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

This page is part of the Da Vinci Patient Cost Transparency Implementation Guide (v1.1.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Extension: GFEConsentForBalanceBilling

Official URL: http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling Version: 1.1.0
Standards status: Trial-use Computable Name: GFEConsentForBalanceBilling

If the provider has received a written consent form indicating a patient has agreed to waive their protections and pay up to the full cost for the out-of-network item or service, this will be “true”. If the provider has not received written consent, this will be “false”. This is an attestation only. The billing provider is legally required to maintain the written notice and consent form.

Context of Use

This extension may be used on the following element(s):

  • Element ID Claim.provider

Usage info

Usage:

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

Summary

Simple Extension of type boolean: If the provider has received a written consent form indicating a patient has agreed to waive their protections and pay up to the full cost for the out-of-network item or service, this will be “true”. If the provider has not received written consent, this will be “false”. This is an attestation only. The billing provider is legally required to maintain the written notice and consent form.

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..*ExtensionExtension
... extension 0..0
... url 1..1uri"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling"
... value[x] 1..1booleanValue of extension

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..*ExtensionExtension
... id 0..1stringUnique id for inter-element referencing
... extension 0..0
... url 1..1uri"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling"

doco Documentation for this format

This structure is derived from Extension

Summary

Simple Extension of type boolean: If the provider has received a written consent form indicating a patient has agreed to waive their protections and pay up to the full cost for the out-of-network item or service, this will be “true”. If the provider has not received written consent, this will be “false”. This is an attestation only. The billing provider is legally required to maintain the written notice and consent form.

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..*ExtensionExtension
... extension 0..0
... url 1..1uri"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling"
... value[x] 1..1booleanValue of extension

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Extension 0..*ExtensionExtension
... id 0..1stringUnique id for inter-element referencing
... extension 0..0
... url 1..1uri"http://hl7.org/fhir/us/davinci-pct/StructureDefinition/gfeConsentForBalanceBilling"

doco Documentation for this format

 

Other representations of profile: CSV, Excel, Schematron