Response for tariff request by careprovider

Identification of the insurer

Patient identification

holder code 1

holder code 2

Identification of the type of tariff request

List of services

Provider ID

(pseudo-)nomenclature code of the service that was performed.

Date on which the service was performed.

Tariff

Legal fee for the service (reimbursement amount + co-payment). The AO will provide the unit price, regardless of the rules for applying the nomenclature.

Amount paid by insurer

Personal co-payment paid by the patient

Approval number of the tariff commitment that the service provider must indicate in its billing.

Refusal of the service requested

code for refusal of intervention by the AO for the requested service

The possible values are as follows. 001 Renewal period not yet expired 002 () Maximum number of services already reached within the authorised period (and/or no exemption granted)* 003 () Benefit is no longer authorised (already reimbursed) for this location (tooth, quadrant, ..)* 004 L600 value reached for the authorised period 005 No MC/CTD agreement registered for the requested service 006 Tariff consultation is not allowed for this benefit as it requires TTR approval as per reimbursement conditions. 007 Tariff consultation is not allowed for this service as the tariff is dependent on other services being billed at the same time. 008 Precondition not met. 009 Nomenclature code cannot be certified on this date 010 () Service cannot be combined with another service* In certain cases (), the AO will indicate the nomenclature code and the date of the service received by the patient which justifies the refusal of reimbursement of the service requested.*

Nomenclature code of the service justifying the refusal

Date of the service justifying the refusal

Response for tariff request by careprovider

Identification of the insurer

Patient identification

holder code 1

holder code 2

Identification of the type of tariff request

List of services

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Provider ID

(pseudo-)nomenclature code of the service that was performed.

Date on which the service was performed.

Tariff

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Legal fee for the service (reimbursement amount + co-payment). The AO will provide the unit price, regardless of the rules for applying the nomenclature.

Amount paid by insurer

Personal co-payment paid by the patient

Approval number of the tariff commitment that the service provider must indicate in its billing.

Refusal of the service requested

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

code for refusal of intervention by the AO for the requested service

The possible values are as follows. 001 Renewal period not yet expired 002 () Maximum number of services already reached within the authorised period (and/or no exemption granted)* 003 () Benefit is no longer authorised (already reimbursed) for this location (tooth, quadrant, ..)* 004 L600 value reached for the authorised period 005 No MC/CTD agreement registered for the requested service 006 Tariff consultation is not allowed for this benefit as it requires TTR approval as per reimbursement conditions. 007 Tariff consultation is not allowed for this service as the tariff is dependent on other services being billed at the same time. 008 Precondition not met. 009 Nomenclature code cannot be certified on this date 010 () Service cannot be combined with another service* In certain cases (), the AO will indicate the nomenclature code and the date of the service received by the patient which justifies the refusal of reimbursement of the service requested.*

Nomenclature code of the service justifying the refusal

Date of the service justifying the refusal

Response for tariff request by careprovider

Identification of the insurer

Patient identification

holder code 1

holder code 2

Identification of the type of tariff request

List of services

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Provider ID

(pseudo-)nomenclature code of the service that was performed.

Date on which the service was performed.

Tariff

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Legal fee for the service (reimbursement amount + co-payment). The AO will provide the unit price, regardless of the rules for applying the nomenclature.

Amount paid by insurer

Personal co-payment paid by the patient

Approval number of the tariff commitment that the service provider must indicate in its billing.

Refusal of the service requested

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

code for refusal of intervention by the AO for the requested service

The possible values are as follows. 001 Renewal period not yet expired 002 () Maximum number of services already reached within the authorised period (and/or no exemption granted)* 003 () Benefit is no longer authorised (already reimbursed) for this location (tooth, quadrant, ..)* 004 L600 value reached for the authorised period 005 No MC/CTD agreement registered for the requested service 006 Tariff consultation is not allowed for this benefit as it requires TTR approval as per reimbursement conditions. 007 Tariff consultation is not allowed for this service as the tariff is dependent on other services being billed at the same time. 008 Precondition not met. 009 Nomenclature code cannot be certified on this date 010 () Service cannot be combined with another service* In certain cases (), the AO will indicate the nomenclature code and the date of the service received by the patient which justifies the refusal of reimbursement of the service requested.*

Nomenclature code of the service justifying the refusal

Date of the service justifying the refusal