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. For a full list of available versions, see the Directory of published versions
Official URL: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexPayerBenefitPaymentStatus | Version: 2.0.0 | |||
Active as of 2024-01-06 | Computable Name: PDexPayerBenefitPaymentStatus | |||
Copyright/Legal: This Valueset is not copyrighted. |
Indicates the in network or out of network payment status of the claim.
References
http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus
Code | Display | Definition |
innetwork | In Network | Indicates the claim or claim line was paid in network. This does not indicate the contracting status of the provider |
outofnetwork | Out Of Network | Indicates the claim or claim line was paid out of network. This does not indicate the contracting status of the provider |
other | Other | Indicates other network status or when a network does not apply |
Expansion based on codesystem PDex Payer Adjudication Status v2.0.0 (CodeSystem)
This value set contains 3 concepts
Code | System | Display | Definition |
innetwork | http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus | In Network | Indicates the claim or claim line was paid in network. This does not indicate the contracting status of the provider |
outofnetwork | http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus | Out Of Network | Indicates the claim or claim line was paid out of network. This does not indicate the contracting status of the provider |
other | http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus | Other | 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 |