UnitedHealth Group · JSON Structure

Optum Fhir Coverage Structure

FHIR R4 Coverage resource representing UnitedHealth Group insurance coverage including plan, group, and benefit period

Type: object Properties: 0
HealthcareHealth InsuranceFHIRClaimsInteroperabilityFortune 100

UnitedHealth Group FHIR Coverage is a JSON Structure definition published by UnitedHealth Group. It conforms to the https://json-structure.org/meta/core/v0/# meta-schema.

Meta-schema: https://json-structure.org/meta/core/v0/#

JSON Structure

Raw ↑
{
  "$schema": "https://json-structure.org/meta/core/v0/#",
  "$id": "https://raw.githubusercontent.com/api-evangelist/unitedhealth/refs/heads/main/json-structure/optum-fhir-coverage-structure.json",
  "name": "UnitedHealth Group FHIR Coverage",
  "type": "object",
  "description": "FHIR R4 Coverage resource representing UnitedHealth Group insurance coverage including plan, group, and benefit period",
  "fields": [
    {
      "name": "resourceType",
      "type": "string",
      "description": "FHIR resource type",
      "enum": [
        "Coverage"
      ]
    },
    {
      "name": "id",
      "type": "string",
      "description": "Resource ID"
    },
    {
      "name": "status",
      "type": "string",
      "description": "Coverage status",
      "enum": [
        "active",
        "cancelled",
        "draft",
        "entered-in-error"
      ]
    },
    {
      "name": "type",
      "type": "object",
      "description": "Coverage type coding"
    },
    {
      "name": "subscriber",
      "type": "object",
      "description": "Subscriber reference"
    },
    {
      "name": "subscriberId",
      "type": "string",
      "description": "Subscriber/member ID"
    },
    {
      "name": "beneficiary",
      "type": "object",
      "description": "Beneficiary patient reference"
    },
    {
      "name": "relationship",
      "type": "object",
      "description": "Relationship to subscriber"
    },
    {
      "name": "period",
      "type": "object",
      "description": "Coverage period"
    },
    {
      "name": "payor",
      "type": "array",
      "description": "Payer references",
      "items": {
        "type": "object"
      }
    },
    {
      "name": "class",
      "type": "array",
      "description": "Plan classification",
      "items": {
        "type": "object"
      }
    }
  ]
}