CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
2.0.0 - STU 2 US

This page is part of the CARIN Blue Button Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

ValueSet: C4BB Payer Benefit Payment Status Value Set

Official URL: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus Version: 2.0.0
Active as of 2022-11-28 Computable Name: C4BBPayerBenefitPaymentStatus

Copyright/Legal: This Valueset is not copyrighted.

Indicates the in network or out of network payment status of the claim.

References

Logical Definition (CLD)

 

Expansion

This value set contains 3 concepts

Expansion based on C4BB Payer Adjudication Status Code System v2.0.0 (CodeSystem)

CodeSystemDisplayDefinition
  innetworkhttp://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBPayerAdjudicationStatusIn Network

Indicates an in network status in relation to a patient's coverage

  outofnetworkhttp://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBPayerAdjudicationStatusOut Of Network

Indicates a not in network status in relation to a patient's coverage

  otherhttp://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBPayerAdjudicationStatusOther

Indicates other network status or when a network does not apply

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
System 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