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/ValueSet/insuranceplan-applicability
Version:4.1.0
Name:BenefitCostApplicability
Status:draft
Title:Benefit cost applicability
Definition:

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

Publisher:HL7 (FHIR Project)
Committee:Patient Administration
OID:2.16.840.1.113883.4.642.3.0 (for OID based terminology systems)
Maturity:0
Source Resource:XML / JSON / Turtle

References

This value set is not used

Content Logical Definition

Logical Definition (CLD)

 

Expansion

This value set contains 3 concepts

Expansion based on Benefit cost applicability v4.2.0 (CodeSystem)

All codes from system http://terminology.hl7.org/CodeSystem/applicability

CodeDisplayDefinition
in-networkIn NetworkProvider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
out-of-networkOut of NetworkProvider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
otherOtherOther 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
Source 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

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