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  1. FHIR Specification Feedback
  2. FHIR-27003

Replace CARIN Blue Button Network Contracting Status Value Set with Payer Provider Contracting Status Value Set

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    Details

    • Type: Change Request
    • Status: Published (View Workflow)
    • Priority: Highest
    • Resolution: Persuasive with Modification
    • Specification:
      US CARIN Blue Button (FHIR)
    • Raised in Version:
      0.1
    • Work Group:
      Financial Mgmt
    • Related Page(s):
      (NA)
    • Related Section(s):
      Terminology
    • Grouping:
    • Resolution Description:
      Hide

      Delete Value Set CARIN Blue Button Network Contracting Status Value Set

       

      Replace with the following Value Set:

       

      Defining URL: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderContractingStatus
      Name: C4BBPayerProviderContractingStatus
      Title: C4BB Payer Provider Contracting Status
      Definition: Indicates that the Provider has a contract with the Payer as of the effective date of service or admission.
      Copyright: This Value Set is not copyrighted. 
      Logical Definition: This value set includes codes from the following code system:
      ·       Include contracted and non-contracted defined in http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBPayerAdjudicationStatus
      Expansion: This value set contains 2 concepts
      Code Display Definition
      contracted Contracted Indicates the provider was contracted for the service
      noncontracted Non-Contracted Indicates the provider was not contracted for the service

       

      Bind with binding strength Required to the slice slice:billingnetworkcontractingstatus, data element supportingInfo in the Inpatient Institutional, Outpatient Institutional Professional and Non-Clinician and Pharmacy Profiles

      Bind with binding strength Required to the slice slice:performingnetworkcontractingstatus, data element supportingInfo in the Professional and Non-Clinician Profile

       

      Delete Code System CARIN-BB-Network-Contracting-Status

      The Code System for this Value Set was defined in FHIR-27002

      Show
      Delete Value Set  CARIN Blue Button Network Contracting Status Value Set   Replace with the following Value Set:   Defining URL: http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerProviderContractingStatus Name: C4BBPayerProviderContractingStatus Title: C4BB Payer Provider Contracting Status Definition: Indicates that the Provider has a contract with the Payer as of the effective date of service or admission. Copyright: This Value Set is not copyrighted.  Logical Definition: This value set includes codes from the following code system: ·       Include contracted and non-contracted defined in http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBPayerAdjudicationStatus Expansion: This value set contains 2 concepts Code Display Definition contracted Contracted Indicates the provider was contracted for the service noncontracted Non-Contracted Indicates the provider was not contracted for the service   Bind with binding strength Required to the slice slice:billingnetworkcontractingstatus, data element supportingInfo in the Inpatient Institutional, Outpatient Institutional Professional and Non-Clinician and Pharmacy Profiles Bind with binding strength Required to the slice slice:performingnetworkcontractingstatus, data element supportingInfo in the Professional and Non-Clinician Profile   Delete Code System CARIN-BB-Network-Contracting-Status The Code System for this Value Set was defined in FHIR-27002
    • Resolution Vote:
      Pat Taylor/Mark Roberts: 24-0-2
    • Change Category:
      Correction
    • Change Impact:
      Compatible, substantive

      Description

      Ballot feedback was that the Terminology Section of the IG requires a major overall, renaming the Value Sets and Code Systems and updating links.  Following is a recommended resolution for the network contracting status:

      1)  Delete Value Set CARIN Blue Button Network Contracting Status Value Set

      2)  Define Value Set PayerProviderContractingStatus

      3)  Title:  Payer Provider Contracting Status

      4) Description:  Indicates that the Provider has a contract with the Plan (regardless of the network) as of the effective date of service or admission.

      5) Value Set: http://hl7.org/fhir/us/ValueSet/payer-providercontractingstatus  where values include the following codes from the Code System, payer-adjudication-category:  contracted | non-contracted

      6)  Bind the ValueSet with binding strength required to the slice billingnetworkcontractingstatus, data element supportinginfo.code in the Inpatient Institutional, Outpatient Institutional, Professional and Non-Clinician and Pharmacy profiles.  

      7)  Bind the ValueSet with binding strength required to the following slice performingnetworkcontractingstatus, data element supportinginfo.code in the Professional and Non-clinician Profile

      The Code System is also used to source the following Value Sets: Payer Benefit Payment Status, Claim Payment Status Code

       

       

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              Assignee:
              Unassigned Unassigned
              Reporter:
              taylorpatriciab Patricia Taylor
              Request in-person:
              Patricia Taylor
              Watchers:
              1 Start watching this issue

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                Updated:
                Resolved:
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