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

• Narrative Content
• XML
• JSON
• TTL

: Insurance Plan Benefit Type Codes - XML Representation

Active as of 2022-11-10

Raw xml | Download

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="insurance-plan-benefit-type"/>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <url
       value="http://linuxforhealth.org/fhir/cdm/CodeSystem/insurance-plan-benefit-type"/>
  <version value="8.0.0"/>
  <name value="InsurancePlanBenefitTypeCodeSystem"/>
  <title value="Insurance Plan Benefit Type Codes"/>
  <status value="active"/>
  <date value="2022-11-10T16:00:46+00:00"/>
  <publisher value="LinuxForHealth Team"/>
  <description
               value="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 value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="6"/>
  <concept>
    <code value="administrative-fee"/>
    <display value="Administrative Fee"/>
    <definition
                value="Indicates the administrative fee for the component on the eligibility data"/>
  </concept>
  <concept>
    <code value="capitation-amount"/>
    <display value="Capitation Amount"/>
    <definition
                value="Indicates the pre-paid amount, on the eligibility data, paid to plans or providers under risk-based managed care contracts"/>
  </concept>
  <concept>
    <code value="employee-contribution"/>
    <display value="Employee Contribution"/>
    <definition
                value="Indicates the employee premium contribution for the component on the eligibility data"/>
  </concept>
  <concept>
    <code value="non-claim-payment"/>
    <display value="Non Claim Payment"/>
    <definition
                value="Indicates the miscellaneous other non-claim payments on the eligibility data, not included in Administrative Fee, Capitation Amount, HMO Premium or Employee Contribution Amount"/>
  </concept>
  <concept>
    <code value="monthly-premium-billed"/>
    <display value="Monthly Premium Billed"/>
    <definition
                value="Indicates the monthly premium billed for the component on the eligibility data"/>
  </concept>
  <concept>
    <code value="monthly-premium-paid"/>
    <display value="Monthly Premium Paid"/>
    <definition
                value="Indicates the monthly premium paid for the component on the eligibility data"/>
  </concept>
</CodeSystem>