National Directory of Healthcare Providers & Services (NDH) Implementation Guide
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National Directory of Healthcare Providers & Services (NDH) Implementation Guide, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-ndh/ and changes regularly. See the Directory of published versions

CodeSystem: Insurance Product Type Code System

Official URL: http://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCS Version: 1.0.0-ballot
Active as of 2024-06-17 Computable Name: InsuranceProductTypeCS

A distinct package of health insurance coverage benefits that are offered using a particular product network type.

This Code system is referenced in the content logical definition of the following value sets:

This case-sensitive code system http://hl7.org/fhir/us/ndh/CodeSystem/InsuranceProductTypeCS defines the following codes:

CodeDisplayDefinition
commppo Commercial PPO Health insurance provided through a Preferred Provider Organization (PPO).
commhdhp Commercial HDHP Health insurance provided through a High Deductible Health Plan (HDHP).
commpos Commercial POS Health insurance provided through a Point-of-Service (POS) Plan.
commhmo Commercial HMO Health insurance provided through a Health Maintenance Organization (HMO).
commepo Commercial EPO Health insurance provided through a Exclusive Provider Organization(EPO).
medi Medicaid Health insurance provided to eligible adults and children under the Federal Medicaid program
medihmo Medicaid HMO Health insurance provided to eligible adults and children under the Federal Medicaid program through a Health Maintenance Organization (HMO).
mediadv Medicare Advantage Health insurance provided by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits.
mediadvhmo Medicare Advantage HMO Health insurance offered by a private company that contracts with Medicare to provide all Medicare Part A and Part B benefits through a Health Maintenance Organization (HMO).
media Medicare Part A Health insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
medib Medicare Part B Health insurance provided under the Federal Medicfare program covering certain doctors' services, outpatient care, medical supplies, and preventive services.
medid Medicare Part D Health insurance provided under the Federal Medicare program covering prescription drugs.
mediab Medicare A/B Health insurance provided under the Federal Medicare program covering inpatient hospital stays, care in a skilled nursing facility, hospice care, some home health care, certain doctors' services, outpatient care, medical supplies, and preventive services.
qhp Qualified Health Plan Health insurance provided through and certified by the Health Insurance Marketplace that provides essential health benefits (EHBs), follows established limits on cost sharing, and meets other requirements outlined within the application process.
ihs Indian Health Service Health care program provided to United States American Indians and Alaska Natives.
fep Federal Employee Program Health insurance provided to employees of the Federal government.
tri TRICARE Health care program provided to uniformed service members, retirees, and their families around the world.
va Veterans Affairs Plan Health care program provided to eligible veterans.
dent Dental Plan Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity.
denthmo Dental HMO Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the oral cavity provided through a Health Maintenance Organization (HMO).
vis Vision Plan Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes.
vishmo Vision HMO Health insurance provided to cover services related to the study, diagnosis, prevention, and treatment of diseases, disorders, and conditions of the eyes provided through a Health Maintenance Organization (HMO).