HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v6.0.0: Release) based on FHIR (HL7® FHIR® Standard) v5.0.0. 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

ValueSet: ActBillingArrangementCode

Official URL: http://terminology.hl7.org/ValueSet/v3-ActBillingArrangementCode Version: 3.0.0
Active as of 2014-03-26 Responsible: Health Level Seven International Computable Name: ActBillingArrangementCode
Other Identifiers: OID:2.16.840.1.113883.1.11.17478

Copyright/Legal: 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.html

The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period.

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)

Generated Narrative: ValueSet v3-ActBillingArrangementCode

Language: en

This value set includes codes based on the following rules:

This value set excludes codes based on the following rules:

 

Expansion

Generated Narrative: ValueSet

Language: en

Expansion based on codesystem ActCode v9.0.0 (CodeSystem)

This value set contains 10 concepts

CodeSystemDisplayInactiveDefinition
  BLKhttp://terminology.hl7.org/CodeSystem/v3-ActCodeblock funding

A billing arrangement where a Provider charges a lump sum to provide a prescribed group (volume) of services to a single patient which occur over a period of time. Services included in the block may vary.

This billing arrangement is also known as Program of Care for some specific Payors and Program Fees for other Payors.

  CAPhttp://terminology.hl7.org/CodeSystem/v3-ActCodecapitation funding

A billing arrangement where the payment made to a Provider is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the Provider (in their practice).

  CONTFhttp://terminology.hl7.org/CodeSystem/v3-ActCodecontract funding

A billing arrangement where a Provider charges a lump sum to provide a particular volume of one or more interventions/procedures or groups of interventions/procedures.

  FINBILLhttp://terminology.hl7.org/CodeSystem/v3-ActCodefinancial

A billing arrangement where a Provider charges for non-clinical items. This includes interest in arrears, mileage, etc. Clinical content is not included in Invoices submitted with this type of billing arrangement.

  ROSThttp://terminology.hl7.org/CodeSystem/v3-ActCoderoster funding

A billing arrangement where funding is based on a list of individuals registered as patients of the Provider.

  SESShttp://terminology.hl7.org/CodeSystem/v3-ActCodesessional funding

A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/procedures to one or more patients within a defined period of time, typically on the same date. Interventions/procedures included in the session may vary.

  FFShttp://terminology.hl7.org/CodeSystem/v3-ActCodefee for serviceinactive

A billing arrangement where a Provider charges a separate fee for each intervention/procedure/event or product.

Fee for Service is used when an individual intervention/procedure/event is used for billing purposes. In other words, fees are associated with the intervention/procedure/event. For example, a specific CCI (Canadian Classification of Interventions) code has an associated fee and is used for billing purposes.

  FFPShttp://terminology.hl7.org/CodeSystem/v3-ActCodefirst fill, part fill, partial strength

A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets)

  FFCShttp://terminology.hl7.org/CodeSystem/v3-ActCodefirst fill complete, partial strength

A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

  TFShttp://terminology.hl7.org/CodeSystem/v3-ActCodetrial fill partial strength

A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).


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
2023-11-14reviseTSMGMarc DuteauAdd standard copyright and contact to internal content; up-476
2022-10-18reviseTSMGMarc DuteauFixing missing metadata; up-349
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26revise2014T1_2014-03-26_001283 (RIM release ID)Vocabulary (Woody Beeler) (no record of original request)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26