Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot
US
Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot
US
This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v2.0.0-ballot: STU 2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions
| Page standards status: Informative |
Resource Claim "PCT-GFE-Summary-1"
Profile: PCT Good Faith Estimate Summary
status: active
type: Estimate Summary (PCT Estimate Type Code System#estimate-summary)
use: predetermination
patient: Patient/patient1001 " BETTERHALF"
billablePeriod: 2021-10-31 --> 2021-10-31
created: 2021-10-05
insurer: Organization/org1001 "Umbrella Insurance Company"
provider: ??
priority: Normal (Process Priority Codes#normal)
| Sequence | Diagnosis[x] | Type | PackageCode |
| 1 | Unspecified focal traumatic brain injury (International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)#S06.30) | Principal Diagnosis (Example Diagnosis Type Codes#principal) | Head trauma - concussion (Example Diagnosis Related Group Codes#400) |
| Sequence | Focal | Coverage |
| 1 | true | Coverage/coverage1001 |
| Value | Currency |
| 200 | USD |
IG © 2023+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pct#2.0.0-ballot based on FHIR 4.0.1. Generated 2024-04-08
Links: Table of Contents |
QA Report
| Version History |
|
Propose a change