Package | hl7.fhir.us.davinci-pct |
Type | CodeSystem |
Id | PCTFinancialType |
FHIR Version | R4 |
Source | http://hl7.org/fhir/us/davinci-pct/https://build.fhir.org/ig/HL7/davinci-pct/CodeSystem-PCTFinancialType.html |
URL | http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTFinancialType |
Version | 2.0.0-draft |
Status | active |
Date | 2025-06-03T13:32:08+00:00 |
Name | PCTFinancialType |
Title | PCT Financial Type Code System |
Realm | us |
Authority | hl7 |
Description | Financial Type codes for benefitBalance.financial.type. This CodeSystem is currently defined by this IG, but is anticipated to be temporary. The concepts within are expected to be moved in a future version to a more central terminology specification such as THO, which will result in a code system url change and possibly modified codes and definitions. |
Copyright | This CodeSystem is not copyrighted. |
Content | complete |
ValueSet | |
PCTFinancialTypeVS | PCT Financial Type Value Set |
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: CodeSystem PCTFinancialType
This case-sensitive code system http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTFinancialType
defines the following codes:
{ "resourceType": "CodeSystem", "id": "PCTFinancialType", "text": { "status": "generated", "div": "<!-- snip (see above) -->" }, "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg", "valueCode": "fm" }, { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status", "valueCode": "trial-use", "_valueCode": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom", "valueCanonical": "http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct" } ] } } ], "url": "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTFinancialType", "identifier": [ { "system": "urn:ietf:rfc:3986", "value": "urn:oid:2.16.840.1.113883.4.642.40.4.16.8" } ], "version": "2.0.0-draft", "name": "PCTFinancialType", "title": "PCT Financial Type Code System", "status": "active", "experimental": false, "date": "2025-06-03T13:32:08+00:00", "publisher": "HL7 International / Financial Management", "contact": [ { "name": "HL7 International / Financial Management", "telecom": [ { "system": "url", "value": "http://www.hl7.org/Special/committees/fm" }, { "system": "email", "value": "fmlists@lists.hl7.org" } ] } ], "description": "Financial Type codes for benefitBalance.financial.type. This CodeSystem is currently defined by this IG, but is anticipated to be temporary. The concepts within are expected to be moved in a future version to a more central terminology specification such as THO, which will result in a code system url change and possibly modified codes and definitions.", "jurisdiction": [ { "coding": [ { "system": "urn:iso:std:iso:3166", "code": "US" } ] } ], "copyright": "This CodeSystem is not copyrighted.", "caseSensitive": true, "content": "complete", "count": 10, "concept": [ { "code": "allowed", "display": "Allowed", "definition": "The maximum amount a plan will pay for a covered health care service. May also be called \"payment allowance\", or \"negotiated rate\"." }, { "code": "coinsurance", "display": "Co-Insurance", "definition": "The amount the insured individual pays, as a set percentage of the cost of covered services, as an out-of-pocket payment to the provider. Example: Insured pays 20% and the insurer pays 80%." }, { "code": "copay", "display": "CoPay", "definition": "A fixed amount ($20, for example) the insured individual pays for a covered health care service after the deductible is paid." }, { "code": "deductible", "display": "Deductible", "definition": "The amount the insured individual pays for covered health care services before the insurance plan starts to pay." }, { "code": "eligible", "display": "Eligible Amount", "definition": "Amount of the charge which is considered for adjudication." }, { "code": "memberliability", "display": "Member Liability", "definition": "The amount of the member's liability." }, { "code": "noncovered", "display": "Noncovered", "definition": "The portion of the cost of the service that was deemed not eligible by the insurer because the service or member was not covered by the subscriber contract." }, { "code": "out-of-pocket-maximum", "display": "Out-of-Pocket Maximum", "definition": "The most the insured individual has to pay for covered services in a plan year. After this amount is spent on deductibles, copayments, and coinsurance for in-network care and services, the health plan pays 100% of the costs of covered benefits." }, { "code": "visit", "display": "Visit", "definition": "A medical visit means diagnostic, therapeutic, or consultative services provided to a client by a healthcare professional in an outpatient setting." }, { "code": "penalty", "display": "Penalty", "definition": "Benefit penalty is an approach used by the insurance company to reduce their payment on a claim when the patient or medical provider does not satisfy the rules of the health plan. Benefit penalties may occur when a pre-authorization is not obtained, for example." } ] }