Coverage (ATR)

Use this profile to associate a specific coverage instance with a specific member who is on the Member Attribution List. Because patients can have multiple coverages, it is important to identify the specific coverage instance that led to the patient being included in the Member Attribution List. The Coverage instance contains the member information, payer information, and plan information.

Note: Implementers are advised to read Data Model Requirements to implement the Patient profile.

The Coverage instance is retrieved as part of the Bulk API request on the Group resource representing the Member Attribution List.

This structure is derived from the Coverage resource.

Related Resources

This structure refers to these other structures:

• Patient (ATR)
• RelatedPerson (ATR)
• Organization (ATR)

Examples

The following links provide examples in XML, JSON, and TTL for the Coverage profile.

• Coverage for Patient 1
• Coverage for Patient 2
• Coverage for Patient 3

For More Information

• Da Vinci - Member Attribution (ATR) List
• Resource Profile: ATRCoverage (9.3)
• Detailed Descriptions (9.3.5) for the elements in the Coverage (ATR) resource
• Terminology Bindings (9.3.1.2.1) for the Coverage (ATR) resource
• Constraints (9.3.1.2.2) for the Coverage (ATR) resource
• Differential Table (9.3.1.2) for the Coverage (ATR) resource
• FHIR R4
• US Core STU3
• Bulk Data IG
• SMART on FHIR Backend Services Authorization