Patient Cost Transparency Implementation Guide
0.1.0 - ci-build

Patient Cost Transparency Implementation Guide, published by HL7 International - Financial Management Work Group. This is not an authorized publication; it is the continuous build for version 0.1.0). This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

Table of Contents

..0 Table of Contents
...1 Patient Cost Transparency Implementation Guide Home Page
...2 Use Cases and Overview
...3 Technical Background and Underlying Technologies
...4 Formal Specification
...5 Terminology Licensure
...6 Credits
...7 Artifacts Summary
....7.1 GFESubmitOperation
....7.2 PCT AEOB Bundle
....7.3 PCT Advanced EOB
....7.4 PCT Coverage
....7.5 PCT GFE Bundle
....7.6 PCT Good Faith Estimate Institutional
....7.7 PCT Good Faith Estimate Professional
....7.8 PCT Location
....7.9 PCT Organization
....7.10 PCT Patient
....7.11 PCT Practitioner
....7.12 PCT PractitionerRole
....7.13 CompoundDrugLinkingNumber
....7.14 CountrySubdivisionCode
....7.15 Disclaimer
....7.16 EstimatedDateOfService
....7.17 Expiration Date
....7.18 GFEBillingProviderLineItemCtrlNum
....7.19 GFEProviderAssignedIdentifier
....7.20 GFE Reference
....7.21 GFEServiceLinkingInfo
....7.22 GFESubmitter
....7.23 InterTransIdentifier
....7.24 Out Of Network Provider Info
....7.25 PCTEndpoint
....7.26 ProviderEventMethodology
....7.27 ProviderTaxonomy
....7.28 ReferralNumber
....7.29 Subject To Medical Management
....7.30 PCT Care Team Role Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.31 PCT Coverage Copay Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.32 PCT Diagnosis Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.33 PCT ICD-10 Diagnostic Codes
....7.34 PCT GFE CMS Place of Service Value Set
....7.35 PCT GFE Item Adjudication Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.36 PCT GFE Item CPT - HCPCS - HIPPS Value Set
....7.37 PCT GFE Item CPT - HCPCS Value Set
....7.38 PCT GFE Item NDC Value Set
....7.39 PCT GFE NUBC Revenue Value Set
....7.40 PCT GFE NUBC Uniform Billing (UB-04) Type of Bill Value Set
....7.41 PCT Organization Contact Purpose Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.42 PCT Organization Identifier Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.43 PCT Organization Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.44 PCT CMS HCPCS and AMA CPT Procedure Surgical Codes
....7.45 PCT Procedure Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.46 PCT Subject-To-Medical-Management Reason Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.47 PCT Supporting Info Type Value Set - locally defined for testing purpose; an external FHIR value set will be created through the HL7 Terminology (THO) process to replace this value set
....7.48 PCT Adjudication Category Type
....7.49 PCT Care Team Role
....7.50 PCT Coverage Copay Type Code System
....7.51 PCT Diagnosis Type
....7.52 PCT GFE Item Procedure Code System
....7.53 PCT GFE Item Revenue Code System
....7.54 PCT GFE Type Of Bill Code System
....7.55 PCT Organization Contact Purpose Type Code System
....7.56 PCT Organization Identifier Type Code System
....7.57 PCT Organization Type Code System
....7.58 PCT Procedure Surgical Code System
....7.59 PCT Procedure Type
....7.60 PCT Subject-To-Medical-Management Reason Code System
....7.61 PCT GFE Supporting Info Type Code System
....7.62 PCT-AEOB-1
....7.63 PCT-AEOB-Bundle-1
....7.64 PCT-GFE-Bundle-Inst-1
....7.65 PCT-GFE-Bundle-Prof-1
....7.66 PCT-GFE-Institutional-1
....7.67 PCT-GFE-Professional-1
....7.68 Provider-Org-Loc-2
....7.69 Submitter-Org-1
....7.70 Submitter-Practitioner-1
....7.71 contract1001
....7.72 coverage1001
....7.73 endpoint001
....7.74 org1001
....7.75 org1002
....7.76 patient1001
....7.77 prac001
....7.78 prac002
....7.79 pracRole002