HL7 Terminology (THO)
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HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This guide is not an authorized publication; it is the continuous build for version 7.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions

ValueSet: ActInvoiceDetailGenericProviderCode

Official URL: http://terminology.hl7.org/ValueSet/v3-ActInvoiceDetailGenericProviderCode Version: 3.0.0
Responsible: Health Level Seven International Computable Name: ActInvoiceDetailGenericProviderCode
Other Identifiers: OID:2.16.840.1.113883.1.11.19408

Copyright/Legal: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html

The billable item codes to identify provider supplied charges or changes to the total billing of a claim.

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: en

This value set includes codes based on the following rules:

This value set excludes codes based on the following rules:

 

Expansion

Expansion performed internally based on codesystem ActCode v10.0.0 (CodeSystem)

This value set contains 13 concepts

SystemCodeDisplay (en)DefinitionJSONXML
http://terminology.hl7.org/CodeSystem/v3-ActCode  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-ActCode  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-ActCode  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-ActCode  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-ActCode  FNLFEEfinal fee

Anticipated or actual final fee associated with treating a patient.

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

Anticipated or actual initial fee associated with treating a patient.

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

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

http://terminology.hl7.org/CodeSystem/v3-ActCode  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-ActCode  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-ActCode  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-ActCode  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-ActCode  URGENTurgent

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


Description of the above table(s).


History

DateActionCustodianAuthorComment
2023-11-14reviseTSMGMarc DuteauAdd standard copyright and contact to internal content; up-476
2022-10-18reviseTSMGMarc DuteauFixing missing metadata; up-349
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26revise2014T1_2014-03-26_001283 (RIM release ID)Vocabulary (Woody Beeler) (no record of original request)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26