HL7 Europe Laboratory Report
0.1.1 - trial-use 150

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## : A.1.3 - Health insurance and payment information model to this guide - XML Representation

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    <ConceptMap xmlns="http://hl7.org/fhir">
      <id value="payer2FHIR-eu-lab"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ConceptMap payer2FHIR-eu-lab</b></p><a name="payer2FHIR-eu-lab"> </a><a name="hcpayer2FHIR-eu-lab"> </a><a name="payer2FHIR-eu-lab-en-US"> </a><p>Mapping from (not specified) to (not specified)</p><br/><p><b>Group 1 </b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="StructureDefinition-ServiceRequest-eu-lab.html">ServiceRequest: Laboratory Order</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto" title="relatedto">is related to</a></td><td>ServiceRequest.insurance</td><td>insurance.ofType(Coverage)</td></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto" title="relatedto">is related to</a></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto" title="relatedto">is related to</a></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto" title="relatedto">is related to</a></td><td>ServiceRequest.insurance</td><td>details in Group 2</td></tr></table><hr/><p><b>Group 2 </b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="http://hl7.org/fhir/R4/coverage.html">Coverage</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto" title="relatedto">is related to</a></td><td>Coverage</td><td/></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.payor.identifier</td><td>payor.ofType(Organization)</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.payor.name</td><td>payor.ofType(Organization)</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.policyHolder.identifier</td><td>If it refers to the owner of the policy</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.beneficiary.identifier</td><td>If it refers to the plan beneficiary</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.subscriberId</td><td>If it is the ID assigned to the subscriber</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#equivalent" title="equivalent">is equivalent to</a></td><td>Coverage.subscriber.identifier</td><td>If it refers to the subscriber to the policy and the Subscriber is of type Patient</td></tr></table><hr/><p><b>Group 3 </b>Mapping from <a href="StructureDefinition-Payer.html">A.1.3 - Health insurance and payment information</a> to <a href="StructureDefinition-Patient-eu-lab.html">Patient: Person</a></p><table class="grid"><tr><td><b>Source Code</b></td><td><b>Relationship</b></td><td><b>Target Code</b></td><td><b>Comment</b></td></tr><tr><td>Payer.insurance (A.1.3.1 Health insurance information)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.identifier (A.1.3.1.1 Health insurance code)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.name (A.1.3.1.2 Health insurance name)</td><td colspan="3" style="background-color: #efefef">(not mapped)</td></tr><tr><td>Payer.insurance.subjectIdentifier (A.1.3.1.3 Health insurance number)</td><td><a href="http://hl7.org/fhir/R5/codesystem-concept-map-relationship.html#relatedto" title="relatedto">is related to</a></td><td>Patient.identifier</td><td>Sometimes the identifier assigned by the payor (e.g. the SSN) is used as one of the Patient Identifiers</td></tr></table></div>
      </text>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
        <valueInteger value="2"/>
      </extension>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
        <valueCode value="informative"/>
      </extension>
      <url value="http://hl7.eu/fhir/laboratory/ConceptMap/payer2FHIR-eu-lab"/>
      <identifier>
        <system value="urn:ietf:rfc:3986"/>
        <value value="urn:oid:2.16.840.1.113883.2.51.22.1.18.6"/>
      </identifier>
      <version value="0.1.1"/>
      <name value="Payer2Fhir"/>
      <title value="eHN Payer to this guide Map"/>
      <status value="draft"/>
      <experimental value="true"/>
      <date value="2025-03-25T12:23:34+01:00"/>
      <publisher value="HL7 Europe"/>
      <contact>
        <name value="HL7 Europe"/>
        <telecom>
          <system value="url"/>
          <value value="http://hl7.eu"/>
        </telecom>
      </contact>
      <description value="eHN Payer Model to this guide Map"/>
      <jurisdiction>
        <coding>
          <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
          <code value="150"/>
          <display value="Europe"/>
        </coding>
      </jurisdiction>
      <purpose
               value="It shows how the Laboratory Report Payer data set defined by the EU eHN guidelines is mapped into this guide"/>
      <copyright
                 value="Used by permission of HL7 Europe, all rights reserved Creative Commons License"/>
      <group>
        <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
        <target
                value="http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab"/>
        <element>
          <code value="Payer.insurance"/>
          <display value="A.1.3.1 Health insurance information"/>
          <target>
            <code value="ServiceRequest.insurance"/>
            <equivalence value="relatedto"/>
            <comment value="insurance.ofType(Coverage)"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.identifier"/>
          <display value="A.1.3.1.1 Health insurance code"/>
          <target>
            <code value="ServiceRequest.insurance"/>
            <equivalence value="relatedto"/>
            <comment value="details in Group 2"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.name"/>
          <display value="A.1.3.1.2 Health insurance name"/>
          <target>
            <code value="ServiceRequest.insurance"/>
            <equivalence value="relatedto"/>
            <comment value="details in Group 2"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.subjectIdentifier"/>
          <display value="A.1.3.1.3 Health insurance number"/>
          <target>
            <code value="ServiceRequest.insurance"/>
            <equivalence value="relatedto"/>
            <comment value="details in Group 2"/>
          </target>
        </element>
      </group>
      <group>
        <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
        <target value="http://hl7.org/fhir/StructureDefinition/Coverage"/>
        <element>
          <code value="Payer.insurance"/>
          <display value="A.1.3.1 Health insurance information"/>
          <target>
            <code value="Coverage"/>
            <equivalence value="relatedto"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.identifier"/>
          <display value="A.1.3.1.1 Health insurance code"/>
          <target>
            <code value="Coverage.payor.identifier"/>
            <equivalence value="equivalent"/>
            <comment value="payor.ofType(Organization)"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.name"/>
          <display value="A.1.3.1.2 Health insurance name"/>
          <target>
            <code value="Coverage.payor.name"/>
            <equivalence value="equivalent"/>
            <comment value="payor.ofType(Organization)"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.subjectIdentifier"/>
          <display value="A.1.3.1.3 Health insurance number"/>
          <target>
            <code value="Coverage.policyHolder.identifier"/>
            <equivalence value="equivalent"/>
            <comment value="If it refers to the owner of the policy"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.subjectIdentifier"/>
          <display value="A.1.3.1.3 Health insurance number"/>
          <target>
            <code value="Coverage.beneficiary.identifier"/>
            <equivalence value="equivalent"/>
            <comment value="If it refers to the plan beneficiary"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.subjectIdentifier"/>
          <display value="A.1.3.1.3 Health insurance number"/>
          <target>
            <code value="Coverage.subscriberId"/>
            <equivalence value="equivalent"/>
            <comment value="If it is the ID assigned to the subscriber"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.subjectIdentifier"/>
          <display value="A.1.3.1.3 Health insurance number"/>
          <target>
            <code value="Coverage.subscriber.identifier"/>
            <equivalence value="equivalent"/>
            <comment
                     value="If it refers to the subscriber to the policy and the Subscriber is of type Patient"/>
          </target>
        </element>
      </group>
      <group>
        <source value="http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"/>
        <target
                value="http://hl7.eu/fhir/laboratory/StructureDefinition/Patient-eu-lab"/>
        <element>
          <code value="Payer.insurance"/>
          <display value="A.1.3.1 Health insurance information"/>
          <target>
            <equivalence value="unmatched"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.identifier"/>
          <display value="A.1.3.1.1 Health insurance code"/>
          <target>
            <equivalence value="unmatched"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.name"/>
          <display value="A.1.3.1.2 Health insurance name"/>
          <target>
            <equivalence value="unmatched"/>
          </target>
        </element>
        <element>
          <code value="Payer.insurance.subjectIdentifier"/>
          <display value="A.1.3.1.3 Health insurance number"/>
          <target>
            <code value="Patient.identifier"/>
            <equivalence value="relatedto"/>
            <comment
                     value="Sometimes the identifier assigned by the payor (e.g. the SSN) is used as one of the Patient Identifiers"/>
          </target>
        </element>
      </group>
    </ConceptMap>