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TX: CodeSystem applicability

Properties

Profile http://hl7.org/fhir/StructureDefinition/shareablecodesystem
Last updated: April 24, 2024 at 12:00:00 AM UTC
Defining URL http://terminology.hl7.org/CodeSystem/applicability
Version 1.0.1
Name BenefitCostApplicability
Title Benefit cost applicability
Status active
Definition

Whether the cost applies to in-network or out-of-network providers.
Publisher Health Level Seven International
Committee pa
Copyright This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license
Source hl7.terminology.r4#7.3.0
Value Set Benefit cost applicability

This case-sensitive code system http://terminology.hl7.org/CodeSystem/applicability defines the following codes:

Code Display Definition
in-network In Network Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
out-of-network Out of Network Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
other Other Other applicability