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>