Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

4.4.1.477 ValueSet http://hl7.org/fhir/ValueSet/insuranceplan-applicability

Patient Administration icon Work Group Maturity Level: 0Trial Use Use Context: Not yet ready for Production use, Not yet ready for Production use

This is a value set defined by the FHIR project.

Summary

Defining URL:http://hl7.org/fhir/ValueSet/insuranceplan-applicability
Version:5.0.0-ballot
Name:BenefitCostApplicability
Title:
Status:draft
Definition:

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

Committee:Patient Administration icon Work Group
OID:2.16.840.1.113883.4.642.3.0 (for OID based terminology systems)
Flags:Experimental, Immutable

This value set is used in the following places:

4.4.1.477.1 Content Logical Definition

 

4.4.1.477.2 Expansion

This expansion generated 10 Sep 2022

This value set contains 3 concepts

Expansion based on Benefit cost applicability v0.1.0 (CodeSystem) icon

CodeSystemDisplayDefinition
  in-network iconhttp://terminology.hl7.org/CodeSystem/applicabilityIn Network

Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates

  out-of-network iconhttp://terminology.hl7.org/CodeSystem/applicabilityOut of Network

Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates

  other iconhttp://terminology.hl7.org/CodeSystem/applicabilityOther

Other applicability

 

See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page:

LvlA few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information
SourceThe source of the definition of the code (when the value set draws in codes defined elsewhere)
CodeThe code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')
DisplayThe 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
DefinitionAn explanation of the meaning of the concept
CommentsAdditional notes about how to use the code