Da Vinci Payer Data Exchange
2.1.0 - STU2 Ballot 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

: PDex Payer Benefit Payment Status - TTL Representation

Page standards status: Informative

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ValueSet ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "PDexPayerBenefitPaymentStatus"] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir: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>"
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
fhir:value [ fhir:v "fm" ]
  ] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ;
fhir:value [
fhir:v "informative" ;
      ( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
fhir:v "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex>         ]       ] )     ]
  ] ) ; # 
  fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexPayerBenefitPaymentStatus"^^xsd:anyURI] ; # 
  fhir:version [ fhir:v "2.1.0"] ; # 
  fhir:name [ fhir:v "PDexPayerBenefitPaymentStatus"] ; # 
  fhir:title [ fhir:v "PDex Payer Benefit Payment Status"] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:experimental [ fhir:v "true"^^xsd:boolean] ; # 
  fhir:date [ fhir:v "2024-12-26T22:55:41+00:00"^^xsd:dateTime] ; # 
  fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; # 
  fhir:contact ( [
fhir:name [ fhir:v "HL7 International / Financial Management" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ]     ] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "fm@lists.HL7.org" ]     ] )
  ] [
fhir:name [ fhir:v "Mark Scrimshire (mark.scrimshire@onyxhealth.io)" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "mailto:mark.scrimshire@onyxhealth.io" ]     ] )
  ] [
fhir:name [ fhir:v "HL7 International - Financial Management" ] ;
    ( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ]     ] )
  ] ) ; # 
  fhir:description [ fhir:v "Indicates the in network or out of network payment status of the claim."] ; # 
  fhir:jurisdiction ( [
    ( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US" ] ;
fhir:display [ fhir:v "United States of America" ]     ] )
  ] ) ; # 
  fhir:copyright [ fhir:v "This Valueset is not copyrighted."] ; # 
  fhir:compose [
    ( fhir:include [
fhir:system [ fhir:v "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatus"^^xsd:anyURI ] ;
      ( fhir:concept [
fhir:code [ fhir:v "innetwork" ] ;
fhir:display [ fhir:v "In Network" ]       ] [
fhir:code [ fhir:v "outofnetwork" ] ;
fhir:display [ fhir:v "Out Of Network" ]       ] [
fhir:code [ fhir:v "other" ] ;
fhir:display [ fhir:v "Other" ]       ] )     ] )
  ] . #