ProductPlan Resource Proposal
- 1 ProductPlan
- 1.1 Owning work group name
- 1.2 Committee Approval Date:
- 1.3 Contributing or Reviewing Work Groups
- 1.4 FHIR Resource Development Project Insight ID
- 1.5 Scope of coverage
- 1.6 RIM scope
- 1.7 Resource appropriateness
- 1.8 Expected implementations
- 1.9 Content sources
- 1.10 Example Scenarios
- 1.11 Resource Relationships
- 1.12 Timelines
- 1.13 gForge Users
- 1.14 When Resource Proposal Is Complete
- 1.15 FMG Notes
Owning work group name
Committee Approval Date:
Contributing or Reviewing Work Groups
- Financial Management
- Seeking other interested workgroups
FHIR Resource Development Project Insight ID
Scope of coverage
A product is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or coverage benefits. A plan pairs the health insurance coverage benefits under a product with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans.
ProductPlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.
The ProductPlan does not represent the details for a specific patient, that is the Coverage resource.
A catalog to discover providers that provide specific insurance products is useful for both patients/consumers, and also for providers to verify details.
The information from the catalog will also be able to be utilized in Patient Coverage resources.
The ONC has indicated that they desire to create a service that uses this capability where they will be distributing aggregated healthcare directory data from a central service to Organizations for local usage (based on a specific data usage agreement)
- Centralized Healthcare Directory service
- Distributed/Federated Provider Directory service
- Aggregated Directory Service
Reference(any) - Our initial requirements are needed against:
We do not currently expect other resources to specifically reference ProductPlan
Sept Ballot 2018 - draft was in Jan 2018 Comment ballot
- Cooper Thompson
- Andrew Torres
When Resource Proposal Is Complete
When you have completed your proposal, please send an email to FMGcontact@HL7.org