HL7.TERMINOLOGY\Benefit cost applicability

This page is part of the HL7 Terminology (v2.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions

ValueSet: Benefit cost applicability

Summary

Defining URL:

http://terminology.hl7.org/ValueSet/insuranceplan-applicability

Version:

0.1.0

Name:

BenefitCostApplicability

Title:

Benefit cost applicability

Status:

Draft as of 2018-06-05T14:06:02+00:00 (Standards Status: Trial Use)

Definition:

Whether the cost applies to in-network or out-of-network providers.

Publisher:

HL7 (FHIR Project)

Committee:

Patient Administration

Maturity:

OID:

2.16.840.1.113883.4.642.3.0 (for OID based terminology systems)

Source Resource:

XML / JSON / Turtle

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

Include all codes defined in http://terminology.hl7.org/CodeSystem/applicability

Expansion

This value set contains 3 concepts

Expansion based on Benefit cost applicability v0.1.0 (CodeSystem)

All codes from system http://terminology.hl7.org/CodeSystem/applicability

Code	Display	Definition
in-network	In Network	Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
out-of-network	Out of Network	Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
other	Other	Other applicability

Explanation of the columns that may appear on this page:

Level

A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies

Source

The source of the definition of the code (when the value set draws in codes defined elsewhere)

Code

The code (used as the code in the resource instance)

Display

The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application

Definition

An explanation of the meaning of the concept

Comments

Additional notes about how to use the code

History

Date

Action

Author

Custodian

Comment

2020-10-14

revise