CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®)
1.1.0 - STU1 Update

This page is part of the CARIN Blue Button Implementation Guide (v1.1.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

ValueSet: C4BB Payer Benefit Payment Status

Summary

Defining URL:http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerBenefitPaymentStatus
Version:1.1.0
Name:C4BBPayerBenefitPaymentStatus
Title:C4BB Payer Benefit Payment Status
Status:Active as of 2021-07-02T17:53:32+00:00
Definition:

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

Publisher:HL7 Financial Management Working Group
Copyright:

This Valueset is not copyrighted.

Source Resource:XML / JSON / Turtle

References

Logical Definition (CLD)

 

Expansion

This value set contains 3 concepts

Expansion based on C4BB Payer Adjudication Status v1.1.0 (CodeSystem)

All codes from system http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBPayerAdjudicationStatus

CodeDisplayDefinition
innetworkIn NetworkIndicates the claim or claim line was paid in network. This does not indicate the contracting status of the provider
outofnetworkOut Of NetworkIndicates the claim or claim line was paid out of network. This does not indicate the contracting status of the provider
otherOtherIndicates 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
Source 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