LinuxForHealth FHIR Implementation Guide
8.0.0 - draft United States of America flag

LinuxForHealth FHIR Implementation Guide - Local Development build (v8.0.0). See the Directory of published versions

CodeSystem: Insurance Plan Benefit Type Codes

Official URL: http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-benefit-type Version: 8.0.0
Active as of 2022-11-10 Computable Name: InsurancePlanBenefitTypeCodeSystem

The codes that indicates the specific types of costs (admin fees, premiums, etc.) that may be tied to a member based on their Insurance plan cost category

This Code system is referenced in the content logical definition of the following value sets:

This code system http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-benefit-type defines the following codes:

CodeDisplayDefinition
administrative-fee Administrative FeeIndicates the administrative fee for the component on the eligibility data
capitation-amount Capitation AmountIndicates the pre-paid amount, on the eligibility data, paid to plans or providers under risk-based managed care contracts
employee-contribution Employee ContributionIndicates the employee premium contribution for the component on the eligibility data
non-claim-payment Non Claim PaymentIndicates the miscellaneous other non-claim payments on the eligibility data, not included in Administrative Fee, Capitation Amount, HMO Premium or Employee Contribution Amount
monthly-premium-billed Monthly Premium BilledIndicates the monthly premium billed for the component on the eligibility data
monthly-premium-paid Monthly Premium PaidIndicates the monthly premium paid for the component on the eligibility data