1. FHIR R4 APIs for Oracle Health Millennium Platform
  2. Tasks
  3. Coverage

Create a coverage

post

/Coverage

Creates new patient-level or encounter-level coverage.

Note: Only the body fields mentioned below are supported. Unsupported fields are ignored, or can result in errors.

Authorization Types

This operation supports the following authorization types:

Request

Supported Media Types
Header Parameters
Body ()
Root Schema : CoverageCreate
Type: object
Show Source
  • beneficiary

    Plan beneficiary.

  • class

    Additional coverage classifications.

    Example: 

    {
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "plan"
          }
        ],
        "text": "plan"
      },
      "value": "729825",
      "name": "Aetna Missouri POS Open"
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "group"
          }
        ],
        "text": "group"
      },
      "value": "7298139",
      "name": "Aetna Missouri POS Open group"
    }
  ]
}

  • Dependent number.

    Note: Not required for Public Healthcare writes.

    Example: 
    {
  "dependent": "1626016"
}
    Example: 1626016
  • extension

    Reference to the encounter associated with the encounter-level coverage.

    Example: 
    {
  "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter",
  "valueReference": {
    "reference": "Encounter/31363178"
  }
}
    Note:
    • The valueReference.reference must be an encounter reference.
    • If provided, an encounter-level coverage is created.

    See the StructureDefinition of this extension for further formatting details.

  • payor

    Issuer of the policy.

    Note: For public coverages, payor[0].reference is not supported.

    Example: 

    {
  "payor": [
    {
      "reference": "Organization/643847",
      "display": "Aetna Missouri POS - Open"
    }
  ]
}

  • period

    Coverage start and end dates.

    Note: Both period.start and period.end must contain date and time components.

    Example: 

    {
  "period": {
    "start": "2014-09-05T14:30:12.000Z",
    "end": "2015-09-05T14:30:12.000Z"
  }
}

  • relationship

    Indicates the beneficiary relationship to the subscriber.

    Note: Not required for Public Healthcare writes.

    Example: 
    {
  "relationship": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
          "code": "child"
        }
      ]
    }
  ]
}
  • Allowed Values: [ "Coverage" ]

    The type of the FHIR resource.

  • Allowed Values: [ "active" ]

    The status of the coverage.

  • subscriber

    Subscriber to the policy.

    Note:
    • Currently supports only patient references.
    • Not required for Public Healthcare writes.
    Example: 
    {
  "subscriber": {
    "reference": "Patient/1626016"
  }
}

  • ID assigned to the subscriber.

    Example: 1626016
Nested Schema : beneficiary
Type: object

Plan beneficiary.

Show Source
Nested Schema : class
Type: array

Additional coverage classifications.

Example: 

{
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "plan"
          }
        ],
        "text": "plan"
      },
      "value": "729825",
      "name": "Aetna Missouri POS Open"
    },
    {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/ValueSet/coverage-class",
            "code": "group"
          }
        ],
        "text": "group"
      },
      "value": "7298139",
      "name": "Aetna Missouri POS Open group"
    }
  ]
}

Show Source
Nested Schema : extension
Type: object

Reference to the encounter associated with the encounter-level coverage.

Example: 
{
  "url": "https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter",
  "valueReference": {
    "reference": "Encounter/31363178"
  }
}
Note:
  • The valueReference.reference must be an encounter reference.
  • If provided, an encounter-level coverage is created.

See the StructureDefinition of this extension for further formatting details.

Show Source
Nested Schema : payor
Type: array

Issuer of the policy.

Note: For public coverages, payor[0].reference is not supported.

Example: 

{
  "payor": [
    {
      "reference": "Organization/643847",
      "display": "Aetna Missouri POS - Open"
    }
  ]
}

Show Source
Nested Schema : period
Type: object

Coverage start and end dates.

Note: Both period.start and period.end must contain date and time components.

Example: 

{
  "period": {
    "start": "2014-09-05T14:30:12.000Z",
    "end": "2015-09-05T14:30:12.000Z"
  }
}

Show Source
Nested Schema : relationship
Type: object

Indicates the beneficiary relationship to the subscriber.

Note: Not required for Public Healthcare writes.

Example: 
{
  "relationship": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
          "code": "child"
        }
      ]
    }
  ]
}
Show Source
Nested Schema : subscriber
Type: object

Subscriber to the policy.

Note:
  • Currently supports only patient references.
  • Not required for Public Healthcare writes.
Example: 
{
  "subscriber": {
    "reference": "Patient/1626016"
  }
}
Show Source
Nested Schema : items
Type: object
Show Source

  • Human-readable description of the type and value.

    Example: 

    {
  "name": "Aetna Missouri POS Open group"
}

  • type

    Type of class such as group or plan.

    Example: 

    {
  "type": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/ValueSet/coverage-class",
        "code": "group"
      }
    ],
    "text": "group"
  }
}
    {
  "type": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/ValueSet/coverage-class",
        "code": "plan"
      }
    ],
    "text": "plan"
  }
}

  • Value associated with type.

    Example: 

    {
  "value": "7298139"
}

Nested Schema : type
Type: object

Type of class such as group or plan.

Example: 

{
  "type": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/ValueSet/coverage-class",
        "code": "group"
      }
    ],
    "text": "group"
  }
}
{
  "type": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/ValueSet/coverage-class",
        "code": "plan"
      }
    ],
    "text": "plan"
  }
}

Show Source
Nested Schema : coding
Type: array
Show Source
Nested Schema : items
Type: object
Show Source
Nested Schema : items
Type: object
Show Source
Nested Schema : coding
Type: array
Show Source
Nested Schema : items
Type: object
Show Source
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Response

Supported Media Types

Default Response

Example creation of patient-level private coverage.

Example Request: 
POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage
Example Request Body: 
{
    'resourceType': 'Coverage',
    'status': 'active',
    'subscriber': {
      'reference': 'Patient/589763'
    },
    'subscriberId': '123',
    'beneficiary': {
      'reference': 'Patient/589763'
    },
    'relationship': {
      'coding': [
        {
          'system': 'http://terminology.hl7.org/CodeSystem/subscriber-relationship',
          'code': 'other'
        }
      ]
    },
    'period': {
      'start': '2014-09-05T14:30:12.000Z',
      'end': '2015-09-05T14:30:12.000Z'
    },
    'payor': [
      {
        'reference': 'Organization/643847',
        'display': 'Aetna Missouri POS - Open'
      }
    ],
    'class': [
      {
        'type': {
          'coding': [
            {
              'system': 'http://hl7.org/fhir/ValueSet/coverage-class',
              'code': 'plan'
            }
          ],
          'text': 'plan'
        },
        'value': '729827',
        'name': 'Aetna Missouri POS Open'
      },
      {
        'type': {
          'coding': [
            {
              'system': 'http://hl7.org/fhir/ValueSet/coverage-class',
              'code': 'group'
            }
          ],
          'text': 'group'
        },
        'value': '729839',
        'name': 'Aetna Missouri POS Open group'
      }
    ]
  }
Example Response: 
  Cache-Control: no-cache
  Content-Length: 0
  Content-Type: text/html
  Date: Tue, 22 Oct 2019 15:59:33 GMT
  Etag: W/"0$0"
  Last-Modified: Tue, 22 Oct 2019 15:59:30 GMT
  Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/589763-11500257-11500257
  Vary: Origin
  X-Request-Id: 11111111-1111-1111-1111-111111111111
  opc-request-id: /11111111111111111111111111111111/11111111111111111111111111111111
The ETag response header indicates the current If-Match version to use on a subsequent update.
Headers
  • For Update or Patch versioning controls. Related to If-Match. When a resource performs an operation that creates or updates a record, an Etag value is returned as a header. This same value should be included in request headers as an If-Match for any subsequent update to that record.
  • Unique Oracle-assigned identifier for the request. If you need to contact Oracle about a particular request, provide the X-Request-Id, if present.
  • Unique Oracle-assigned identifier for the request. If you need to contact Oracle about a particular request, provide the opc-Request-Id, if present.

x-encounter-level-private Response

Example creation of encounter-level private coverage.

Example Request: 
POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage
Example Request Body: 
{
    'resourceType': 'Coverage',
    'status': 'active',
    'subscriber': {
      'reference': 'Patient/1626016',
      'display': 'WOLFE, STEPHANIE T'
    },
    'extension': [
      {
        'url': 'https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter',
        'valueReference': {
          'reference': 'Encounter/31363178'
        }
      }
    ],
    'subscriberId': '2461235',
    'dependent': '74965675',
    'beneficiary': {
      'reference': 'Patient/1626016'
    },
    'relationship': {
      'coding': [
        {
          'system': 'https://fhir.cerner.com/2c400054-42d8-4e74-87b7-80b5bd5fde9f/codeSet/40',
          'code': '156',
          'display': 'child',
          'userSelected': true
        }
      ]
    },
    'period': {
      'start': '2014-09-05T14:30:12.000Z',
      'end': '2015-09-05T14:30:12.000Z'
    },
    'payor': [
      {
        'reference': 'Organization/643847',
        'display': 'Aetna Missouri POS - Open'
      }
    ],
    'class': [
      {
        'type': {
          'coding': [
            {
              'system': 'http://hl7.org/fhir/ValueSet/coverage-class',
              'code': 'plan'
            }
          ],
          'text': 'plan'
        },
        'value': '729825',
        'name': 'Aetna Missouri POS Open'
      },
      {
        'type': {
          'coding': [
            {
              'system': 'http://hl7.org/fhir/ValueSet/coverage-class',
              'code': 'group'
            }
          ],
          'text': 'group'
        },
        'value': '8939999',
        'name': 'Aetna Missouri POS Open group'
      }
    ]
  }
Example Response: 
  Cache-Control: no-cache
  Content-Length: 0
  Content-Type: text/html
  Date: Tue, 22 Oct 2019 15:59:33 GMT
  Etag: W/"0"
  Last-Modified: Tue, 22 Oct 2019 15:59:30 GMT
  Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/31363178-11500257
  Vary: Origin
  X-Request-Id: 11111111-1111-1111-1111-111111111111
  opc-request-id: /11111111111111111111111111111111/11111111111111111111111111111111
The ETag response header indicates the current If-Match version to use on a subsequent update.
Headers
  • For Update or Patch versioning controls. Related to If-Match. When a resource performs an operation that creates or updates a record, an Etag value is returned as a header. This same value should be included in request headers as an If-Match for any subsequent update to that record.
  • Unique Oracle-assigned identifier for the request. If you need to contact Oracle about a particular request, provide the X-Request-Id, if present.
  • Unique Oracle-assigned identifier for the request. If you need to contact Oracle about a particular request, provide the opc-Request-Id, if present.

x-encounter-level-public Response

Example creation of encounter-level public coverage.

Example Request: 
POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage
Example Request Body: 
{
    'resourceType': 'Coverage',
    'status': 'active',
    'beneficiary': {
      'reference': 'Patient/1626016'
    },
    'period': {
      'start': '2021-01-18T14:30:20.000Z',
      'end': '2021-01-18T14:30:21.000Z'
    },
    'payor': [
      {
        'display': 'Government'
      }
    ],
    'extension': [
      {
        'url': 'https://fhir-ehr.cerner.com/r4/StructureDefinition/coverage-encounter',
        'valueReference': {
          'reference': 'Encounter/31363178'
        }
      }
    ],
    'class': [
      {
        'type': {
          'coding': [
            {
              'system': 'http://hl7.org/fhir/ValueSet/coverage-class',
              'code': 'plan'
            }
          ],
          'text': 'Charging Category'
        },
        'value': '2572940471',
        'name': '10-OPC, Class II'
      }
    ]
  }
Example Response: 
  Cache-Control: no-cache
  Content-Length: 0
  Content-Type: text/html
  Date: Tue, 22 Oct 2019 15:59:33 GMT
  Etag: W/"42-0"
  Last-Modified: Tue, 22 Oct 2019 15:59:30 GMT
  Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PH-31363178-11500257
  Vary: Origin
  X-Request-Id: 11111111-1111-1111-1111-111111111111
  opc-request-id: /11111111111111111111111111111111/11111111111111111111111111111111
The ETag response header indicates the current If-Match version to use on a subsequent update.
Headers
  • For Update or Patch versioning controls. Related to If-Match. When a resource performs an operation that creates or updates a record, an Etag value is returned as a header. This same value should be included in request headers as an If-Match for any subsequent update to that record.
  • Unique Oracle-assigned identifier for the request. If you need to contact Oracle about a particular request, provide the X-Request-Id, if present.
  • Unique Oracle-assigned identifier for the request. If you need to contact Oracle about a particular request, provide the opc-Request-Id, if present.

x-patient-level-public Response

Example creation of patient-level public coverage.

Example Request: 
POST https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage
Example Request Body: 
{
    'resourceType': 'Coverage',
    'status': 'active',
    'beneficiary': {
      'reference': 'Patient/1626016'
    },
    'period': {
      'start': '2021-01-18T14:30:20.000Z',
      'end': '2021-01-18T14:30:21.000Z'
    },
    'payor': [
      {
        'display': 'Government'
      }
    ],
    'class': [
      {
        'type': {
          'coding': [
            {
              'system': 'http://hl7.org/fhir/ValueSet/coverage-class',
              'code': 'plan'
            }
          ],
          'text': 'Charging Category'
        },
        'value': '2572940471',
        'name': '10-OPC, Class II'
      }
    ]
  }
Example Response: 
  Cache-Control: no-cache
  Content-Length: 0
  Content-Type: text/html
  Date: Tue, 22 Oct 2019 15:59:33 GMT
  Etag: W/"135-0"
  Last-Modified: Tue, 22 Oct 2019 15:59:30 GMT
  Location: https://fhir-ehr-code.cerner.com/r4/ec2458f2-1e24-41c8-b71b-0e701af7583d/Coverage/PHP-1626016-11500257
  Vary: Origin
  X-Request-Id: 11111111-1111-1111-1111-111111111111
  opc-request-id: /11111111111111111111111111111111/11111111111111111111111111111111
The ETag response header indicates the current If-Match version to use on a subsequent update.
Headers
  • For Update or Patch versioning controls. Related to If-Match. When a resource performs an operation that creates or updates a record, an Etag value is returned as a header. This same value should be included in request headers as an If-Match for any subsequent update to that record.
  • Unique Oracle-assigned identifier for the request. If you need to contact Oracle about a particular request, provide the X-Request-Id, if present.
  • Unique Oracle-assigned identifier for the request. If you need to contact Oracle about a particular request, provide the opc-Request-Id, if present.
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