Name Flags Card. Type Description & Constraints Coverage 0..* JP_Coverage 保険情報、公費情報 id S 0..1 string このリソースのID text S 0..1 Narrative このリソースの概要 status S 1..1 code generated | extensions | additional | empty Fixed Value: generated div S 1..1 xhtml このリソースの概要 extension S 0..* Extension Extension StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol S 0..* string 被保険者証記号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonSymbol StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo S 0..* string 被保険者証番号を表す拡張 URL: https://igs.healthdataworks.net/jp-rezept-medication/StructureDefinition-JP-REZEPT-ExtensionCoverageInsuredPersonNo status S 1..1 code 保険情報、公費情報の状態 type S 0..1 CodeableConcept 保険種別 coding S 0..* Coding 保険種別 system S 0..1 uri 保険種別のOID code S 0..1 code 保険種別コード display S 0..1 string 保険種別の名称 subscriber S 0..1 Reference(Patient | RelatedPerson) 被保険者(患者)情報の参照 reference S 0..1 string 被保険者(患者)情報の参照 subscriberId S 0..1 string 受診券整理番号 beneficiary S 1..1 Reference(Patient) 患者の参照 reference S 0..1 string この保険で給付される患者の参照 dependent S 0..1 string 被保険者の枝番号 relationship S 0..1 CodeableConcept 患者との関係区分 coding S 0..* Coding 患者との関係区分 system S 0..1 uri 患者との関係区分のOID Fixed Value: urn:oid:1.2.392.100495.20.2.62 code S 0..1 code 患者との関係区分コード display S 0..1 string 患者との関係区分コードの名称 period S 0..1 Period 保険証の有効期間 start S 0..1 dateTime 保険証の有効開始日 end S 0..1 dateTime 保険証の有効期限日 payor S 1..* Reference(Organization | Patient | RelatedPerson) 保険者の参照 reference S 0..1 string 保険者の参照 class S 0..* BackboneElement 保険(公費)区分 type S 1..1 CodeableConcept 保険(公費)区分 coding S 0..* Coding 保険(公費)区分 system S 0..1 uri 保険(公費)区分のOID code S 0..1 code 保険(公費)区分コード Binding: 負担者種別コード (required) display S 0..1 string 保険(公費)区分コードの名称 value S 1..1 string 保険(公費)番号 name S 0..1 string 保険(公費)名称 Fixed Value: 公費負担者番号 order S 0..1 positiveInt 保険適用順序 costToBeneficiary S 0..* BackboneElement Patient payments for services/products サービスやプロダクトに対する患者支払い value[x] S 1..1 SimpleQuantity A fixed quantity (no comparator) Example Example for Quantity: {"value":30,"unit":"%"} Documentation for this format
実装ガイド作成：小山内 尚、西山 喜樹、能崎 克行
保険情報、公費情報です。 医療サービスや調剤等の請求額と自己負担金の両方が含まれます。
Canadian Dental Association eclaims standard
Canadian Pharmacy Associaiton eclaims standard
レセプト電算処理システムの請求に係る記録条件仕様(歯科用)をFHIRにマッピングします。
レセプト電算処理システムの請求に係る記録条件仕様(DPC用)をFHIRにマッピングします。
レセプト電算処理システムの請求に係る記録条件仕様(医科用)をFHIRにマッピングします。
レセプト電算処理システムの請求に係る記録条件仕様(調剤用)をFHIRにマッピングします。
レセプト電算処理システムの加入者情報をFHIRにマッピングします。
保険対象者(患者)と保険者の間のリンクを提供します。
If the resource is contained in another resource, it SHALL NOT contain nested Resources
not(parent::f:contained and f:contained)
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
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))
If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
If a resource is contained in another resource, it SHALL NOT have a security label
When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
A resource should have narrative for robust management
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
All FHIR elements must have a @value or children
hasValue() or (children().count() > id.count())
A set of rules under which this content was created
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
The base language in which the resource is written.
Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
保険者向け例: ・保険者番号 ・被保険者証記号 ・被保険者証番号 公費向け例: ・負担者番号 ・受給者番号
Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Extensions are always sliced by (at least) url
Additional content defined by implementations
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
Must have either extensions or value[x], not both
exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
generated | extensions | additional | empty
このリソースの概要がリソースのコンテンツから⽣成されたことを⽰す。
The contents of the html element are an XHTML fragment containing only the basic html formatting elements described in chapters 7-11 and 15 of the HTML 4.0 standard, elements (either name or href), images and internally contained stylesheets. The XHTML content SHALL NOT contain a head, a body, external stylesheet references, scripts, forms, base/link/xlink, frames, iframes and objects.
The narrative SHALL contain only the basic html formatting elements and attributes described in chapters 7-11 (except section 4 of chapter 9) and 15 of the HTML 4.0 standard, elements (either name or href), images and internally contained style attributes
not(descendant-or-self::*[not(local-name(.)=('a', 'abbr', 'acronym', 'b', 'big', 'blockquote', 'br', 'caption', 'cite', 'code', 'col', 'colgroup', 'dd', 'dfn', 'div', 'dl', 'dt', 'em', 'h1', 'h2', 'h3', 'h4', 'h5', 'h6', 'hr', 'i', 'img', 'li', 'ol', 'p', 'pre', 'q', 'samp', 'small', 'span', 'strong', 'sub', 'sup', 'table', 'tbody', 'td', 'tfoot', 'th', 'thead', 'tr', 'tt', 'ul', 'var'))]) and not(descendant-or-self::*/@*[not(name(.)=('abbr', 'accesskey', 'align', 'alt', 'axis', 'bgcolor', 'border', 'cellhalign', 'cellpadding', 'cellspacing', 'cellvalign', 'char', 'charoff', 'charset', 'cite', 'class', 'colspan', 'compact', 'coords', 'dir', 'frame', 'headers', 'height', 'href', 'hreflang', 'hspace', 'id', 'lang', 'longdesc', 'name', 'nowrap', 'rel', 'rev', 'rowspan', 'rules', 'scope', 'shape', 'span', 'src', 'start', 'style', 'summary', 'tabindex', 'title', 'type', 'valign', 'value', 'vspace', 'width'))])
The narrative SHALL have some non-whitespace content
descendant::text()[normalize-space(.)!=''] or descendant::h:img[@src]
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
健康保険における被保険者証記号
健康保険における被保険者証記号を示す拡張
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. 健康保険における被保険者証記号を示す拡張
exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
Source of the definition for the extension code - a logical name or a URL.
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).
A stream of bytes, base64 encoded 被保険者記号の文字列。
健康保険における被保険者証番号
健康保険における被保険者証番号を示す拡張
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. 健康保険における被保険者証番号を示す拡張
A stream of bytes, base64 encoded 被保険者番号
健康保険における被保険者証番号の枝番
健康保険における被保険者証番号の枝番を示す拡張
There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. 健康保険における被保険者証番号の枝番を示す拡張 枝番号は2桁。
A stream of bytes, base64 encoded 2桁の半角数字文字列。一桁の場合には先頭に０をつけて2桁にする。
被保険者証記号を表す拡張「InsuredPersonSymbol」です。保険種別が「1:医保」、「2:国保」の場合に記録します。被保険者証記号がない場合は、本拡張要素は出現しません。
被保険者証番号を表す拡張「InsuredPersonNumber」です。保険種別が「1:医保」、「2:国保」、「7:後期⾼齢者」の場合に記録します。それ以外の場合は、本拡張要素は出現しません。
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Business Identifier for the coverage このカバレッジに割り当てられた一意の識別子。
A unique identifier assigned to this coverage. このカバレッジに割り当てられた一意の識別子。
The main (and possibly only) identifier for the coverage - often referred to as a Member Id, Certificate number, Personal Health Number or Case ID. May be constructed as the concatenation of the Coverage.SubscriberID and the Coverage.dependant. カバレッジのメイン（および場合によっては唯一の）識別子-多くの場合、メンバーID、証明書番号、個人の健康番号、またはケースIDと呼ばれる。 Coverage.SubscriberIDとCoverage.dependantの連結として構築できる。
Allows coverages to be distinguished and referenced. カバレッジを区別して参照できるようにする。
保険情報、公費情報では「active」固定とします。
Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'. 「ドラフト」リソースはさらに編集される可能性があり、「アクティブ」リソースは不変であり、ステータスが「キャンセル」に変更されるだけである可能性があるため、リソースのステータスを追跡する必要がある。
This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
A code specifying the state of the resource instance.
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. すべてのターミノロジーの使用がこの一般的なパターンに適合するわけではない。場合によっては、モデルはCodeableConceptを使用せず、コーディングを直接使用して、テキスト、コーディング、翻訳、および要素間の関係とpre-coordinationとpost-coordinationの用語関係を管理するための独自の構造を提供する必要がある。 【JP-CORE】 厚労省保険局の電子処方等で使用される保険種別コード（system=”urn:oid:1.2.392.100495.20.2.61”）として、https://www.mhlw.go.jp/content/10800000/000342368.pdf の別表１１が使用できる。
The order of application of coverages is dependent on the types of coverage. カバレッジの適用順序は、カバレッジのタイプによって異なる。
The type of insurance: public health, worker compensation; private accident, auto, private health, etc.) or a direct payment by an individual or organization.
Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
Allows for alternative encodings within a code system, and translations to other code systems.
fhir:CodeableConcept.coding rdfs:subPropertyOf dt:CD.coding
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.
Need to be unambiguous about the source of the definition of the symbol.
fhir:Coding.system rdfs:subPropertyOf dt:CDCoding.codeSystem
The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.
Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
fhir:Coding.version rdfs:subPropertyOf dt:CDCoding.codeSystemVersion
医療保険として作成する場合は「1～7」、公費として作成する場合は「8」になる。 1:医保 2:国保 3:労災 4:自賠 5:公害 6:自費 7:後期高齢者 8:公費
Need to refer to a particular code in the system.
fhir:Coding.code rdfs:subPropertyOf dt:CDCoding.code
保険者番号から該当するコード(1:医保、2:国保、、3:労災、4:自賠、5:公害、6:自費、7:後期高齢者、8:公費)を決める。
Need to be able to carry a human-readable meaning of the code for readers that do not know the system.
C*E.2 - but note this is not well followed
fhir:Coding.display rdfs:subPropertyOf dt:CDCoding.displayName
If this coding was chosen directly by the user
Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).
Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.
fhir:Coding.userSelected fhir:mapsTo dt:CDCoding.codingRationale. fhir:Coding.userSelected fhir:hasMap fhir:Coding.userSelected.map. fhir:Coding.userSelected.map a fhir:Map; fhir:target dt:CDCoding.codingRationale. fhir:Coding.userSelected\#true a [ fhir:source "true"; fhir:target dt:CDCoding.codingRationale\#O ]
Plain text representation of the concept
A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.
Very often the text is the same as a displayName of one of the codings.
The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.
C*E.9. But note many systems use C*E.2 for this
fhir:CodeableConcept.text rdfs:subPropertyOf dt:CD.originalText
The party who 'owns' the insurance policy. 保険証券を「所有する」当事者。
For example: may be an individual, corporation or the subscriber's employer. 例：個人、企業、または加入者の雇用主である可能性がある。
This provides employer information in the case of Worker's Compensation and other policies. これは、労働者災害補償およびその他のポリシーの場合に雇用者情報を提供する。
IN1-16, 18, 19-name of insured, address, date of birth
May be self or a parent in the case of dependants. 扶養家族の場合、自己または親である可能性がある。
This is the party who is entitled to the benfits under the policy. これは、ポリシーに基づいて給付を受ける権利を有する当事者である。 【JP-CORE】 公費情報で本リソースを使用する場合には、この要素に公費受給者番号を設定する。
Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
保険者レコード(HO).保険者番号、保険者レコード(HO).被保険者証(手帳)の記号・番号
加入者情報.保険者番号、加入者情報.被保険者証(手帳)の記号・番号
Type the reference refers to (e.g. "Patient")
The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent. The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).
This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.
Aa resource (or, for logical models, the URI of the logical model).
Logical reference, when literal reference is not known
An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.
When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it. Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).
Plain text narrative that identifies the resource in addition to the resource reference.
This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
The insurer requires this identifier on correspondance and claims (digital and otherwise). 保険者は、連絡や請求（デジタルおよびその他）でこの識別子を要求する。 保険会社は、通信および請求（デジタルおよびその他）でこの識別子を要求する。 被保険者番号を全角で格納する
XML No: 9.6.1 XPath: /ClinicalDocument/participant/associatedEntity/id/@extension
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、解決可能（内容に到達可能）である必要がある（アクセス制御、一時的な使用不可などを考慮に入れる）。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。 【JP_CORE】 患者Patientリソースへの参照。
This is the party who receives treatment for which the costs are reimbursed under the coverage. これは、補償の下で費用が償還される治療を受ける側のことである。
この保険で給付される患者の参照
この保険で給付される患者の参照です。
Periodically the member number is constructed from the subscriberId and the dependant number. 定期的に subscriberId と従属番号からメンバー番号を構築する。
For some coverages a single identifier is issued to the Subscriber and then a unique dependent number is issued to each beneficiary. 一部の補償では、単一の識別子が加入者に発行され、次に一意の従属番号が各受益者に発行される。 一部の保険では、単一の識別子が加入者に発行され、その後、各受益者に固有の扶養番号が発行される。 【JP-CORE】 医療保険で本リソースを使用する場合には、この要素に拡張 InsuredPersonSubNumberに設定した値と同じ、被保険者番号の枝番号2桁を設定する。
- No exact HL7 v2 equivalent concept seems to exist;
Typically, an individual uses policies which are theirs (relationship='self') before policies owned by others. 一般的に、個人は、他人が所有するポリシーよりも、自分のポリシー（relationship='self'）を使用する。
To determine relationship between the patient and the subscriber to determine coordination of benefits. 患者と加入者の関係を決定し、給付の調整を決定する。 【JP-CORE】 厚労省保険局の電子処方等で使用される被保険者区分コード（system=”urn:oid:1.2.392.100495.20.2.62”）として、https://www.mhlw.go.jp/content/10800000/000342368.pdf の別表１２が使用できる。 1 被保険者 2 被扶養者
The relationship between the Subscriber and the Beneficiary (insured/covered party/patient).
加入者情報の「続柄」が無ければ「1」、あれば「2」。 1:被保険者 2:被扶養者
患者との関係区分コードの名称です。
A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See [Duration](http://hl7.org/fhir/R4/datatypes.html#Duration). Period（期間）は時間の範囲を指定する。使用状況は、範囲全体が適用されるか（たとえば、「患者はこの時間範囲で入院していた」）、範囲から1つの値が適用されるか（たとえば、「この2回の間に患者に投与する」）を指定する。 Period（期間）は、Duration（時間区間＝経過時間の測定値）には使用されない。 [Duration]（datatypes.html＃Duration）を参照のこと。 This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration. これはDuration（時間区間）ではない- Durationは時間の尺度（別のタイプ）だが、時間の固定値で発生する時間区間である。Period（期間）は時間の範囲を指定する。使用状況は、範囲全体が適用されるか（たとえば、「患者はこの時間範囲で入院していた」）、範囲から1つの値が適用されるか（たとえば、「この2回の間に患者に投与する」）を指定する。もし、Duration（時間区間）が必要な場合は、タイプをInterval | Durationとして指定する。 これは期間ではなく-これは時間の尺度（別のタイプ）あるが、時間の固定値で発生する期間である。期間は時間の範囲を指定する。使用状況は、範囲全体が適用されるか（たとえば、「患者はこの時間範囲で入院していた」）、または範囲から1つの値が適用されるか（たとえば、「これら2回の間に患者に与える」）を指定する。期間が必要な場合は、タイプをInterval | Durationとして指定する。 【JP-CORE】 医療保険、公費で本リソースを使用する場合には、保険証または公費の有効期間の開始日、終了日をstart とendに yyyy-mm-dd形式で設定する。
Some insurers require the submission of the coverage term. 保険会社によっては、補償期間の提出を義務付けているところもある。
If the low element is missing, the meaning is that the low boundary is not known.
The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has an end value of 2012-02-03.
If the end of the period is missing, it means that the period is ongoing
May provide multiple identifiers such as insurance company identifier or business identifier (BIN number). For selfpay it may provide multiple paying persons and/or organizations. 保険会社の識別子や事業者の識別子（BIN番号）など、複数の識別子を提供してもよい。自己負担の場合は、複数の支払者および/または組織を提供してもよい。
Need to identify the issuer to target for claim processing and for coordination of benefit processing. 請求処理および給付処理の調整の対象となる発行者を特定する必要がある。 【JP-CORE】 医療保険で本リソースを使用する場合には、保険者組織Organizationリソースへの参照。自費の場合には、患者Patientリソースへの参照。公費の場合には、公費負担者組織Organizationリソースへの参照。
For example may be used to identify a class of coverage or employer group, Policy, Plan. 例えば、保険の種類または雇用者グループ、保険契約、Planを識別するために使用することができる。
The codes provided on the health card which identify or confirm the specific policy for the insurer. 健康カードに記載されているコードで、保険者の特定の保険契約を識別または確認するもの。
Extensions that cannot be ignored even if unrecognized
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. すべての用語の使用がこの一般的なパターンに適合するわけではない。いくつかのケースでは、モデルはCodeableConceptを使用せず、Codingを直接使用し、テキスト、コーディング、翻訳、要素間の関係、および前後の調整を管理するための独自の構造を提供することが望ましい。
The insurer issued label for a specific health card value. 保険者が発行した特定の健康カード番号のラベル。
The policy classifications, eg. Group, Plan, Class, etc.
1:医療保険、国民健康保険、退職者医療又は後期高齢者医療 2:第１公費負担医療 3:第２公費負担医療 4:第３公費負担医療 5:第４公費負担医療
資格確認レコード(SN).負担者種別コード
For example, the Group or Plan number. 例えば、グループ番号やプラン番号など。
The insurer issued label and value are necessary to identify the specific policy. 保険者が発行したラベルと値は、特定の保険契約を識別するために必要なものである。
Used to provide a meaningful description in correspondence to the patient. 患者に対応するのに意味のある説明をするために使用する。
保険(公費)区分コードをそのまま優先度にする。 1:医療保険、国民健康保険、退職者医療又は後期高齢者医療 2:第１公費負担医療 3:第２公費負担医療 4:第３公費負担医療 5:第４公費負担医療
Used in managing the coordination of benefits. 保険給付の調整管理に使用する。 【JP-CORE】 公費情報で本リソースを使用する場合で、複数の公費負担情報がある場合に、その適用順序番号を示す１，２，３．．．を設定する。
The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply. 保険者が定義したプロバイダーの保険者定義ネットワークの保険者固有の識別子で、被保険者が「ネットワーク内」の料金でカバーされる治療を受けることができるが、そうでなければ「ネットワーク外」の条件が適用される。
Used in referral for treatment and in claims processing. 治療のための紹介や請求処理の際に使用する。
Patient payments for services/products サービスやプロダクトに対する患者支払い
A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card. ポリシーに詳細が記載されており、ヘルスカードに含まれている可能性のあるコストカテゴリと関連する金額を示す一連のコード。
For example by knowing the patient visit co-pay, the provider can collect the amount prior to undertaking treatment. 例えば、患者の訪問時の自己負担額を知ることで、医療提供者は治療を行う前にその金額を回収することができる。 【JP-CORE】 公費の場合には自己負担率。判明している場合のみ設定する。
Required by providers to manage financial transaction with the patient. 事業者が患者との金銭的な取引を管理するために必要となる。
The category of patient centric costs associated with treatment. 治療に伴う患者中心の費用のカテゴリー。
For example visit, specialist visits, emergency, inpatient care, etc. 例えば、訪問診療、専門医の訪問診療、救急診療、入院診療など。
Needed to identify the category associated with the amount for the patient. 患者の金額に関連するカテゴリーを特定する必要がありました。
The types of services to which patient copayments are specified.
A reference to a code defined by a terminology system.
The identification of the code system that defines the meaning of the symbol in the code.
The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously. 保険や公費における自己負担率の種別を識別するコード体系のコード。 "http://terminology.hl7.org/CodeSystem/coverage-copay-type"
A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).
Note that FHIR strings SHALL NOT exceed 1MB in size 自己負担率を表すコード "copaypct"
A representation of the meaning of the code in the system, following the rules of the system.
The comparator is not used on a SimpleQuantity
The context of use may frequently define what kind of quantity this is and therefore what kind of units can be used. The context of use may also restrict the values for the comparator.
Needed to identify the amount for the patient associated with the category. カテゴリーに関連する患者の支払い金額を特定する必要がありました。
If a code for the unit is present, the system SHALL also be present
PQ, IVL<PQ>, MO, CO, depending on the values
A suite of codes indicating exceptions or reductions to patient costs and their effective periods. 患者費用の例外または削減を示すコードとその有効期間を示すコード群。
The code for the specific exception. 特定の例外のコード。
Needed to identify the exception associated with the amount for the patient. 患者の金額に関連する例外を特定する必要があった。
The types of exceptions from the part or full value of financial obligations such as copays.
The timeframe during when the exception is in force. 例外が発生している間の時間枠。
Needed to identify the applicable timeframe for the exception for the correct calculation of patient costs. 患者の費用を正しく計算するための例外の適用時期を特定する必要があった。
When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs. subrogation=trueの場合、この保険インスタンスは裁定のためではなく、保険者に費用回収のための詳細を提供するために含まれている。 (subrogation=代位、subrogation payment=代位納付)
Typically, automotive and worker's compensation policies would be flagged with 'subrogation=true' to enable healthcare payors to collect against accident claims. 一般的に、自動車保険や労災保険では、医療費支払い者が事故請求に対して回収できるように、subrogation＝true というフラグが立てられている。
See definition for when to be used. 使用時期については定義を参照すること。
The policy(s) which constitute this insurance coverage. この保険の適用範囲を構成するポリシー。
References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. 参照は、実際のFHIRリソースへの参照である必要があり、解決可能（内容に到達可能）である必要がある（アクセス制御、一時的な使用不可などを考慮に入れる）。解決は、URLから取得するか、リソースタイプによって該当する場合は、絶対参照を正規URLとして扱い、ローカルレジストリ/リポジトリで検索することによって行うことができる。
To reference the legally binding contract between the policy holder and the insurer. 契約者と保険者との間の法的拘束力のある契約を参照するため。