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Packagehl7.fhir.uv.xver-r4b.r5
Resource TypeCodeSystem
IdCodeSystem-insuranceplan-applicability.json
FHIR VersionR5
Sourcehttp://hl7.org/fhir/uv/xver-r4b.r5/0.0.1-snapshot-2/CodeSystem-insuranceplan-applicability.html
URLhttp://hl7.org/fhir/insuranceplan-applicability
Version4.3.0
Statusdraft
Date2018-06-06T00:06:02+10:00
NameBenefitCostApplicability
Realmuv
Authorityhl7
DescriptionWhether the cost applies to in-network or out-of-network providers.
Contentcomplete

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Narrative

Note: links and images are rebased to the (stated) source

This code system http://hl7.org/fhir/insuranceplan-applicability defines the following codes:

Code Display Definition
in-network In Network Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
out-of-network Out of Network Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
other Other Other applicability

Source1

{
  "resourceType": "CodeSystem",
  "id": "insuranceplan-applicability",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "extension": [
        {
          "url": "packageId",
          "valueId": "hl7.fhir.uv.xver-r4b.r5"
        },
        {
          "url": "version",
          "valueString": "0.0.1-snapshot-2"
        }
      ],
      "url": "http://hl7.org/fhir/StructureDefinition/package-source"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "pa"
    }
  ],
  "url": "http://hl7.org/fhir/insuranceplan-applicability",
  "version": "4.3.0",
  "name": "BenefitCostApplicability",
  "status": "draft",
  "experimental": false,
  "date": "2018-06-06T00:06:02+10:00",
  "publisher": "Patient Administration",
  "contact": [
    {
      "name": "Patient Administration",
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/pafm"
        }
      ]
    }
  ],
  "description": "Whether the cost applies to in-network or out-of-network providers.",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code": "001",
          "display": "World"
        }
      ]
    }
  ],
  "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"
    }
  ]
}