Patient Cost Transparency Implementation Guide
1.0.0 - STU 1 United States of America flag

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v1.0.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

ValueSet: PCT Payer Benefit Payment Status

Official URL: http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTPayerBenefitPaymentStatusVS Version: 1.0.0
Active as of 2023-03-30 Computable Name: PCTPayerBenefitPaymentStatusVS

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

References

Logical Definition (CLD)

This value set includes codes based on the following rules:

 

Expansion

This value set contains 3 concepts

Expansion based on PCT Network Status v1.0.0 (CodeSystem)

CodeSystemDisplayDefinition
  innetworkhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCSIn Network

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

  outofnetworkhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCSOut Of Network

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

  otherhttp://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCSOther

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