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

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: Plan Benefits Network Status - XML Representation

Active as of 2026-10-14

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="plan-benefits-network-status"/>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <url
       value="https://haau3.com/fhir/CodeSystem/plan-benefits-network-status"/>
  <version value="1.0.0"/>
  <name value="PlanBenefitsNetworkStatusCS"/>
  <title value="Plan Benefits Network Status"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2026-10-14T18:01:46+00:00"/>
  <publisher value="haau3"/>
  <contact>
    <name value="haau3"/>
    <telecom>
      <system value="url"/>
      <value value="https://haau3.com"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="hello@haau3.com"/>
    </telecom>
  </contact>
  <description
               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."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="4"/>
  <concept>
    <code value="in-network"/>
    <display value="In network"/>
    <definition
                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."/>
  </concept>
  <concept>
    <code value="not-found"/>
    <display value="Not found in the network's listings"/>
    <definition
                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."/>
  </concept>
  <concept>
    <code value="not-in-directory"/>
    <display value="Not in the directory"/>
    <definition
                value="The directory holds no practitioner or organization with this NPI."/>
  </concept>
  <concept>
    <code value="no-network-data"/>
    <display value="No network data"/>
    <definition
                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."/>
  </concept>
</CodeSystem>