Coverages contain information about a patients payer and health insurance - they represent the episodes in RED. Coverages can be searched using a search request (GET). Search must include the identifier of the patient to fetch the coverage for and returns a bundle of one or more FHIR items of type KBV_PR_AW_Krankenversicherungsverhaeltnis.
{{baseURL}}/{{tenant}}/Coverage?page=1&beneficiary=Patient/6006
Example: this search requests fetches all coverages for patient 6006 using paging to limit the number of results.
Release 102: A request for Coverages may be extended with a date range. The given date range will always be extended to the quarter(s) - e.g. a given range from 02.02.2023 to 15.06.2023 will always return coverages within the quarters 1 and 2 of 2023. If date range is given RED will return coverages only if their from and/or to dates will match the quarter(s) of given date range. The number of coverages to be returned for one request is limited, so paging should be used.
{{baseURL}}/{{tenant}}/Coverage?page=1&beneficiary=Patient/6020&from=20230401&to=20230630
Giving only one parameter will return all episodes matching the daterange.
{{baseURL}}/{{tenant}}/Coverage?page=1&beneficiary=Patient/6020&from=20230101
Data of a specific coverage may be fetched using a read request (GET) with the identifier of the specific coverage. The request returns a FHIR item of type KBV_PR_AW_Krankenversicherungsverhaeltnis.
{{baseURL}}/{{tenant}}/Coverage/ehcTAC8LUn$lKtRW
Example: this read request returns the FHIR item for a the coverage with ID ehcTAC8LUn$lKtRW. The ID may be retrieved by a search request sent before this request.
<Coverage xmlns="http://hl7.org/fhir">
<id value="ehcTAC8LUn$lKtRW"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2022-08-03T12:29:36+00:00"/>
<profile value="https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Krankenversicherungsverhaeltnis|1.2.0"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">Krankenversicherungsverhaeltnis von Patient Luca Fink</div>
</text>
<extension url="http://fhir.de/StructureDefinition/gkv/versichertenart">
<valueCoding>
<system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_VERSICHERTENSTATUS"/>
<code value="1"/>
</valueCoding>
</extension>
<extension url="http://fhir.de/StructureDefinition/gkv/wop">
<valueCoding>
<system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_ITA_WOP"/>
<code value="51"/>
</valueCoding>
</extension>
<extension url="http://fhir.de/StructureDefinition/gkv/besondere-personengruppe">
<valueCoding>
<system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PERSONENGRUPPE"/>
<code value="00"/>
</valueCoding>
</extension>
<extension url="http://fhir.de/StructureDefinition/gkv/dmp-kennzeichen">
<valueCoding>
<system value="https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DMP"/>
<code value="00"/>
</valueCoding>
</extension>
<extension url="http://fhir.de/StructureDefinition/gkv/zuzahlungsstatus">
<extension url="status">
<valueBoolean value="false"/>
</extension>
</extension>
<status value="cancelled"/>
<type>
<coding>
<system value="http://fhir.de/CodeSystem/versicherungsart-de-basis"/>
<version value="0.9.12"/>
<code value="GKV"/>
</coding>
</type>
<beneficiary>
<reference value="Patient/6tVbNJZq1buNwKmp6UKpd8CpLceNDlRF/_history/1"/>
</beneficiary>
<period>
<start value="2022-01-01"/>
<end value="2022-03-31"/>
</period>
<payor>
<identifier>
<system value="http://fhir.de/NamingSystem/arge-ik/iknr"/>
<value value="100019806"/>
</identifier>
<display value="Sozialamt des Kreises Borken"/>
</payor>
</Coverage>
