Da Vinci Payer Data Exchange
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This page is part of the Da Vinci Payer Data Exchange (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) 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

: PDex Payer Benefit Payment Status - XML Representation

Active as of 2024-01-06

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<ValueSet xmlns="http://hl7.org/fhir">
  <id value="PDexPayerBenefitPaymentStatus"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><ul><li>Include these codes as defined in <a href="CodeSystem-PDexPayerAdjudicationStatus.html"><code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus</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-PDexPayerAdjudicationStatus.html#PDexPayerAdjudicationStatus-innetwork">innetwork</a></td><td>In Network</td><td>Indicates the claim or claim line was paid in network.  This does not indicate the contracting status of the provider</td></tr><tr><td><a href="CodeSystem-PDexPayerAdjudicationStatus.html#PDexPayerAdjudicationStatus-outofnetwork">outofnetwork</a></td><td>Out Of Network</td><td>Indicates the claim or claim line was paid out of network.  This does not indicate the contracting status of the provider</td></tr><tr><td><a href="CodeSystem-PDexPayerAdjudicationStatus.html#PDexPayerAdjudicationStatus-other">other</a></td><td>Other</td><td>Indicates other network status or when a network does not apply</td></tr></table></li></ul></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <url
       value="http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexPayerBenefitPaymentStatus"/>
  <version value="2.0.0"/>
  <name value="PDexPayerBenefitPaymentStatus"/>
  <title value="PDex Payer Benefit Payment Status"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2024-01-06T03:07:01+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="fm@lists.HL7.org"/>
    </telecom>
  </contact>
  <contact>
    <name value="Mark Scrimshire (mark.scrimshire@onyxhealth.io)"/>
    <telecom>
      <system value="email"/>
      <value value="mailto:mark.scrimshire@onyxhealth.io"/>
    </telecom>
  </contact>
  <contact>
    <name value="HL7 International - Financial Management"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/fm"/>
    </telecom>
  </contact>
  <description
               value="Indicates the in network or out of network payment status of the claim."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <copyright value="This Valueset is not copyrighted."/>
  <compose>
    <include>
      <system
              value="http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus"/>
      <concept>
        <code value="innetwork"/>
        <display value="In Network"/>
      </concept>
      <concept>
        <code value="outofnetwork"/>
        <display value="Out Of Network"/>
      </concept>
      <concept>
        <code value="other"/>
        <display value="Other"/>
      </concept>
    </include>
  </compose>
</ValueSet>