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schematron.ccd.templates.2.16.840.1.113883.10.20.1.26.ent Maven / Gradle / Ivy

	
	
	A policy activity (templateId 2.16.840.1.113883.10.20.1.26) SHALL be represented with Act.
	The value for Act / classCode in a policy activity SHALL be 'ACT' 2.16.840.1.113883.5.6 ActClass STATIC.
	The value for Act / moodCode in a policy activity SHALL be "EVN" 2.16.840.1.113883.5.1001 ActMood STATIC.
	A policy activity SHALL contain at least one Act / id, which represents the group or contract number related to the insurance policy or program. 
	A coverage policy SHALL contain exactly one Act / statusCode.
	The value for Act / statusCode in a policy activity SHALL be 'completed'  2.16.840.1.113883.5.14 ActStatus STATIC.
	A policy activity SHALL contain exactly one Act / performer [@typeCode="PRF"], representing the payer.
	A policy activity SHALL contain exactly one Act / participant [@typeCode="COV"], representing the covered party. 
	A policy activity SHALL contain exactly one Act / participant [@typeCode="COV"], representing the covered party. 
	A policy activity MAY contain exactly one Act / participant [@typeCode='HLD'], representing the subscriber.
	The value for Act / entryRelationship / typeCode in a policy activity SHALL be 'REFR'  2.16.840.1.113883.5.1002 ActRelationshipType STATIC.
	
	
	
	
	A covered party in a policy activity MAY contain exactly one participant / time, to represent the time period over which the patient is covered.
	
	
	
	The target of a policy activity with Act / entryRelationship / @typeCode='REFR' SHALL be an authorization activity (templateId 2.16.840.1.113883.10.20.1.19) or an Act, with Act [@classCode = 'ACT'] and Act [@moodCode = 'DEF'], representing a description of the coverage plan. 
	
	
	
	
	A description of the coverage plan SHALL contain one or more Act / Id, to represent the plan identifier.
	





	
	
	A policy activity SHOULD contain zero to one Act / code, which represents the type of coverage.
	
	
	
	
	A covered party in a policy activity SHOULD contain one or more participant / participantRole / id, to represent the patient's member or subscriber identifier with respect to the payer.
	A covered party in a policy activity SHOULD contain exactly one participant / participantRole / code, to represent the reason for coverage (e.g. Self, Family dependent, student).
	
	
	
	
	A subscriber in a policy activity SHOULD contain one or more participant / participantRole / id, to represent the subscriber's identifier with respect to the payer.