German Practice Management FHIR Profiles (R4)
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: Debeka — PKV Tarif mit GOÄ-Faktor 2.3 - XML Representation

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<InsurancePlan xmlns="http://hl7.org/fhir">
  <id value="example-debeka-plus"/>
  <meta>
    <profile
             value="https://fhir.cognovis.de/praxis/StructureDefinition/insurance-plan-de"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: InsurancePlan example-debeka-plus</b></p><a name="example-debeka-plus"> </a><a name="hcexample-debeka-plus"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-insurance-plan-de.html">InsurancePlan DE</a></p></div><p><b>identifier</b>: <a href="NamingSystem-insurance-plan-id.html" title="PVS-interner Identifier fuer InsurancePlan-Ressourcen (Kassentarife, PKV-Tarife)">InsurancePlanId</a>/debeka-plus</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode EHCPOL}">extended healthcare</span></p><p><b>name</b>: Debeka Premium Plus</p><blockquote><p><b>coverage</b></p><p><b>type</b>: <span title="Codes:">Aerztliche Leistungen</span></p><h3>Benefits</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">GOÄ-Positionen bis Faktor 2.3</span></td></tr></table></blockquote><blockquote><p><b>plan</b></p><p><b>type</b>: <span title="Codes:{https://fhir.cognovis.de/praxis/CodeSystem/insurance-plan-type pkv}">PKV</span></p><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title="Codes:">GOÄ-Faktor-Limit</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title="Codes:">GOÄ-Faktor 2.3</span></p><h3>Costs</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Maximaler GOÄ-Faktor</span></td><td>2.3 1<span style="background: LightGoldenRodYellow"> (Details: UCUM  code1 = '1')</span></td></tr></table></blockquote></blockquote><blockquote><p><b>specificCost</b></p><p><b>category</b>: <span title="Codes:">Implantate</span></p><blockquote><p><b>benefit</b></p><p><b>type</b>: <span title="Codes:">Implantatversorgung</span></p><h3>Costs</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:">Erstattung</span></td><td>100 %<span style="background: LightGoldenRodYellow"> (Details: UCUM  code% = '%')</span></td></tr></table></blockquote></blockquote></blockquote></div>
  </text>
  <identifier>
    <system value="https://fhir.cognovis.de/praxis/sid/insurance-plan-id"/>
    <value value="debeka-plus"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <code value="EHCPOL"/>
      <display value="extended healthcare"/>
    </coding>
  </type>
  <name value="Debeka Premium Plus"/>
  <coverage>
    <type>
      <text value="Aerztliche Leistungen"/>
    </type>
    <benefit>
      <type>
        <text value="GOÄ-Positionen bis Faktor 2.3"/>
      </type>
    </benefit>
  </coverage>
  <plan>
    <type>
      <coding>
        <system
                value="https://fhir.cognovis.de/praxis/CodeSystem/insurance-plan-type"/>
        <code value="pkv"/>
        <display value="PKV"/>
      </coding>
    </type>
    <specificCost>
      <category>
        <text value="GOÄ-Faktor-Limit"/>
      </category>
      <benefit>
        <type>
          <text value="GOÄ-Faktor 2.3"/>
        </type>
        <cost>
          <type>
            <text value="Maximaler GOÄ-Faktor"/>
          </type>
          <value>
            <value value="2.3"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="1"/>
          </value>
        </cost>
      </benefit>
    </specificCost>
    <specificCost>
      <category>
        <text value="Implantate"/>
      </category>
      <benefit>
        <type>
          <text value="Implantatversorgung"/>
        </type>
        <cost>
          <type>
            <text value="Erstattung"/>
          </type>
          <value>
            <value value="100"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="%"/>
          </value>
        </cost>
      </benefit>
    </specificCost>
  </plan>
</InsurancePlan>