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

: PCT Payer Benefit Payment Status - XML Representation

Page standards status: Trial-use

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="PCTPayerBenefitPaymentStatusVS"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This value set includes codes based on the following rules:</p><ul><li>Include these codes as defined in <a href="CodeSystem-PCTNetworkStatusCS.html"><code>http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href="CodeSystem-PCTNetworkStatusCS.html#PCTNetworkStatusCS-innetwork">innetwork</a></td><td style="color: #cccccc">In Network</td><td>Indicates an in network status in relation to a patient's coverage</td></tr><tr><td><a href="CodeSystem-PCTNetworkStatusCS.html#PCTNetworkStatusCS-outofnetwork">outofnetwork</a></td><td style="color: #cccccc">Out Of Network</td><td>Indicates a not in network status in relation to a patient's coverage</td></tr><tr><td><a href="CodeSystem-PCTNetworkStatusCS.html#PCTNetworkStatusCS-other">other</a></td><td style="color: #cccccc">Other</td><td>Indicates other network status or when a network does not apply</td></tr></table></li><li>Include all codes defined in <a href="CodeSystem-PCTNetworkStatusCS.html"><code>http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS</code></a></li></ul></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/davinci-pct/ImplementationGuide/hl7.fhir.us.davinci-pct"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTPayerBenefitPaymentStatusVS"/>
  <version value="1.1.0"/>
  <name value="PCTPayerBenefitPaymentStatusVS"/>
  <title value="PCT Payer Benefit Payment Status"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2024-01-03T18:32:02+00:00"/>
  <publisher value="HL7 International / Financial Management"/>
  <contact>
    <name value="HL7 International / Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="fmlists@lists.hl7.org"/>
    </telecom>
  </contact>
  <description
               value="Indicates the in network or out of network payment status of the claim or line item."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <compose>
    <include>
      <system
              value="http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS"/>
      <concept>
        <code value="innetwork"/>
      </concept>
      <concept>
        <code value="outofnetwork"/>
      </concept>
      <concept>
        <code value="other"/>
      </concept>
    </include>
    <include>
      <system
              value="http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS"/>
    </include>
  </compose>
</ValueSet>