Da Vinci Payer Data Exchange
2.1.0 - STU 2.1 United States of America flag

This page is part of the Da Vinci Payer Data Exchange (v2.1.0: STU2.1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

ValueSet: PDex Payer Benefit Payment Status (Experimental)

Official URL: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexPayerBenefitPaymentStatus Version: 2.1.0
Standards status: Informative Computable Name: PDexPayerBenefitPaymentStatus

Copyright/Legal: This Valueset is not copyrighted.

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

References

Logical Definition (CLD)

 

Expansion

Expansion performed internally based on codesystem PDex Payer Adjudication Status v2.1.0 (CodeSystem)

This value set contains 3 concepts

CodeSystemDisplay (en-US)Definition
  innetworkhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatusIn NetworkIndicates the claim or claim line was paid in network. This does not indicate the contracting status of the provider
  outofnetworkhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatusOut Of NetworkIndicates the claim or claim line was paid out of network. This does not indicate the contracting status of the provider
  otherhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexPayerAdjudicationStatusOtherIndicates other network status or when a network does not apply

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code