Belgian MyCareNet eTariff Profiles
1.0.0 - STU Belgium flag

Belgian MyCareNet eTariff Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/etariff/ and changes regularly. See the Directory of published versions

: refusal values - JSON Representation

Draft as of 2024-10-02

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{
  "resourceType" : "CodeSystem",
  "id" : "be-cs-refusal-values",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem be-cs-refusal-values</b></p><a name=\"be-cs-refusal-values\"> </a><a name=\"hcbe-cs-refusal-values\"> </a><a name=\"be-cs-refusal-values-en-US\"> </a><p>This case-sensitive code system <code>https://www.ehealth.fgov.be/standards/fhir/etariff/CodeSystem/be-cs-refusal-values</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td style=\"white-space:nowrap\">001<a name=\"be-cs-refusal-values-001\"> </a></td><td>Renewal period not yet expired</td></tr><tr><td style=\"white-space:nowrap\">002<a name=\"be-cs-refusal-values-002\"> </a></td><td>Maximum number of services already reached over the authorized period (and/or no derogation granted)</td></tr><tr><td style=\"white-space:nowrap\">003<a name=\"be-cs-refusal-values-003\"> </a></td><td>Service no longer authorized (already reimbursed) for this location (tooth, quadrant, etc.)</td></tr><tr><td style=\"white-space:nowrap\">004<a name=\"be-cs-refusal-values-004\"> </a></td><td>L600 value reached for authorized period</td></tr><tr><td style=\"white-space:nowrap\">005<a name=\"be-cs-refusal-values-005\"> </a></td><td>No MC/CTD agreement recorded for the service requested</td></tr><tr><td style=\"white-space:nowrap\">006<a name=\"be-cs-refusal-values-006\"> </a></td><td>Price consultation is not allowed for this service as it requires the approval of the TTR in accordance with the reimbursement conditions.</td></tr><tr><td style=\"white-space:nowrap\">007<a name=\"be-cs-refusal-values-007\"> </a></td><td>Consultation of the tariff is not authorized for this service because the tariff depends on other services invoiced at the same time.</td></tr><tr><td style=\"white-space:nowrap\">008<a name=\"be-cs-refusal-values-008\"> </a></td><td>Prerequisite not met</td></tr><tr><td style=\"white-space:nowrap\">009<a name=\"be-cs-refusal-values-009\"> </a></td><td>The nomenclature code cannot be attested on this date</td></tr><tr><td style=\"white-space:nowrap\">010<a name=\"be-cs-refusal-values-010\"> </a></td><td>Service cannot be combined with another service</td></tr></table></div>"
  },
  "url" : "https://www.ehealth.fgov.be/standards/fhir/etariff/CodeSystem/be-cs-refusal-values",
  "version" : "1.0.0",
  "name" : "BeCSRefusalValues",
  "title" : "refusal values",
  "status" : "draft",
  "experimental" : false,
  "date" : "2024-10-02T11:49:46+00:00",
  "publisher" : "eHealth Platform",
  "contact" : [
    {
      "name" : "eHealth Platform",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.ehealth.fgov.be/"
        },
        {
          "system" : "email",
          "value" : "support@be-ehealth-standards.atlassian.net"
        }
      ]
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "BE",
          "display" : "Belgium"
        }
      ]
    }
  ],
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 10,
  "concept" : [
    {
      "code" : "001",
      "display" : "Renewal period not yet expired"
    },
    {
      "code" : "002",
      "display" : "Maximum number of services already reached over the authorized period (and/or no derogation granted)"
    },
    {
      "code" : "003",
      "display" : "Service no longer authorized (already reimbursed) for this location (tooth, quadrant, etc.)"
    },
    {
      "code" : "004",
      "display" : "L600 value reached for authorized period"
    },
    {
      "code" : "005",
      "display" : "No MC/CTD agreement recorded for the service requested"
    },
    {
      "code" : "006",
      "display" : "Price consultation is not allowed for this service as it requires the approval of the TTR in accordance with the reimbursement conditions."
    },
    {
      "code" : "007",
      "display" : "Consultation of the tariff is not authorized for this service because the tariff depends on other services invoiced at the same time."
    },
    {
      "code" : "008",
      "display" : "Prerequisite not met"
    },
    {
      "code" : "009",
      "display" : "The nomenclature code cannot be attested on this date"
    },
    {
      "code" : "010",
      "display" : "Service cannot be combined with another service"
    }
  ]
}