| Patient Administration Work Group | Maturity Level: N/A | Standards Status: Informative |
Raw JSON (canonical form + also see JSON Format Specification)
Definition for Code SystemBenefitCostApplicability
{
"resourceType" : "CodeSystem",
"id" : "insuranceplan-applicability",
"meta" : {
"lastUpdated" : "2022-05-28T12:47:40.239+10:00",
"profile" : ["http://hl7.org/fhir/StructureDefinition/shareablecodesystem"]
},
"text" : {
"status" : "generated",
"div" : "<div>!-- Snipped for Brevity --></div>"
},
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "pa"
}],
"url" : "http://hl7.org/fhir/insuranceplan-applicability",
"identifier" : [{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.1.0"
}],
"version" : "4.3.0",
"name" : "BenefitCostApplicability",
"status" : "draft",
"experimental" : false,
"date" : "2018-06-05T14:06:02+00:00",
"publisher" : "HL7 (FHIR Project)",
"contact" : [{
"telecom" : [{
"system" : "url",
"value" : "http://hl7.org/fhir"
},
{
"system" : "email",
"value" : "[email protected]"
}]
}],
"description" : "Whether the cost applies to in-network or out-of-network providers.",
"caseSensitive" : true,
"valueSet" : "http://hl7.org/fhir/ValueSet/applicability",
"content" : "complete",
"concept" : [{
"code" : "in-network",
"display" : "In Network",
"definition" : "Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates"
},
{
"code" : "out-of-network",
"display" : "Out of Network",
"definition" : "Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates"
},
{
"code" : "other",
"display" : "Other",
"definition" : "Other applicability"
}]
}
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.