Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

Example ExplanationOfBenefit: PCT-AEOB-Summary-1

Page standards status: Informative

Generated Narrative: ExplanationOfBenefit PCT-AEOB-Summary-1

Service Description: Example service

In Network Provider Options Link: http://example.com/out-of-network.html

status: Active

type: Estimate Summary

use: Predetermination

patient: Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)

billablePeriod: 2022-01-01 --> 2022-01-01

created: 2021-10-12

insurer: Organization Umbrella Insurance Company

provider: ??

outcome: Processing Complete

Insurances

-FocalCoverage
*trueCoverage: extension = insurance,false; status = active; subscriberId = PFP123450000; relationship = Self; period = 2021-01-01 --> 2022-01-01

total

category: Submitted Amount

Amounts

-ValueCurrency
*200United States dollar

ProcessNotes

-ExtensionText
*processNote disclaimer text

benefitPeriod: 2022-01-01 --> 2022-01-01

benefitBalance

category: Medical Care

unit: Individual

term: Annual

Financials

-ExtensionTypeAllowed[x]Used[x]
*Allowed$1.00 (USD)$1.00 (USD)