TS>) |
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| value [0..1] Observation (COLL<ED>) |
UsageNotes: ERROR - Business name from Visio is too long and was truncated. Full businessName follows. (scan of a member id, certificate of creditable coverage, health status report or assessment |
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| Subject3 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationTargetSubject, root= "SBJ"} |
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| verification [1..1] (A_VerificationUniversal) | |||||||||
| Part | |||||||||
| typeCode [1..1] (M) RoleLink (CS) {CNE:V:RoleLinkHasPart, root= "PART"} |
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| priorityNumber [0..1] RoleLink (INT.NONNEG) |
UsageNotes: ERROR - Business name from Visio is too long and was truncated. Full businessName follows. (e.g., adopted child who is a relative, priority is the role that is the basis for coverage |
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| effectiveTime [0..1] RoleLink (IVL<TS>) |
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| personalRelationship [1..1] (PersonalRelationship) | |||||||||
| PersonalRelationship | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassPersonalRelationship, root= "PRS"} |
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| id [0..*] Role (DSET<II>) |
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| code [0..1] Role (CD) {CWE:D:PersonalRelationshipRoleType} |
UsageNotes: ERROR - Business name from Visio is too long and was truncated. Full businessName follows. (personal relationship pertinent to the covered party role (e.g.,) adopted child, spouse |
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| relationshipHolder [0..1] (Person) | |||||||||
| personalRelationshipWith [0..1] (Person) | |||||||||
| IndirectAuthorithyOver | |||||||||
| typeCode [1..1] (M) RoleLink (CS) {CNE:V:RoleLinkHasIndirectAuthorityOver, root= "INDAUTH"} |
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| responsibleParty [1..1] (ResponsibleParty) | |||||||||
| ResponsibleParty | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassAgent, root= "AGNT"} |
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| id [0..*] Role (DSET<II>) |
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| code [0..1] Role (CD) {CWE:D:ResponsiblePartyRoleType} |
UsageNotes: ERROR - Business name from Visio is too long and was truncated. Full businessName follows. (Party responsible for the status of an entity as a covered party who is a dependent e.g., subscriber, guardian, executor |
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| addr [0..*] Role (COLL<AD>) |
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| telecom [0..*] Role (COLL<TEL>) |
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| agentPerson [0..1] (Person) | |||||||||
| representedEntityChoice [0..1] (EntityChoice) | |||||||||
| Person | |||||||||
| classCode [1..1] (M) Person (CS) {CNE:V:EntityClassPerson, root= "PSN"} |
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| determinerCode [1..1] (M) Person (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"} |
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| name [1..*] Person (COLL<PN>) |
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| telecom [0..*] Person (COLL<TEL>) |
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| birthTime [0..1] Person (TS) |
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| addr [0..*] Person (COLL<AD>) |
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| EntityChoice | |||||||||
| choice of Person | |||||||||
| or Organization | |||||||||
| IndirectAuthorithyOver2 | |||||||||
| typeCode [1..1] (M) RoleLink (CS) {CNE:V:RoleLinkHasIndirectAuthorityOver, root= "INDAUTH"} |
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| policyHolder [1..1] (PolicyHolder) | |||||||||
| PolicyHolder | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassPolicyHolder, root= "POLHOLD"} |
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| id [0..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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| policyHolderEntityChoice [0..1] (EntityChoice) | |||||||||
| underwritingOrganization [0..1] (E_OrganizationUniversal) | |||||||||
| Holder | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationHolder, root= "HLD"} |
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| policyHolder [1..1] (PolicyHolder) | |||||||||
| ResponsibleParty2 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationResponsibleParty, root= "RESP"} |
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| functionCode [0..1] Participation (CD) {CWE:D:SponsorParticipationFunction} |
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| sponsor [1..1] (Sponsor) | |||||||||
| Sponsor | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassCoverageSponsor, root= "SPNSR"} |
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| id [0..*] Role (DSET<II>) |
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| code [0..1] Role (CD) {CWE:D:SponsorRoleType} |
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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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| sponsorOrganization [0..1] (E_OrganizationUniversal) | |||||||||
| underwritingOrganization [0..1] (E_OrganizationUniversal) | |||||||||
| directAuthorityOver [0..*] (DirectAuthorityOver3) | |||||||||
| DirectAuthorityOver3 | |||||||||
| typeCode [1..1] (M) RoleLink (CS) {CNE:V:RoleLinkHasDirectAuthorityOver, root= "DIRAUTH"} |
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| underwriter [1..1] (Underwriter) | |||||||||
| PrimaryPerformer | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationPrimaryPerformer, root= "PPRF"} |
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| functionCode [0..1] Participation (CD) {CWE:D:PayorParticipationFunction} |
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| payor [1..1] (Payor) | |||||||||
| Author2 | |||||||||
| typeCode [1..1] (M) Participation (CS) {CNE:V:ParticipationAuthorOriginator, root= "AUT"} |
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| functionCode [0..1] Participation (CD) {CWE:D:UnderwriterParticipationFunction} |
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| underwriter [1..1] (Underwriter) | |||||||||
| Underwriter | |||||||||
| classCode [1..1] (M) Role (CS) {CNE:V:RoleClassUnderwriter, root= "UNDWRT"} |
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| id [0..*] Role (DSET<II>) |
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| code [0..1] Role (CD) {CWE:D:UnderwriterRoleType} |
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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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| underwritingOrganization [0..1] (E_OrganizationUniversal) | |||||||||
| scoperOrganization [0..1] (E_OrganizationUniversal) | |||||||||
| directAuthorityOver1 [0..*] (DirectAuthorityOver2) | |||||||||
| directAuthorityOver2 [0..*] (DirectAuthorityOver) | |||||||||
| DirectAuthorityOver2 | |||||||||
| typeCode [1..1] (M) RoleLink (CS) {CNE:V:RoleLinkHasDirectAuthorityOver, root= "DIRAUTH"} |
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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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| code [0..1] Role (CD) {CWE:D:CoverageAdministratorRoleType} |
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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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| invoicePayorOrganization [0..1] (E_OrganizationUniversal) | |||||||||
| underwritingOrganization [0..1] (E_OrganizationUniversal) | |||||||||
| directAuthorityOver [0..*] (DirectAuthorityOver4) | |||||||||
| DirectAuthorityOver4 | |||||||||
| typeCode [1..1] (M) RoleLink (CS) {CNE:V:RoleLinkHasDirectAuthorityOver, root= "DIRAUTH"} |
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| payor [1..1] (Payor) | |||||||||
| DirectAuthorityOver | |||||||||
| typeCode [1..1] (M) RoleLink (CS) {CNE:V:RoleLinkHasDirectAuthorityOver, root= "DIRAUTH"} |
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| underwriter [1..1] (Underwriter) | |||||||||
| Definition3 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipInstantiatesMaster, root= "INST"} |
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| coverageDefinition [1..1] (CoverageDefinition) | |||||||||
| CoverageDefinition | |||||||||
| classCode [1..1] (M) FinancialContract (CS) {CNE:V:ActClassCoverage, root= "COV"} |
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| moodCode [1..1] (M) FinancialContract (CS) {CNE:V:ActMoodDefinition, root= "DEF"} |
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| id [0..*] FinancialContract (DSET<II>) |
UsageNotes: ERROR - Business name from Visio is too long and was truncated. Full businessName follows. (identifier assigned to the policy or program master document by a jurisdictional regulator of insurance products, e.g., plan identifer |
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| title [0..1] FinancialContract (ST) |
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| text [0..1] FinancialContract (ST) |
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| ReplacementOf | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipReplaces, root= "RPLC"} |
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| previousPolicyOrProgram [1..1] (PreviousPolicyOrProgram) | |||||||||
| PreviousPolicyOrProgram | |||||||||
| 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 [1..1] FinancialContract (CS) {CNE:D:_NotDefined} |
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| effectiveTime [0..1] FinancialContract (IVL<TS>) |
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| Limitation3 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipLimitedBy, root= "LIMIT"} |
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| policyOrProgramFinancialLimit [1..1] (PolicyOrProgramFinancialLimit) | |||||||||
| PolicyOrProgramFinancialLimit | |||||||||
| classCode [1..1] (M) InvoiceElement (CS) {CNE:V:ActClassInvoiceElement, root= "INVE"} |
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| moodCode [1..1] (M) InvoiceElement (CS) {CNE:V:ActMoodDefinition, root= "DEF"} |
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| id [0..*] InvoiceElement (DSET<II>) |
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| code [0..1] InvoiceElement (CD) {CWE:D:ActCoverageQuantityLimitCode} |
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| effectiveTime [0..1] InvoiceElement (IVL<TS>) |
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| netAmt [0..1] InvoiceElement (MO) |
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| Limitation | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipLimitedBy, root= "LIMIT"} |
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| coverageLimitObservation [1..1] (CoverageLimitObservation) | |||||||||
| CoverageLimitObservation | |||||||||
| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassObservation, root= "OBS"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodDefinition, root= "DEF"} |
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| id [0..*] Observation (DSET<II>) |
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| code [0..1] Observation (CD) {CWE:D:CoverageLimitObservationCode} |
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| effectiveTime [0..1] Observation (IVL<TS>) |
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| value [0..1] Observation (CD) {CWE:D:CoverageLimitObservationValue} |
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| Coverage2 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipCoveredBy, root= "COVBY"} |
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| negationInd [0..1] ActRelationship (BL) |
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| benefit [1..1] (Benefit) | |||||||||
| Benefit | |||||||||
| classCode [1..1] (M) Act (CS) {CNE:V:ActClassCareProvision, root= "PCPR"} |
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| moodCode [1..1] (M) Act (CS) {CNE:V:ActMoodCompletionTrack} |
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| id [0..*] Act (DSET<II>) |
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| code [0..1] Act (CD) {CWE:V:x_ActBillableCode} |
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| negationInd [0..1] Act (BL) |
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| effectiveTime [0..1] Act (IVL<TS>) |
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| confidentialityCode [0..*] Act (DSET<CD>) {CWE:D:Confidentiality} |
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| reasonCode [0..*] Act (DSET<CD>) {CWE:D:ActCoverageReason} |
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| definition [0..*] (Definition) | |||||||||
| precondition [0..*] (Precondition) | |||||||||
| reference [0..*] (Reference) | |||||||||
| limitation [0..*] (Limitation2) | |||||||||
| Definition | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipInstantiatesMaster, root= "INST"} |
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| benefitChoice [1..1] (BenefitChoice) |
Design Comments: The A_SupportingClinicalStatement and A_TransportationCMETs will be replaced with the A_CareStatement CMET RM00100 in DEF ActMood |
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| BenefitChoice |
Design Comments: The A_SupportingClinicalStatement and A_TransportationCMETs will be replaced with the A_CareStatement CMET RM00100 in DEF ActMood |
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| choice of A_BillableUniversal | |||||||||
| or A_SupportingClinicalStatementUniversal | |||||||||
| or A_TransportationUniversal | |||||||||
| or ServiceDefinition | |||||||||
| ServiceDefinition | |||||||||
| classCode [1..1] (M) Act (CS) {CNE:V:ActClassRoot, root= "ACT"} |
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| moodCode [1..1] (M) Act (CS) {CNE:V:ActMoodDefinition, root= "DEF"} |
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| code [0..1] Act (CD) {CWE:V:x_ActBillableCode} |
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| Precondition | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipHasPre-condition, root= "PRCN"} |
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| clinicalStatement [1..1] (A_SupportingClinicalStatementUniversal) | |||||||||
| Reference | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipRefersTo, root= "REFR"} |
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| coveragePolicy [1..1] (CoveragePolicy) | |||||||||
| CoveragePolicy | |||||||||
| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassPolypeptide, root= "POL"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodDefinition, root= "DEF"} |
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| id [0..*] Observation (DSET<II>) |
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| code [0..1] Observation (CD) {CWE:D:ActPolicyType} |
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| statusCode [0..1] Observation (CS) {CNE:V:ActStatus} |
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| effectiveTime [0..1] Observation (IVL<TS>) |
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| reasonCode [0..*] Observation (DSET<CD>) {CWE:D:ActCoverageReason} |
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| Limitation2 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipLimitedBy, root= "LIMIT"} |
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| coverageChargeChoice [1..1] (CoverageChargeChoice) | |||||||||
| CoverageChargeChoice | |||||||||
| reference [0..*] (Reference2) | |||||||||
| choice of CoverageCharge | |||||||||
| or FinancialParticipationCharge | |||||||||
| Reference2 | |||||||||
| typeCode [1..1] (M) ActRelationship (CS) {CNE:V:ActRelationshipRefersTo, root= "REFR"} |
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| coverageChargePolicy [1..1] (CoverageChargePolicy) | |||||||||
| CoverageChargePolicy | |||||||||
| classCode [1..1] (M) Observation (CS) {CNE:V:ActClassPolypeptide, root= "POL"} |
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| moodCode [1..1] (M) Observation (CS) {CNE:V:ActMoodDefinition, root= "DEF"} |
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| id [0..*] Observation (DSET<II>) |
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| code [0..1] Observation (CD) {CWE:D:ActPolicyType} |
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| statusCode [0..1] Observation (CS) {CNE:V:ActStatus} |
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| effectiveTime [0..1] Observation (IVL<TS>) |
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| reasonCode [0..*] Observation (DSET<CD>) {CWE:D:ActCoverageReason} |
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| CoverageCharge | |||||||||
| classCode [1..1] (M) InvoiceElement (CS) {CNE:V:ActClassInvoiceElement, root= "INVE"} |
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| moodCode [1..1] (M) InvoiceElement (CS) {CNE:V:ActMoodCriterion, root= "CRT"} |
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| id [0..*] InvoiceElement (DSET<II>) |
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| code [0..1] InvoiceElement (CD) {CWE:D:ActCoverageLimitCode} |
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| effectiveTime [0..1] InvoiceElement (IVL<TS>) |
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| unitQuantity [0..1] InvoiceElement (RTO<PQ,PQ>) |
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| unitPriceAmt [0..1] InvoiceElement (RTO<MO,PQ>) |
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| netAmt [0..1] InvoiceElement (MO) |
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| factorNumber [0..1] InvoiceElement (REAL) |
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| Inherits associations from CoverageChargeChoice | |||||||||
| FinancialParticipationCharge | |||||||||
| classCode [1..1] (M) InvoiceElement (CS) {CNE:V:ActClassInvoiceElement, root= "INVE"} |
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| moodCode [1..1] (M) InvoiceElement (CS) {CNE:V:ActMoodCriterion, root= "CRT"} |
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| id [0..*] InvoiceElement (DSET<II>) |
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| code [0..1] InvoiceElement (CD) {CWE:V:ActInvoiceDetailGenericAdjudicatorCode} |
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| effectiveTime [0..1] InvoiceElement (IVL<TS>) |
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| unitQuantity [0..1] InvoiceElement (RTO<PQ,PQ>) |
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| unitPriceAmt [0..1] InvoiceElement (RTO<MO,PQ>) |
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| netAmt [0..1] InvoiceElement (MO) |
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| factorNumber [0..1] InvoiceElement (REAL) |
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| Inherits associations from CoverageChargeChoice | |||||||||