haau3 FHIR Implementation Guide (HFIG)
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haau3 FHIR Implementation Guide (HFIG) - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Plan Benefits Network Status - TTL Representation

Active as of 2026-10-14

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/plan-benefits-network-status> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "plan-benefits-network-status"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem plan-benefits-network-status</b></p><a name=\"plan-benefits-network-status\"> </a><a name=\"hcplan-benefits-network-status\"> </a><p>This case-sensitive code system <code>https://haau3.com/fhir/CodeSystem/plan-benefits-network-status</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\">in-network<a name=\"plan-benefits-network-status-in-network\"> </a></td><td>In network</td><td>The directory lists the provider in a network this plan names, for the plan's year, in a practitioner role or an organization affiliation that names the network. A listing, not a statement that the provider has a contract with the plan.</td></tr><tr><td style=\"white-space:nowrap\">not-found<a name=\"plan-benefits-network-status-not-found\"> </a></td><td>Not found in the network's listings</td><td>The directory holds the provider, and none of the networks this plan names lists them. The directory's network data is incomplete, so this never means the provider is out of network.</td></tr><tr><td style=\"white-space:nowrap\">not-in-directory<a name=\"plan-benefits-network-status-not-in-directory\"> </a></td><td>Not in the directory</td><td>The directory holds no practitioner or organization with this NPI.</td></tr><tr><td style=\"white-space:nowrap\">no-network-data<a name=\"plan-benefits-network-status-no-network-data\"> </a></td><td>No network data</td><td>The directory holds no network data for this plan in the plan's year, so no provider can be checked against it. The answer's reason says why.</td></tr></table></div>"
  ] ;
  fhir:CodeSystem.url [ fhir:value "https://haau3.com/fhir/CodeSystem/plan-benefits-network-status"] ;
  fhir:CodeSystem.version [ fhir:value "1.0.0"] ;
  fhir:CodeSystem.name [ fhir:value "PlanBenefitsNetworkStatusCS"] ;
  fhir:CodeSystem.title [ fhir:value "Plan Benefits Network Status"] ;
  fhir:CodeSystem.status [ fhir:value "active"] ;
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-10-14T18:01:46+00:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "haau3"] ;
  fhir:CodeSystem.contact [
     fhir:index 0 ;
     fhir:ContactDetail.name [ fhir:value "haau3" ] ;
     fhir:ContactDetail.telecom [
       fhir:index 0 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://haau3.com" ]
     ], [
       fhir:index 1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "hello@haau3.com" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "What the CMS National Provider Directory says about one provider and the networks of one plan, for the plan's year: the status codes of the $in-network operation on InsurancePlan. A directory listing is not a statement of a contract, which is why HL7's applicability codes, defined by a contract with the insurer, are not used."] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index 0 ;
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "US" ] ;
       fhir:Coding.display [ fhir:value "United States of America" ]
     ]
  ] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "4"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index 0 ;
     fhir:CodeSystem.concept.code [ fhir:value "in-network" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "In network" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The directory lists the provider in a network this plan names, for the plan's year, in a practitioner role or an organization affiliation that names the network. A listing, not a statement that the provider has a contract with the plan." ]
  ], [
     fhir:index 1 ;
     fhir:CodeSystem.concept.code [ fhir:value "not-found" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Not found in the network's listings" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The directory holds the provider, and none of the networks this plan names lists them. The directory's network data is incomplete, so this never means the provider is out of network." ]
  ], [
     fhir:index 2 ;
     fhir:CodeSystem.concept.code [ fhir:value "not-in-directory" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Not in the directory" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The directory holds no practitioner or organization with this NPI." ]
  ], [
     fhir:index 3 ;
     fhir:CodeSystem.concept.code [ fhir:value "no-network-data" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "No network data" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "The directory holds no network data for this plan in the plan's year, so no provider can be checked against it. The answer's reason says why." ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/plan-benefits-network-status.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/plan-benefits-network-status.ttl> .