HL7 Terminology (THO)
5.5.0 - Publication
This page is part of the HL7 Terminology (v5.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Draft as of 2018-06-05 | Maturity Level: 0 |
<CodeSystem xmlns="http://hl7.org/fhir">
<id value="applicability"/>
<meta>
<lastUpdated value="2020-04-09T21:10:28.568+00:00"/>
<profile
value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p>This case-sensitive code system <code>http://terminology.hl7.org/CodeSystem/applicability</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">in-network<a name="applicability-in-network"> </a></td><td>In Network</td><td>Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates</td></tr><tr><td style="white-space:nowrap">out-of-network<a name="applicability-out-of-network"> </a></td><td>Out of Network</td><td>Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates</td></tr><tr><td style="white-space:nowrap">other<a name="applicability-other"> </a></td><td>Other</td><td>Other applicability</td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="pa"/>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
<valueInteger value="0"/>
</extension>
<url value="http://terminology.hl7.org/CodeSystem/applicability"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.1.0"/>
</identifier>
<version value="1.0.0"/>
<name value="BenefitCostApplicability"/>
<title value="Benefit cost applicability"/>
<status value="draft"/>
<experimental value="false"/>
<date value="2018-06-05T14:06:02+00:00"/>
<publisher value="Health Level Seven International"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://hl7.org"/>
</telecom>
<telecom>
<system value="email"/>
<value value="hq@HL7.org"/>
</telecom>
</contact>
<description
value="Whether the cost applies to in-network or out-of-network providers."/>
<copyright
value="This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license"/>
<caseSensitive value="true"/>
<valueSet
value="http://terminology.hl7.org/ValueSet/insuranceplan-applicability"/>
<content value="complete"/>
<concept>
<code value="in-network"/>
<display value="In Network"/>
<definition
value="Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates"/>
</concept>
<concept>
<code value="out-of-network"/>
<display value="Out of Network"/>
<definition
value="Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates"/>
</concept>
<concept>
<code value="other"/>
<display value="Other"/>
<definition value="Other applicability"/>
</concept>
</CodeSystem>