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

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: Insurance Plan Benefit Type Codes - JSON Representation

Active as of 2022-11-10

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{
  "resourceType" : "CodeSystem",
  "id" : "insurance-plan-benefit-type",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system <code>http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-benefit-type</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">administrative-fee<a name=\"insurance-plan-benefit-type-administrative-fee\"> </a></td><td>Administrative Fee</td><td>Indicates the administrative fee for the component on the eligibility data</td></tr><tr><td style=\"white-space:nowrap\">capitation-amount<a name=\"insurance-plan-benefit-type-capitation-amount\"> </a></td><td>Capitation Amount</td><td>Indicates the pre-paid amount, on the eligibility data, paid to plans or providers under risk-based managed care contracts</td></tr><tr><td style=\"white-space:nowrap\">employee-contribution<a name=\"insurance-plan-benefit-type-employee-contribution\"> </a></td><td>Employee Contribution</td><td>Indicates the employee premium contribution for the component on the eligibility data</td></tr><tr><td style=\"white-space:nowrap\">non-claim-payment<a name=\"insurance-plan-benefit-type-non-claim-payment\"> </a></td><td>Non Claim Payment</td><td>Indicates the miscellaneous other non-claim payments on the eligibility data, not included in Administrative Fee, Capitation Amount, HMO Premium or Employee Contribution Amount</td></tr><tr><td style=\"white-space:nowrap\">monthly-premium-billed<a name=\"insurance-plan-benefit-type-monthly-premium-billed\"> </a></td><td>Monthly Premium Billed</td><td>Indicates the monthly premium billed for the component on the eligibility data</td></tr><tr><td style=\"white-space:nowrap\">monthly-premium-paid<a name=\"insurance-plan-benefit-type-monthly-premium-paid\"> </a></td><td>Monthly Premium Paid</td><td>Indicates the monthly premium paid for the component on the eligibility data</td></tr></table></div>"
  },
  "url" : "http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-benefit-type",
  "version" : "8.0.0",
  "name" : "InsurancePlanBenefitTypeCodeSystem",
  "title" : "Insurance Plan Benefit Type Codes",
  "status" : "active",
  "date" : "2022-11-10T16:00:46+00:00",
  "publisher" : "LinuxForHealth Team",
  "description" : "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",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 6,
  "concept" : [
    {
      "code" : "administrative-fee",
      "display" : "Administrative Fee",
      "definition" : "Indicates the administrative fee for the component on the eligibility data"
    },
    {
      "code" : "capitation-amount",
      "display" : "Capitation Amount",
      "definition" : "Indicates the pre-paid amount, on the eligibility data, paid to plans or providers under risk-based managed care contracts"
    },
    {
      "code" : "employee-contribution",
      "display" : "Employee Contribution",
      "definition" : "Indicates the employee premium contribution for the component on the eligibility data"
    },
    {
      "code" : "non-claim-payment",
      "display" : "Non Claim Payment",
      "definition" : "Indicates the miscellaneous other non-claim payments on the eligibility data, not included in Administrative Fee, Capitation Amount, HMO Premium or Employee Contribution Amount"
    },
    {
      "code" : "monthly-premium-billed",
      "display" : "Monthly Premium Billed",
      "definition" : "Indicates the monthly premium billed for the component on the eligibility data"
    },
    {
      "code" : "monthly-premium-paid",
      "display" : "Monthly Premium Paid",
      "definition" : "Indicates the monthly premium paid for the component on the eligibility data"
    }
  ]
}