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 2.1.1 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

• Narrative Content
• XML
• JSON
• TTL

: PDex Payer Benefit Payment Status - JSON Representation

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{
  "resourceType" : "ValueSet",
  "id" : "PDexPayerBenefitPaymentStatus",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet PDexPayerBenefitPaymentStatus</b></p><a name=\"PDexPayerBenefitPaymentStatus\"> </a><a name=\"hcPDexPayerBenefitPaymentStatus\"> </a><a name=\"PDexPayerBenefitPaymentStatus-en-US\"> </a><ul><li>Include these codes as defined in <a href=\"CodeSystem-PDexPayerAdjudicationStatus.html\"><code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-PDexPayerAdjudicationStatus.html#PDexPayerAdjudicationStatus-innetwork\">innetwork</a></td><td>In Network</td><td>Indicates the claim or claim line was paid in network.  This does not indicate the contracting status of the provider</td></tr><tr><td><a href=\"CodeSystem-PDexPayerAdjudicationStatus.html#PDexPayerAdjudicationStatus-outofnetwork\">outofnetwork</a></td><td>Out Of Network</td><td>Indicates the claim or claim line was paid out of network.  This does not indicate the contracting status of the provider</td></tr><tr><td><a href=\"CodeSystem-PDexPayerAdjudicationStatus.html#PDexPayerAdjudicationStatus-other\">other</a></td><td>Other</td><td>Indicates other network status or when a network does not apply</td></tr></table></li></ul></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "informative",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexPayerBenefitPaymentStatus",
  "version" : "2.1.1",
  "name" : "PDexPayerBenefitPaymentStatus",
  "title" : "PDex Payer Benefit Payment Status",
  "status" : "active",
  "experimental" : true,
  "date" : "2024-11-22T19:55:17+00:00",
  "publisher" : "HL7 International / Financial Management",
  "contact" : [
    {
      "name" : "HL7 International / Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        },
        {
          "system" : "email",
          "value" : "fm@lists.HL7.org"
        }
      ]
    },
    {
      "name" : "Mark Scrimshire (mark.scrimshire@onyxhealth.io)",
      "telecom" : [
        {
          "system" : "email",
          "value" : "mailto:mark.scrimshire@onyxhealth.io"
        }
      ]
    },
    {
      "name" : "HL7 International - Financial Management",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description" : "Indicates the in network or out of network payment status of the claim.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "copyright" : "This Valueset is not copyrighted.",
  "compose" : {
    "include" : [
      {
        "system" : "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus",
        "concept" : [
          {
            "code" : "innetwork",
            "display" : "In Network"
          },
          {
            "code" : "outofnetwork",
            "display" : "Out Of Network"
          },
          {
            "code" : "other",
            "display" : "Other"
          }
        ]
      }
    ]
  }
}