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 - TTL Representation

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

    # - resource -------------------------------------------------------------------

     a fhir:ConceptMap ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "payer2FHIR-eu-lab"] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div "<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>"^^rdf:XMLLiteral
      ] ; #
      fhir:extension ( [
    fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:integer ;
    fhir:v 2     ]
      ] [
    fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ;
    fhir:value [
    a fhir:code ;
    fhir:v "informative"     ]
      ] ) ; #
      fhir:url [ fhir:v "http://hl7.eu/fhir/laboratory/ConceptMap/payer2FHIR-eu-lab"^^xsd:anyURI] ; #
      fhir:identifier [
    fhir:system [ fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ] ;
    fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.2.51.22.1.18.6" ]
      ] ; #
      fhir:version [ fhir:v "0.1.1"] ; #
      fhir:name [ fhir:v "Payer2Fhir"] ; #
      fhir:title [ fhir:v "eHN Payer to this guide Map"] ; #
      fhir:status [ fhir:v "draft"] ; #
      fhir:experimental [ fhir:v true] ; #
      fhir:date [ fhir:v "2025-03-25T12:23:34+01:00"^^xsd:dateTime] ; #
      fhir:publisher [ fhir:v "HL7 Europe"] ; #
      fhir:contact ( [
    fhir:name [ fhir:v "HL7 Europe" ] ;
        ( fhir:telecom [
    fhir:system [ fhir:v "url" ] ;
    fhir:value [ fhir:v "http://hl7.eu" ]     ] )
      ] ) ; #
      fhir:description [ fhir:v "eHN Payer Model to this guide Map"] ; #
      fhir:jurisdiction ( [
        ( fhir:coding [
    fhir:system [ fhir:v "http://unstats.un.org/unsd/methods/m49/m49.htm"^^xsd:anyURI ] ;
    fhir:code [ fhir:v "150" ] ;
    fhir:display [ fhir:v "Europe" ]     ] )
      ] ) ; #
      fhir:purpose [ fhir:v "It shows how the Laboratory Report Payer data set defined by the EU eHN guidelines is mapped into this guide"] ; #
      fhir:copyright [ fhir:v "Used by permission of HL7 Europe, all rights reserved Creative Commons License"] ; #
      fhir:group ( [
    fhir:source [ fhir:v "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"^^xsd:anyURI ] ;
    fhir:target [ fhir:v "http://hl7.eu/fhir/laboratory/StructureDefinition/ServiceRequest-eu-lab"^^xsd:anyURI ] ;
        ( fhir:element [
    fhir:code [ fhir:v "Payer.insurance" ] ;
    fhir:display [ fhir:v "A.1.3.1 Health insurance information" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "ServiceRequest.insurance" ] ;
    fhir:equivalence [ fhir:v "relatedto" ] ;
    fhir:comment [ fhir:v "insurance.ofType(Coverage)" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.identifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.1 Health insurance code" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "ServiceRequest.insurance" ] ;
    fhir:equivalence [ fhir:v "relatedto" ] ;
    fhir:comment [ fhir:v "details in Group 2" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.name" ] ;
    fhir:display [ fhir:v "A.1.3.1.2 Health insurance name" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "ServiceRequest.insurance" ] ;
    fhir:equivalence [ fhir:v "relatedto" ] ;
    fhir:comment [ fhir:v "details in Group 2" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.subjectIdentifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.3 Health insurance number" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "ServiceRequest.insurance" ] ;
    fhir:equivalence [ fhir:v "relatedto" ] ;
    fhir:comment [ fhir:v "details in Group 2" ]       ] )     ] )
      ] [
    fhir:source [ fhir:v "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"^^xsd:anyURI ] ;
    fhir:target [ fhir:v "http://hl7.org/fhir/StructureDefinition/Coverage"^^xsd:anyURI ] ;
        ( fhir:element [
    fhir:code [ fhir:v "Payer.insurance" ] ;
    fhir:display [ fhir:v "A.1.3.1 Health insurance information" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "Coverage" ] ;
    fhir:equivalence [ fhir:v "relatedto" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.identifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.1 Health insurance code" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "Coverage.payor.identifier" ] ;
    fhir:equivalence [ fhir:v "equivalent" ] ;
    fhir:comment [ fhir:v "payor.ofType(Organization)" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.name" ] ;
    fhir:display [ fhir:v "A.1.3.1.2 Health insurance name" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "Coverage.payor.name" ] ;
    fhir:equivalence [ fhir:v "equivalent" ] ;
    fhir:comment [ fhir:v "payor.ofType(Organization)" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.subjectIdentifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.3 Health insurance number" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "Coverage.policyHolder.identifier" ] ;
    fhir:equivalence [ fhir:v "equivalent" ] ;
    fhir:comment [ fhir:v "If it refers to the owner of the policy" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.subjectIdentifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.3 Health insurance number" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "Coverage.beneficiary.identifier" ] ;
    fhir:equivalence [ fhir:v "equivalent" ] ;
    fhir:comment [ fhir:v "If it refers to the plan beneficiary" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.subjectIdentifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.3 Health insurance number" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "Coverage.subscriberId" ] ;
    fhir:equivalence [ fhir:v "equivalent" ] ;
    fhir:comment [ fhir:v "If it is the ID assigned to the subscriber" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.subjectIdentifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.3 Health insurance number" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "Coverage.subscriber.identifier" ] ;
    fhir:equivalence [ fhir:v "equivalent" ] ;
    fhir:comment [ fhir:v "If it refers to the subscriber to the policy and the Subscriber is of type Patient" ]       ] )     ] )
      ] [
    fhir:source [ fhir:v "http://hl7.eu/fhir/laboratory/StructureDefinition/Payer"^^xsd:anyURI ] ;
    fhir:target [ fhir:v "http://hl7.eu/fhir/laboratory/StructureDefinition/Patient-eu-lab"^^xsd:anyURI ] ;
        ( fhir:element [
    fhir:code [ fhir:v "Payer.insurance" ] ;
    fhir:display [ fhir:v "A.1.3.1 Health insurance information" ] ;
          ( fhir:target [
    fhir:equivalence [ fhir:v "unmatched" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.identifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.1 Health insurance code" ] ;
          ( fhir:target [
    fhir:equivalence [ fhir:v "unmatched" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.name" ] ;
    fhir:display [ fhir:v "A.1.3.1.2 Health insurance name" ] ;
          ( fhir:target [
    fhir:equivalence [ fhir:v "unmatched" ]       ] )     ] [
    fhir:code [ fhir:v "Payer.insurance.subjectIdentifier" ] ;
    fhir:display [ fhir:v "A.1.3.1.3 Health insurance number" ] ;
          ( fhir:target [
    fhir:code [ fhir:v "Patient.identifier" ] ;
    fhir:equivalence [ fhir:v "relatedto" ] ;
    fhir:comment [ fhir:v "Sometimes the identifier assigned by the payor (e.g. the SSN) is used as one of the Patient Identifiers" ]       ] )     ] )
      ] ) . #