Patient Cost Transparency Implementation Guide
2.0.2 - STU 2 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 2.0.2 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

ValueSet: PCT Payer Benefit Payment Status

Official URL: http://hl7.org/fhir/us/davinci-pct/ValueSet/PCTPayerBenefitPaymentStatusVS Version: 2.0.2
Standards status: Trial-use Maturity Level: 2 Computable Name: PCTPayerBenefitPaymentStatusVS
Other Identifiers: OID:2.16.840.1.113883.4.642.40.4.48.28

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

References

Changes since version 1.1.0:

  • The logical definition of the value set has changed

    • Logical Definition (CLD)

    This value set includes codes based on the following rules:

     

    Expansion

    Expansion performed internally based on codesystem PCT Network Status v2.0.2 (CodeSystem)

    This value set contains 4 concepts

    SystemCodeDisplay (en)DefinitionJSONXML
    http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS  innetworkIn NetworkIndicates an in network status in relation to a patient's coverage
    http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS  outofnetworkOut Of NetworkIndicates a not in network status in relation to a patient's coverage
    http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS  negotiatedNegotiated Service or ProductIndicates a special negotiated status in relation to a patient's coverage
    http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTNetworkStatusCS  otherOtherIndicates other network status or when a network does not apply

    Description of the above table(s).