API end point: https://clovermembers.careevolution.com/WebClient/api/Clover-PostData.

Resource Coverage (STU3)

Maps the CareEvolution Insurance concept

• Supported interactions
• Search parameters
• Sorts
• Includes
• Operations
• To FHIR mappings
• From FHIR mappings

Supported interactions

• read
• search
• create
• update
• delete

Search parameters

Name	Type	Modifiers , prefixes	Multiple values	Can be chained	Description
_count	Special	eq			The maximum number of resources to return in a result page.
_elements	Special	eq			Used to request a specific set of elements be returned as part of a resource.
_id	Token		Yes		Resource id
_lastUpdated	Date	eq ne lt le gt ge sa eb ap			When the resource last changed
_source	Uri	:missing	Yes		Where the resource comes from
_summary	Special	eq			Used to return only a portion of the resouces. Defaults to 'false', which returns the whole resource.
_total	Special	eq			Use the value 'estimate' to populate the result bundle's 'total' element with an estimate of the matching number of resources.
beneficiary	Reference (Patient)	:missing	Yes	Yes	The patient the Coverage is about. Functionally identical to the "patient" search parameter.
dependent	String	:contains :exact	Yes		Dependent number
group	String	:contains :exact :missing	Yes		Group identifier
identifier	Token	:missing	Yes		The primary identifier of the insured and the coverage
patient	Reference (Patient)	:missing	Yes	Yes	The patient the Coverage is about
plan	String	:contains :exact :missing	Yes		A plan or policy identifier
provenance-agent	Reference (Organization)	:missing	Yes	Yes	Search by provenance, specified by its author (aka originator) Organization
sequence	String	:contains :exact	Yes		Sequence number
subplan	String	:contains :exact :missing	Yes		Sub-plan identifier
type	Token	:not :in :not-in :missing	Yes		The kind of coverage (health plan, auto, Workers Compensation)

Sorts

• _id
• plan
• type

Supports multiple sorts

Includes

• beneficiary
• patient
• provenance-agent
• ExplanationOfBenefit:coverage
• Provenance:target

Operations

• validate - Validate a resource

To FHIR mappings

FHIR	CareEvolution
beneficiary	PatientID
dependent	Property('Dependent')
extension('http://careevolution.com/fhirextensions#coverage-authorizationDate')	AuthorizationDate
extension('http://careevolution.com/fhirextensions#coverage-authorizationNumber')	AuthorizationNumber
extension('http://careevolution.com/fhirextensions#coverage-authorizationSource')	AuthorizationSource
extension('http://careevolution.com/fhirextensions#coverage-details')	Details
extension('http://careevolution.com/fhirextensions#coverage-encounterID')	EncounterID
extension('http://careevolution.com/fhirextensions#coverage-groupEmpName')	GroupEmpName
extension('http://careevolution.com/fhirextensions#coverage-insuredAddress')	InsuredAddress
	InsuredState
	InsuredCity
	InsuredPostalCode
extension('http://careevolution.com/fhirextensions#coverage-insuredAltPhone')	InsuredAltPhone
extension('http://careevolution.com/fhirextensions#coverage-insuredDob')	InsuredDob
extension('http://careevolution.com/fhirextensions#coverage-insuredGender')	InsuredGender
extension('http://careevolution.com/fhirextensions#coverage-insuredName')	InsuredName
extension('http://careevolution.com/fhirextensions#coverage-insuredPhone')	InsuredPhone
extension('http://careevolution.com/fhirextensions#coverage-insuredSsn')	InsuredSsn
extension('http://careevolution.com/fhirextensions#coverage-medicaidCaseName')	MedicaidCaseName
extension('http://careevolution.com/fhirextensions#coverage-medicaidCaseNumber')	MedicaidCaseNumber
extension('http://careevolution.com/fhirextensions#coverage-medicareCardNumber')	MedicareCardNumber
extension('http://careevolution.com/fhirextensions#coverage-pharmacyCoverage')	PharmacyCoverage
extension('http://careevolution.com/fhirextensions#coverage-policyNumber')	PolicyNumber
extension('http://careevolution.com/fhirextensions#coverage-primaryCaregiver')	PrimaryCaregiver
extension('http://careevolution.com/fhirextensions#coverage-rateCode')	RateCode Domain: InsuranceRateCode
extension('http://careevolution.com/fhirextensions#coverage-segment')	Segment Domain: InsuranceSegment
extension('http://careevolution.com/fhirextensions#coverage-sponsor')	Sponsor
extension('http://careevolution.com/fhirextensions#coverage-type')	Type Domain: InsuranceType
extension('http://careevolution.com/fhirextensions#dataSource')	DataSource
grouping.class	Class Domain: InsuranceClass
grouping.classDisplay	Class Domain: InsuranceClass
grouping.extension('http://careevolution.com/fhirextensions#coverage-product')	Product Domain: InsuranceProduct
grouping.extension('http://careevolution.com/fhirextensions#coverage-productgroup')	ProductGroup Domain: InsuranceProductGroup
grouping.group	GroupNumber
grouping.plan	PlanName
grouping.subGroup	GroupName
grouping.subPlan	GroupEmpId
identifier	PlanIdentifier
network	Network Domain: InsuranceNetwork
order	Priority
payor	InsuranceCompanyName
	InsuranceCompanyAddress
	InsuranceCompanyCity
	InsuranceCompanyState
	InsuranceCompanyPostalCode
	InsuranceCompanyPhone
period	StartDate
	EndDate
relationship Bindings:  http://hl7.org/fhir/v3/RoleCode	InsuredRelationship Domain: FamilyRelationship
sequence	Property('Sequence')
status Bindings:  valueset-fm-status	Status Domain: InsuranceStatus
subscriber	InsuredName
	InsuredAddress
	InsuredCity
	InsuredState
	InsuredPostalCode
	InsuredPhone
	InsuredAltPhone
	InsuredDob
	InsuredSsn
	InsuredGender
subscriberId	Property('SubscriberIdentifier')
text	Comment
type	PlanType Domain: InsurancePlanType

From FHIR mappings

FHIR	CareEvolution
beneficiary	PatientID
dependent	Property('Dependent')
extension('http://careevolution.com/fhirextensions#coverage-authorizationDate')	AuthorizationDate
extension('http://careevolution.com/fhirextensions#coverage-authorizationNumber')	AuthorizationNumber
extension('http://careevolution.com/fhirextensions#coverage-authorizationSource')	AuthorizationSource
extension('http://careevolution.com/fhirextensions#coverage-encounterID')	EncounterID
extension('http://careevolution.com/fhirextensions#coverage-groupEmpName')	GroupEmpName
extension('http://careevolution.com/fhirextensions#coverage-medicaidCaseName')	MedicaidCaseName
extension('http://careevolution.com/fhirextensions#coverage-medicaidCaseNumber')	MedicaidCaseNumber
extension('http://careevolution.com/fhirextensions#coverage-medicareCardNumber')	MedicareCardNumber
extension('http://careevolution.com/fhirextensions#coverage-pharmacyCoverage')	PharmacyCoverage
extension('http://careevolution.com/fhirextensions#coverage-policyNumber')	PolicyNumber
extension('http://careevolution.com/fhirextensions#coverage-primaryCaregiver')	PrimaryCaregiver
extension('http://careevolution.com/fhirextensions#coverage-rateCode')	RateCode Domain: InsuranceRateCode
extension('http://careevolution.com/fhirextensions#coverage-segment')	Segment Domain: InsuranceSegment
extension('http://careevolution.com/fhirextensions#coverage-sponsor')	Sponsor
extension('http://careevolution.com/fhirextensions#coverage-type')	Type Domain: InsuranceType
extension('http://careevolution.com/fhirextensions#dataSource')	DataSource
grouping.class	Class Domain: InsuranceClass
grouping.classDisplay	Class Domain: InsuranceClass
grouping.extension('http://careevolution.com/fhirextensions#coverage-product')	Product Domain: InsuranceProduct
grouping.extension('http://careevolution.com/fhirextensions#coverage-productgroup')	ProductGroup Domain: InsuranceProductGroup
grouping.group	GroupNumber
grouping.plan	PlanName
grouping.subGroup	GroupName
grouping.subPlan	PlanName
	GroupEmpId
id	PlanIdentifier
identifier	PlanIdentifier
network	Network Domain: InsuranceNetwork
order	Priority
payor	InsuranceCompanyName
	InsuranceCompanyAddress
	InsuranceCompanyCity
	InsuranceCompanyState
	InsuranceCompanyPostalCode
	InsuranceCompanyPhone
period	StartDate
	EndDate
relationship Bindings:  http://hl7.org/fhir/v3/RoleCode	InsuredRelationship Domain: FamilyRelationship
sequence	Property('Sequence')
status Bindings:  valueset-fm-status	Status Domain: InsuranceStatus
subscriber	InsuredName
	InsuredAddress
	InsuredCity
	InsuredState
	InsuredPostalCode
	InsuredPhone
	InsuredAltPhone
	InsuredDob
	InsuredSsn
	InsuredGender
subscriberId	Property('SubscriberIdentifier')
text	Comment
type	PlanType Domain: InsurancePlanType

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