FHIR Implementation Guide for ABDM
6.5.0 - active
FHIR Implementation Guide for ABDM
6.5.0 - active
This page is part of the FHIR Implementation Guide for ABDM (v6.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
| Official URL: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement | Version: 6.5.0 | |||
| Draft as of 2025-03-18 | Computable Name: ClaimSupportingInfoRequirement | |||
This extension enumerates essential documentation necessary for a health insurance product. It provides a comprehensive list of documents such as identification proofs or medical records needed during the claims process.
Context of Use
This extension may be used on the following element(s):
https://nrces.in/ndhm/fhir/r4/StructureDefinition/InsurancePlan#InsurancePlan
https://nrces.in/ndhm/fhir/r4/StructureDefinition/InsurancePlan#InsurancePlan.coverage
https://nrces.in/ndhm/fhir/r4/StructureDefinition/InsurancePlan#InsurancePlan.coverage.benefit
https://nrces.in/ndhm/fhir/r4/StructureDefinition/InsurancePlan#InsurancePlan.plan
Usage info
Usage:
Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.
This structure is derived from Extension
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  Extension |
0..* | Extension | Enumerates essential documentation necessary for a health insurance product during claim processing. e.g. proof of identity, proof of address | |
  extension |
2..* | Extension | Extension | |
  Slices for extension |
Content/Rules for all slices | |||
   extension:category |
1..1 | Extension | Classification of the supplied information e.g proof of identity, proof of address. | |
  extension |
0..0 | |||
| url |
1..1 | uri | "category" | |
  value[x] |
0..1 | CodeableConcept | Value of extension Binding: SupportingInfo Category (example): The valueset used for additional information category codes. | |
  coding |
0..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
 display |
1..1 | string | Representation defined by the system | |
| extension:code |
1..* | Extension | Additional content defined by implementations e.g ABHA ID, Adhar Card | |
| extension |
0..0 | |||
| url |
1..1 | uri | "code" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: SupportingInfo Code (example): The valueset used for additional information codes. | |
| coding |
0..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| display |
1..1 | string | Representation defined by the system | |
 extension:documentationUrl |
0..1 | Extension | Url of the document or template that needs to be filled. | |
| extension |
0..0 | |||
| url |
1..1 | uri | "documentationUrl" | |
  value[x] |
0..1 | url | Value of extension | |
| url |
1..1 | uri | "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement" | |
| value[x] |
0..0 | |||
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Extension |
0..* | Extension | Enumerates essential documentation necessary for a health insurance product during claim processing. e.g. proof of identity, proof of address | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| Slices for extension |
2..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:category |
1..1 | Extension | Classification of the supplied information e.g proof of identity, proof of address. | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "category" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: SupportingInfo Category (example): The valueset used for additional information category codes. | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| coding |
Σ | 0..1 | Coding | Code defined by a terminology system |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| system |
Σ | 1..1 | uri | Identity of the terminology system |
| version |
Σ | 0..1 | string | Version of the system - if relevant |
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system |
| display |
Σ | 1..1 | string | Representation defined by the system |
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text |
Σ | 0..1 | string | Plain text representation of the concept |
| extension:code |
1..* | Extension | Additional content defined by implementations e.g ABHA ID, Adhar Card | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "code" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: SupportingInfo Code (example): The valueset used for additional information codes. | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| coding |
Σ | 0..1 | Coding | Code defined by a terminology system |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| system |
Σ | 1..1 | uri | Identity of the terminology system |
| version |
Σ | 0..1 | string | Version of the system - if relevant |
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system |
| display |
Σ | 1..1 | string | Representation defined by the system |
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text |
Σ | 0..1 | string | Plain text representation of the concept |
| extension:documentationUrl |
0..1 | Extension | Url of the document or template that needs to be filled. | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "documentationUrl" | |
| value[x] |
0..1 | url | Value of extension | |
| url |
1..1 | uri | "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement" | |
| Documentation for this format | ||||
This structure is derived from Extension
Summary
Complex Extension: This extension enumerates essential documentation necessary for a health insurance product. It provides a comprehensive list of documents such as identification proofs or medical records needed during the claims process.
Differential View
This structure is derived from Extension
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Extension |
0..* | Extension | Enumerates essential documentation necessary for a health insurance product during claim processing. e.g. proof of identity, proof of address | |
| extension |
2..* | Extension | Extension | |
| Slices for extension |
Content/Rules for all slices | |||
| extension:category |
1..1 | Extension | Classification of the supplied information e.g proof of identity, proof of address. | |
| extension |
0..0 | |||
| url |
1..1 | uri | "category" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: SupportingInfo Category (example): The valueset used for additional information category codes. | |
| coding |
0..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| display |
1..1 | string | Representation defined by the system | |
| extension:code |
1..* | Extension | Additional content defined by implementations e.g ABHA ID, Adhar Card | |
| extension |
0..0 | |||
| url |
1..1 | uri | "code" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: SupportingInfo Code (example): The valueset used for additional information codes. | |
| coding |
0..1 | Coding | Code defined by a terminology system | |
| system |
1..1 | uri | Identity of the terminology system | |
| code |
1..1 | code | Symbol in syntax defined by the system | |
| display |
1..1 | string | Representation defined by the system | |
| extension:documentationUrl |
0..1 | Extension | Url of the document or template that needs to be filled. | |
| extension |
0..0 | |||
| url |
1..1 | uri | "documentationUrl" | |
| value[x] |
0..1 | url | Value of extension | |
| url |
1..1 | uri | "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement" | |
| value[x] |
0..0 | |||
| Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Extension |
0..* | Extension | Enumerates essential documentation necessary for a health insurance product during claim processing. e.g. proof of identity, proof of address | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| Slices for extension |
2..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:category |
1..1 | Extension | Classification of the supplied information e.g proof of identity, proof of address. | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "category" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: SupportingInfo Category (example): The valueset used for additional information category codes. | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| coding |
Σ | 0..1 | Coding | Code defined by a terminology system |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| system |
Σ | 1..1 | uri | Identity of the terminology system |
| version |
Σ | 0..1 | string | Version of the system - if relevant |
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system |
| display |
Σ | 1..1 | string | Representation defined by the system |
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text |
Σ | 0..1 | string | Plain text representation of the concept |
| extension:code |
1..* | Extension | Additional content defined by implementations e.g ABHA ID, Adhar Card | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "code" | |
| value[x] |
0..1 | CodeableConcept | Value of extension Binding: SupportingInfo Code (example): The valueset used for additional information codes. | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| coding |
Σ | 0..1 | Coding | Code defined by a terminology system |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| system |
Σ | 1..1 | uri | Identity of the terminology system |
| version |
Σ | 0..1 | string | Version of the system - if relevant |
| code |
Σ | 1..1 | code | Symbol in syntax defined by the system |
| display |
Σ | 1..1 | string | Representation defined by the system |
| userSelected |
Σ | 0..1 | boolean | If this coding was chosen directly by the user |
| text |
Σ | 0..1 | string | Plain text representation of the concept |
| extension:documentationUrl |
0..1 | Extension | Url of the document or template that needs to be filled. | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..0 | |||
| url |
1..1 | uri | "documentationUrl" | |
| value[x] |
0..1 | url | Value of extension | |
| url |
1..1 | uri | "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim-SupportingInfoRequirement" | |
| Documentation for this format | ||||
This structure is derived from Extension
Summary
Complex Extension: This extension enumerates essential documentation necessary for a health insurance product. It provides a comprehensive list of documents such as identification proofs or medical records needed during the claims process.
Other representations of profile: CSV, Excel, Schematron
| Path | Conformance | ValueSet | URI |
| Extension.extension:category.value[x] | example | SupportingInfoCategory (a valid code from SupportingInfo Category)https://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-supportinginfo-categoryfrom this IG | |
| Extension.extension:code.value[x] | example | SupportingInfoCodehttps://nrces.in/ndhm/fhir/r4/ValueSet/ndhm-supportinginfo-codefrom this IG |
| Id | Grade | Path(s) | Details | Requirements |
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |