Unit Test Results.

Designed for use with JUnit and Ant.

Class org.openhealthtools.mdht.uml.cda.hitsp.tests.InsuranceProviderTest

NameTestsErrorsFailuresTime(s)Time StampHost
InsuranceProviderTest24000.8092013-01-31T13:34:32JKMSoftware-desktop

Tests

NameStatusResultTime(s)
testConstructor

Constraint

OCL

SuccessInvalid XML

Valid XML

0.001
testValidateInsuranceProviderPaymentProviders

Constraint

HITSP Insurance Provider All Insurance Provider modules SHALL declare conformance to the IHE Payer Entry by including a <templateID> element with the root attribute set to the value 1.3.6.1.4.1.19376.1.5.3.1.4.18

OCL

self.getActs()->exists(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3"/>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

0.012
testValidateInsuranceProviderPayerEntryID

Constraint

HITSP Insurance Provider The id/@root attribute of a Payer Entry SHOULD be the OID of the assigning authority for the identifier; however, determining the assigning authority is not feasible in all settings. A GUID MAY be used in place of the OID of the assigning authority. Implementers SHOULD use the same GUID for each instance of the same group or contract number

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | not a.id.root->isEmpty())

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<id root="root"/>
</act>
</entryRelationship>
</act>

0.016
testValidateInsuranceProviderHealthInsuranceType

Constraint

HITSP Insurance Provider The code/@code element SHOULD be present in a Payer Entry and SHALL be coded as 2.16.840.1.113883.3.88.12.3221.5.2, Health Insurance Type Value Set, 20081218, STATIC

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.code.codeSystem = '2.16.840.1.113883.6.255.1336' and (a.code.code='12' or a.code.code='13' or a.code.code='14' or a.code.code='15' or a.code.code='16' or a.code.code='41' or a.code.code='42' or a.code.code='43' or a.code.code='47' or a.code.code='AP' or a.code.code='C1' or a.code.code='CO' or a.code.code='CP' or a.code.code='D' or a.code.code='DB' or a.code.code='EP' or a.code.code='FF' or a.code.code='GP' or a.code.code='HM' or a.code.code='HN' or a.code.code='HS' or a.code.code='IN' or a.code.code='IP' or a.code.code='LC' or a.code.code='LD' or a.code.code='LI' or a.code.code='LT' or a.code.code='MA' or a.code.code='MB' or a.code.code='MC' or a.code.code='MH' or a.code.code='MI' or a.code.code='MP' or a.code.code='OT' or a.code.code='PE' or a.code.code='PL' or a.code.code='PP' or a.code.code='PR' or a.code.code='PS' or a.code.code='QM' or a.code.code='RP' or a.code.code='SP' or a.code.code='TF' or a.code.code='WC' or a.code.code='WU'))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<code code="13" codeSystem="2.16.840.1.113883.6.255.1336"/>
</act>
</entryRelationship>
</act>

0.283
testValidateInsuranceProviderInsuranceInformation

Constraint

HITSP Insurance Provider performer/@typeCode='PRF'/assignedEntity SHALL be present to record Payer Information/Health Insurance Information

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.performer->exists (perm : cda::Performer2 | perm.typeCode = vocab::ParticipationPhysicalPerformer::PRF and perm.assignedEntity->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<performer typeCode="PRF">
<assignedEntity/>
</performer>
</act>
</entryRelationship>
</act>

0.021
testValidateInsuranceProviderInsuranceInfoSourceID

Constraint

HITSP Insurance Provider performer/@typeCode='PRF'/assignedEntity/id elements MAY be present. The ID element corresponds to the RxBIN and RxPCN fields found on pharmacy benefit cards. When a national payer identifier is standardized, it would also go in this field. The OID for RxBIN is 2.16.840.1.113883.3.88.3.1. The OID for an RxPCN is 2.16.840.1.113883.3.88.3.1 plus the numeric identifier used in the RxBIN.

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.performer->exists (perm : cda::Performer2 | perm.typeCode = vocab::ParticipationPhysicalPerformer::PRF and perm.assignedEntity.id->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<performer typeCode="PRF">
<assignedEntity>
<id/>
</assignedEntity>
</performer>
</act>
</entryRelationship>
</act>

0.022
testValidateInsuranceProviderInsuranceInfoSourceAddr

Constraint

HITSP Insurance Provider The performer/@typeCode='PRF'/assignedEntity/addr MAY be present.

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.performer->exists (perm : cda::Performer2 | perm.typeCode = vocab::ParticipationPhysicalPerformer::PRF and perm.assignedEntity.addr->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<performer typeCode="PRF">
<assignedEntity>
<addr/>
</assignedEntity>
</performer>
</act>
</entryRelationship>
</act>

0.022
testValidateInsuranceProviderHealthPlanCoverageStartTime

Constraint

HITSP Insurance Provider The date when the plan began covering the member SHOULD be recorded in the <low> element of the <time> element beneath the participant/@typeCode='COV' element

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists (par : cda::Participant2 | par.typeCode = vocab::ParticipationType::COV and par.time.low->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="COV">
<time>
<low/>
</time>
</participant>
</act>
</entryRelationship>
</act>

0.022
testValidateInsuranceProviderHealthPlanCoverageStopTime

Constraint

HITSP Insurance Provider The date when the plan stops covering the member SHOULD be recorded in the <high> element of the <time> element beneath the participant/@typeCode='COV' element

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists (par : cda::Participant2 | par.typeCode = vocab::ParticipationType::COV and par.time.high->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="COV">
<time>
<high/>
</time>
</participant>
</act>
</entryRelationship>
</act>

0.022
testValidateInsuranceProviderPatientInformation

Constraint

HITSP Insurance Provider participant/@typeCode='COV'/participantRole/@classCode='PAT' SHALL be present to record Patient information.

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists (par : cda::Participant2 | par.typeCode = vocab::ParticipationType::COV and par.participantRole.classCode = vocab::RoleClassRoot::PAT))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="COV">
<participantRole classCode="PAT"/>
</participant>
</act>
</entryRelationship>
</act>

0.017
testValidateInsuranceProviderMemberId

Constraint

HITSP Insurance Provider The member identifier number SHALL be recorded in the extension attribute of the <id> element found in the <participant/@typeCode='COV'/participantRole/@classCode='PAT'> element

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists (par : cda::Participant2 | par.typeCode = vocab::ParticipationType::COV and par.participantRole.classCode = vocab::RoleClassRoot::PAT and par.participantRole.id->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="COV">
<participantRole classCode="PAT">
<id/>
</participantRole>
</participant>
</act>
</entryRelationship>
</act>

0.026
testValidateInsuranceProviderMemberIdRoot

Constraint

HITSP Insurance Provider The root attribute of a participant/@typeCode='COV'/participantRole/@classCode='PAT'/id element SHOULD be the OID of the assigning authority for the identifier; however, determining the assigning authority is not feasible in all settings

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists (par : cda::Participant2 | par.typeCode = vocab::ParticipationType::COV and par.participantRole.classCode = vocab::RoleClassRoot::PAT and par.participantRole.id.root->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="COV">
<participantRole classCode="PAT">
<id root="root"/>
</participantRole>
</participant>
</act>
</entryRelationship>
</act>

0.027
testValidateInsuranceProviderRelationshipToSubscriber

Constraint

HITSP Insurance Provider The relationship to the subscriber SHALL be present and SHALL be recorded in the <code> element underneath the <participantRole> element recording the member information

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists (par : cda::Participant2 | par.typeCode = vocab::ParticipationType::COV and par.participantRole.classCode = vocab::RoleClassRoot::PAT and par.participantRole.code->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="COV">
<participantRole classCode="PAT">
<code/>
</participantRole>
</participant>
</act>
</entryRelationship>
</act>

0.027
testValidateInsuranceProviderRelationshipToSubscriberCodeSystem

Constraint

HITSP Insurance Provider The Patient Relationship to Subscriber SHALL be coded as 2.16.840.1.113883.1.11.18877, Coverage Role Type Value, V3NE08, STATIC

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists (par : cda::Participant2 | par.typeCode = vocab::ParticipationType::COV and par.participantRole.classCode = vocab::RoleClassRoot::PAT and par.participantRole.code.codeSystem = '2.16.840.1.113883.5.111' and (par.participantRole.code.code = 'FAMDEP' or par.participantRole.code.code='HANDIC' or par.participantRole.code.code ='INJ' or par.participantRole.code.code='SELF' or par.participantRole.code.code='SPON' or par.participantRole.code.code ='STUD' or par.participantRole.code.code='FSTUD' or par.participantRole.code.code='PSTUD')))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="COV">
<participantRole classCode="PAT">
<code code="FAMDEP" codeSystem="2.16.840.1.113883.5.111"/>
</participantRole>
</participant>
</act>
</entryRelationship>
</act>

0.079
testValidateInsuranceProviderPatientName

Constraint

HITSP Insurance Provider If the member name as recorded by the health plan differs from the patient name as recorded in the registration/medication summary (e.g., due to marriage or for other reasons), then the member name SHALL be recorded in the <name> element of the <playingEntity> element beneath the <participant/@typeCode='COV'/participantRole/@classCode='PAT'> element

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists (par : cda::Participant2 | par.typeCode = vocab::ParticipationType::COV and par.participantRole.classCode = vocab::RoleClassRoot::PAT and par.participantRole.playingEntity.name->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="COV">
<participantRole classCode="PAT">
<playingEntity>
<name/>
</playingEntity>
</participantRole>
</participant>
</act>
</entryRelationship>
</act>

0.028
testValidateInsuranceProviderSubscriberInformation

Constraint

HITSP Insurance Provider The <participant/@typeCode='HLD'> element SHOULD be present to record Subscriber Information.

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists(par : cda::Participant2 | par.typeCode = vocab::ParticipationType::HLD))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="HLD"/>
</act>
</entryRelationship>
</act>

0.013
testValidateInsuranceProviderSubscriberId

Constraint

HITSP Insurance Provider The participant/@typeCode='HLD'/participantRole/id element SHALL be present.

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists(par : cda::Participant2 | par.typeCode = vocab::ParticipationType::HLD and par.participantRole.id->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="HLD">
<participantRole classCode="PAT">
<id root="root"/>
</participantRole>
</participant>
</act>
</entryRelationship>
</act>

0.022
testValidateInsuranceProviderSubscriberIdRoot

Constraint

HITSP Insurance Provider The root attribute SHOULD be the OID of the assigning authority for the identifier; however, determining the assigning authority is not feasible in all settings. A GUID MAY be used in place of the OID of the assigning authority. Implementers SHOULD use the same GUID for each instance of a subscriber identifier from the same health plan

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists(par : cda::Participant2 | par.typeCode = vocab::ParticipationType::HLD and par.participantRole.id.root->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="HLD">
<participantRole classCode="PAT">
<id root="root"/>
</participantRole>
</participant>
</act>
</entryRelationship>
</act>

0.022
testValidateInsuranceProviderSubscriberAddress

Constraint

HITSP Insurance Provider The participant/@typeCode='HLD'/participantRole/addr element SHALL be present to record the Subscriber Address.

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.participant->exists(par : cda::Participant2 | par.typeCode = vocab::ParticipationType::HLD and par.participantRole.addr->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<participant typeCode="HLD">
<participantRole classCode="PAT">
<addr/>
</participantRole>
</participant>
</act>
</entryRelationship>
</act>

0.022
testValidateInsuranceProviderFinancialResponsibilityPartyType

Constraint

HITSP Insurance Provider SHALL satisfy: performer/assignedEntity/code element is used to denote the financial Responsibility Party Type.

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.performer->exists(per : cda::Performer2 | per.typeCode = vocab::ParticipationPhysicalPerformer::PRF and per.assignedEntity.code->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<performer typeCode="PRF">
<assignedEntity>
<code/>
</assignedEntity>
</performer>
</act>
</entryRelationship>
</act>

0.022
testValidateInsuranceProviderFinancialResponsibilityPartyTypeCode

Constraint

HITSP Insurance Provider performer/assignedEntity/code/@code attribute SHALL be coded as 2.16.840.1.113883.1.11.10416, Financially Responsible Party Type Value Set, V3NE08, STATIC

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.performer->exists(per : cda::Performer2 | per.assignedEntity.code.codeSystem = '2.16.840.1.113883.5.110'))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<performer typeCode="PRF">
<assignedEntity>
<code codeSystem="2.16.840.1.113883.5.110"/>
</assignedEntity>
</performer>
</act>
</entryRelationship>
</act>

0.015
testValidateInsuranceProviderFinancialResponsibilityPartyAddress

Constraint

HITSP Insurance Provider performer/assignedEntity/addr SHOULD be present to record Financial Responsibility Party Address

OCL

self.getActs()->select(act : cda::Act | act.oclIsKindOf(ihe::PayerEntry))->forAll(a : cda::Act | a.performer->exists(per : cda::Performer2 | per.assignedEntity.addr->size() > 0))

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act/>
</entryRelationship>
</act>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
<entryRelationship>
<act>
<performer typeCode="PRF">
<assignedEntity>
<addr/>
</assignedEntity>
</performer>
</act>
</entryRelationship>
</act>

0.017
testValidateInsuranceProviderTemplateId

Constraint

SHALL contain exactly one [1..1] templateId ( ) such that it SHALL contain exactly one [1..1] @root="2.16.840.1.113883.3.88.11.83.5"

OCL

self.templateId->exists(id : datatypes::II | id.root = '2.16.840.1.113883.3.88.11.83.5')

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3"/>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
</act>

0.007
testValidateInsuranceProviderCode

Constraint

HITSP Insurance Provider SHALL contain exactly one [1..1] code/@code="48768-6" Payment sources (CodeSystem: 2.16.840.1.113883.6.1 LOINC) (CONF-41, CONF-42)

OCL

(self.code.oclIsUndefined() or self.code.isNullFlavorUndefined()) implies (not self.code.oclIsUndefined() and self.code.oclIsKindOf(datatypes::CD) and let value : datatypes::CD = self.code.oclAsType(datatypes::CD) in value.code = '48768-6' and value.codeSystem = '2.16.840.1.113883.6.1')

SuccessInvalid XML


<act xmlns="urn:hl7-org:v3"/>

Valid XML


<act xmlns="urn:hl7-org:v3" classCode="ACT" moodCode="DEF">
<templateId root="2.16.840.1.113883.3.88.11.83.5"/>
<templateId root="2.16.840.1.113883.10.20.1.20"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.17"/>
<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment sources"/>
<statusCode code="completed"/>
</act>

0.038
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