HL7 Terminology (THO)
3.1.0 - Publication International flag

This page is part of the HL7 Terminology (v3.1.0: Release) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

CodeSystem: Benefit cost applicability

Official URL: http://terminology.hl7.org/CodeSystem/applicability Version: 0.1.0
Standards status: Trial-use Maturity Level: 0 Responsible: HL7 (FHIR Project) Computable Name: BenefitCostApplicability
Other Identifiers: : urn:oid:2.16.840.1.113883.4.642.1.0

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

This Code system is referenced in the content logical definition of the following value sets:

This code system http://terminology.hl7.org/CodeSystem/applicability defines the following codes:

CodeDisplayDefinition
in-network In NetworkProvider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
out-of-network Out of NetworkProvider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
other OtherOther applicability

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.