HL7 Terminology (THO)
5.1.0 - Publication International flag

This page is part of the HL7 Terminology (v5.1.0: 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

Official URL: http://terminology.hl7.org/ValueSet/insuranceplan-applicability Version: 0.1.0
Draft as of 2018-06-05 Maturity Level: 0 Responsible: HL7 (FHIR Project) Computable Name: BenefitCostApplicability
Other Identifiers: id: urn:oid:2.16.840.1.113883.4.642.3.0

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

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)

 

Expansion

This value set contains 3 concepts

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

CodeSystemDisplayDefinition
  in-networkhttp://terminology.hl7.org/CodeSystem/applicabilityIn Network

Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates

  out-of-networkhttp://terminology.hl7.org/CodeSystem/applicabilityOut of Network

Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates

  otherhttp://terminology.hl7.org/CodeSystem/applicabilityOther

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
System 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

DateActionCustodianAuthorComment
2020-10-14reviseVocabulary WGGrahame GrieveReset Version after migration to UTG
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.