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  1. FHIR Specification Feedback
  2. FHIR-30929

Update Payee Type Value Set / Code System

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • R4
    • Financial Mgmt
    • (NA)
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      1) Accept the addition of the code 'beneficiary' for reimbursement to the patient.

      2) The committee does not support the suggested rewording to replace 'benefit payable' with 'adjudication amount' in the other code descriptions.

      If the balloter wishes to provide other translations or notes to support finding the associated element in local standards then the committee would readily review for inclusion in the FHIR specification.

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      1) Accept the addition of the code 'beneficiary' for reimbursement to the patient. 2) The committee does not support the suggested rewording to replace 'benefit payable' with 'adjudication amount' in the other code descriptions. If the balloter wishes to provide other translations or notes to support finding the associated element in local standards then the committee would readily review for inclusion in the FHIR specification.
    • Rachel Foerster/Susan Langford: 4-0-0
    • Enhancement
    • Compatible, substantive
    • R5

    Description

      Add 'beneficiary' to the Code System Values:

      Code Display Definition
      beneficiary Beneficiary The beneficiary (patient) will be reimbursed.

      Additionally, the current descriptions of Payee Type speak to payment of benefits.  Benefits may be paid by either the subscriber; i.e., deductible or co-pay, or to the provider.  Modify the descriptions to reflect that this value set identifies who received the adjudication amount on the claim 

      1) Modify the value set description from 'This value set includes sample Payee Type codes' to 'This value set identifies the type of recipient of the adjudication amount.' 

      2)  Update the code system descriptions of the HL7 Code System http://hl7.org/fhir/R4/codesystem-payeetype.html as follows:

      • provider:  modify from 'Any benefit payable will be paid to the provider (Assignment of Benefit).' to 'The adjudication amount will be paid to the provider (Assignment of Benefit).'
      • other:  modify from 'Any benefit payable will be paid to a third party such as a guarrantor.' to 'The adjudication amount will be paid to a third party such as a guarantor.'  (note:  guarrantor should be guarantor)

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            Unassigned Unassigned
            taylorpatriciab Patricia Taylor
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              Created:
              Updated:
              Resolved: