HL7 Czech Terminology Implementation Guide
0.3.0 - release Czechia flag

HL7 Czech Terminology Implementation Guide, published by HL7 Czech Republic. This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7-cz/terminology/ and changes regularly. See the Directory of published versions

ValueSet: Číselník typů úhrady

Official URL: https://ncez.mzcr.cz/terminology/ValueSet/cz-coverage-type Version: 0.3.0
Computable Name: CZ_CoverageType

Číselník typů úhrady zdravotní péče.

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)

Language: cs

This ValueSet requires the Code system Supplements Coverage SelfPay Codes (CZ supplement) and ActCode (CZ supplement).

This value set includes codes based on the following rules:

  • Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode version 📍10.0.0
    CodeDisplayDefinition
    HIPzdravotní pojištění**Definition:** A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.

    *Discussion:* Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.
  • Include these codes as defined in http://terminology.hl7.org/CodeSystem/coverage-selfpay version 📍1.0.1
    CodeDisplayDefinition
    pay samoplátce An individual or organization is paying directly for goods and services.

 

Expansion

This value set contains 2 concepts

SystemCodeDisplay (cs)DefinitionJSONXML
http://terminology.hl7.org/CodeSystem/v3-ActCode  HIPDefinition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.

Definition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.

Discussion: Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.

http://terminology.hl7.org/CodeSystem/coverage-selfpay  payPayAn individual or organization is paying directly for goods and services.

Description of the above table(s).