Extensions for Using Data Elements from FHIR R5 in FHIR R4
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Extensions for Using Data Elements from FHIR R5 in FHIR R4 - Downloaded Version null See the Directory of published versions

ValueSet: R5V3ActInvoiceDetailGenericProviderCodeForR4

Official URL: http://hl7.org/fhir/uv/xver/ValueSet/R5-v3-ActInvoiceDetailGenericProviderCode-for-R4 Version: 0.1.0
Standards status: Trial-use Maturity Level: 0 Computable Name: R5V3ActInvoiceDetailGenericProviderCodeForR4

This cross-version ValueSet represents content from http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericProviderCode|2.0.0 for use in FHIR R4.

This value set is part of the cross-version definitions generated to enable use of the value set http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericProviderCode|2.0.0 as defined in FHIR R5 in FHIR R4.

The source value set is bound to the following FHIR R5 elements:

Note that all concepts are included in this cross-version definition because no concepts have compatible representations

Following are the generation technical comments:

FHIR ValueSet http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericProviderCode|2.0.0, defined in FHIR R5 does not have any mapping to FHIR R4

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

  • Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode version 📍8.0.0
    CodeDisplayDefinition
    CANCAPTcancelled appointmentA charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient.
    DSCdiscountA reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.
    ESAextraordinary service assessmentA premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.
    FFSTOPfee for service top offUnder agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount.
    FNLFEEfinal feeAnticipated or actual final fee associated with treating a patient.
    FRSTFEEfirst feeAnticipated or actual initial fee associated with treating a patient.
    MARKUPmarkup or up-chargeAn increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.
    MISSAPTmissed appointmentA charge to compensate the provider when a patient does not show for an appointment.
    PERFEEperiodic feeAnticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element.
    PERMBNSperformance bonusThe amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed.
    RESTOCKrestocking feeA charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use.
    TRAVELtravelA charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement.
    URGENTurgentPremium paid on service fees in compensation for providing an expedited response to an urgent situation.

 

Expansion

This value set expansion contains 13 concepts.

SystemVersionCodeDisplayDefinitionJSONXML
http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  CANCAPTcancelled appointment

A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  DSCdiscount

A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  ESAextraordinary service assessment

A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  FFSTOPfee for service top off

Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  FNLFEEfinal fee

Anticipated or actual final fee associated with treating a patient.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  FRSTFEEfirst fee

Anticipated or actual initial fee associated with treating a patient.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  MARKUPmarkup or up-charge

An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  MISSAPTmissed appointment

A charge to compensate the provider when a patient does not show for an appointment.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PERFEEperiodic fee

Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PERMBNSperformance bonus

The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  RESTOCKrestocking fee

A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  TRAVELtravel

A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  URGENTurgent

Premium paid on service fees in compensation for providing an expedited response to an urgent situation.


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