Da Vinci Payer Data Exchange
2.1.0 - STU2 United States of America flag

Da Vinci Payer Data Exchange, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-epdx/ and changes regularly. See the Directory of published versions

ValueSet: PDex Payer Benefit Payment Status (Experimental)

Official URL: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexPayerBenefitPaymentStatus Version: 2.1.0
Active as of 2024-02-23 Computable Name: PDexPayerBenefitPaymentStatus

Copyright/Legal: This Valueset is not copyrighted.

Indicates the in network or out of network payment status of the claim.

References

Logical Definition (CLD)

 

Expansion

Expansion based on codesystem PDex Payer Adjudication Status v2.1.0 (CodeSystem)

This value set contains 3 concepts.

CodeSystemDisplayDefinition
  innetworkhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatusIn Network

Indicates the claim or claim line was paid in network. This does not indicate the contracting status of the provider

  outofnetworkhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatusOut Of Network

Indicates the claim or claim line was paid out of network. This does not indicate the contracting status of the provider

  otherhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatusOther

Indicates other network status or when a network does not apply


Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code