Patient Cost Transparency Implementation Guide
2.0.0-draft - STU 2 - Draft United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0-draft built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

CodeSystem: PCT Document Types

Official URL: http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse Version: 2.0.0-draft
Standards status: Trial-use Computable Name: PCTDocumentTypeTemporaryTrialUse
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.16.23

Copyright/Legal: This CodeSystem is not copyrighted.

Defining codes for types of documents used for Patient Cost Transparency estimates. This CodeSystem is currently defined by this IG, but is anticipated to be temporary. The concepts within are expected to be moved in a future version to a more central terminology specification such as LOINC, which will result in a code system url change and possibly modified codes and definitions.

This Code system is referenced in the content logical definition of the following value sets:

  • This CodeSystem is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Changes since version 1.1.0:

  • New Content

    • Generated Narrative: CodeSystem PCTDocumentTypeTemporaryTrialUse

    This case-sensitive code system http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTDocumentTypeTemporaryTrialUse defines the following codes:

    CodeDisplayDefinition
    gfe-document GFE Document A Good Faith Estimate (GFE) Document providing a notification of reasonably expected charges and billing codes for a scheduled or requested item or service. This document may contain one or more individual GFE (Claim) resources.
    aeob-document AEOB Document An Advanced Explanation of Benefit (AEOB) Document providing a notification of reasonably expected charges and billing codes provided by a payer according to the member benefits in relation a Good Faith Estimate (GFE) supplied by one or more providers for a given period of service. AEOBs need to include which providers are expected to provide treatment, the network status of providers, good faith estimates of cost, cost-sharing and progress towards meeting deductibles and out-of-pocket maximums, as well as whether a service is subject to medical management and relevant disclaimers of estimates; for example, the disclaimer might state that the information provided in the notification is only an estimate based on the items and services reasonably expected, at the time of scheduling (or requesting) and is subject to change.