HL7 Terminology
1.0.0 - Publication

This page is part of the HL7 Terminology (v1.0.0: Release) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Benefit cost applicability

Summary

Defining URL:http://terminology.hl7.org/CodeSystem/applicability
Version:4.2.0
Name:BenefitCostApplicability
Title:Benefit cost applicability
Status:draft
Content:All the concepts defined by the code system are included in the code system resource
Definition:

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

Publisher:HL7 (FHIR Project)
Committee:Patient Administration
OID:2.16.840.1.113883.4.642.1.0 (for OID based terminology systems)
Content Mode:Complete
Value Set:http://terminology.hl7.org/ValueSet/insuranceplan-applicability ( is the value set for all codes in this code system)
Maturity:0
Source Resource:XML / JSON / Turtle

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

Benefit cost applicability

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

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

DateActionAuthorCustodianComment
2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.