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 No Network Data Reason - XML Representation

Active as of 2026-10-14

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="plan-benefits-no-network-data-reason"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem plan-benefits-no-network-data-reason</b></p><a name="plan-benefits-no-network-data-reason"> </a><a name="hcplan-benefits-no-network-data-reason"> </a><p>This case-sensitive code system <code>https://haau3.com/fhir/CodeSystem/plan-benefits-no-network-data-reason</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">marketplace<a name="plan-benefits-no-network-data-reason-marketplace"> </a></td><td>Marketplace plan</td><td>An ACA Marketplace plan. Its insurer publishes its provider directory itself, outside the CMS National Provider Directory, which holds no network data for Marketplace plans.</td></tr><tr><td style="white-space:nowrap">plan-not-in-directory<a name="plan-benefits-no-network-data-reason-plan-not-in-directory"> </a></td><td>Plan not in the directory</td><td>The directory holds no plan with this plan's CMS plan id, or holds it for the plan's year without naming a network.</td></tr><tr><td style="white-space:nowrap">other-plan-year<a name="plan-benefits-no-network-data-reason-other-plan-year"> </a></td><td>Another plan year</td><td>The directory holds a plan with this plan's CMS plan id only for another plan year. A plan's network can change between years, so another year's listings are not used.</td></tr></table></div>
  </text>
  <url
       value="https://haau3.com/fhir/CodeSystem/plan-benefits-no-network-data-reason"/>
  <version value="1.0.0"/>
  <name value="PlanBenefitsNoNetworkDataReasonCS"/>
  <title value="Plan Benefits No Network Data Reason"/>
  <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="Why the CMS National Provider Directory holds no network data for a plan in the plan's year: the reason codes of the $in-network operation on InsurancePlan."/>
  <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="3"/>
  <concept>
    <code value="marketplace"/>
    <display value="Marketplace plan"/>
    <definition
                value="An ACA Marketplace plan. Its insurer publishes its provider directory itself, outside the CMS National Provider Directory, which holds no network data for Marketplace plans."/>
  </concept>
  <concept>
    <code value="plan-not-in-directory"/>
    <display value="Plan not in the directory"/>
    <definition
                value="The directory holds no plan with this plan's CMS plan id, or holds it for the plan's year without naming a network."/>
  </concept>
  <concept>
    <code value="other-plan-year"/>
    <display value="Another plan year"/>
    <definition
                value="The directory holds a plan with this plan's CMS plan id only for another plan year. A plan's network can change between years, so another year's listings are not used."/>
  </concept>
</CodeSystem>