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.

One page will contain 5 coverages (episodes).

For an example see RED Interchange API - Postman Collection 0111 - Patient - All Coverage (Versicherungen)


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 coverages matching the daterange (e.g. from date of 01.01.2023 will return coverages from first quarter of 2023 until today) 

For an example see RED Interchange API - Postman Collection 0112 - Patient - All Coverages in date range


{{baseURL}}/{{tenant}}/Coverage?page=1&beneficiary=Patient/6020&from=20230101

For an example see RED Interchange API - Postman Collection 0113 - Patient - All Coverages from date


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.

For an example see RED Interchange API - Postman Collection 0114 - Patient - Specific Coverage


<Coverage xmlns="http://hl7.org/fhir">
                <id value="exwQFSATO73RzZYX"/>
                <meta>
                    <versionId value="1"/>
                    <lastUpdated value="2023-08-29T08:00:45+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 Swen Weiss</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>
                <identifier>
                    <use value="official"/>
                    <type>
                        <coding>
                            <system value="http://fhir.de/CodeSystem/identifier-type-de-basis"/>
                            <code value="GKV"/>
                        </coding>
                    </type>
                    <system value="http://fhir.de/NamingSystem/gkv/kvid-10"/>
                    <value value="F344544444"/>
                </identifier>
                <status value="active"/>
                <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/RdtYQVbu4pbF8ygm0Zj87A8gx2IyjGAU/_history/1"/>
                </beneficiary>
                <period>
                    <start value="2023-07-28"/>
                    <end value="2023-09-30"/>
                </period>
                <payor>
                    <identifier>
                        <system value="http://fhir.de/sid/arge-ik/iknr"/>
                        <value value="102114819"/>
                    </identifier>
                    <display value="AOK Niedersachsen"/>
                </payor>
            </Coverage>