haau3 FHIR Implementation Guide (HFIG)
1.0.0 - ci-build
haau3 FHIR Implementation Guide (HFIG)
1.0.0 - ci-build
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
| Official URL: https://haau3.com/fhir/ValueSet/plan-benefits-cost-scope-network | Version: 1.0.0 | |||
| Active as of 2026-10-14 | Computable Name: PlanBenefitsCostScopeNetworkVS | |||
Which network a deductible or out-of-pocket maximum belongs to: HL7's in and out (in is the first tier for a plan with two in-network tiers), and haau3's codes for the rest.
References
This value set includes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/benefit-network version 📍2.0.0| Code | Display | Definition |
| in | In Network | Services rendered by a Network provider |
| out | Out of Network | Services rendered by a provider who is not in the Network |
https://haau3.com/fhir/CodeSystem/plan-benefits-cost-scope version 📦1.0.0
| Code | Display | Definition |
| tier-2 | In network, tier 2 | The plan's second in-network tier. |
| point-of-service | Point of service | Care outside an HMO's network under the plan's point-of-service option. |
| combined | In and out of network combined | One amount that counts what the member pays in and out of network together. |
| in-and-out | In and out of network | An amount that applies to services both in and out of network. |
| unstated | Network not stated | The plan's filing does not say which network the amount applies to. |
Expansion performed internally based on:
This value set contains 7 concepts
| System | Code | Display (en) | Definition | JSON | XML |
http://terminology.hl7.org/CodeSystem/benefit-network | in | In Network | Services rendered by a Network provider | ||
http://terminology.hl7.org/CodeSystem/benefit-network | out | Out of Network | Services rendered by a provider who is not in the Network | ||
https://haau3.com/fhir/CodeSystem/plan-benefits-cost-scope | tier-2 | In network, tier 2 | The plan's second in-network tier. | ||
https://haau3.com/fhir/CodeSystem/plan-benefits-cost-scope | point-of-service | Point of service | Care outside an HMO's network under the plan's point-of-service option. | ||
https://haau3.com/fhir/CodeSystem/plan-benefits-cost-scope | combined | In and out of network combined | One amount that counts what the member pays in and out of network together. | ||
https://haau3.com/fhir/CodeSystem/plan-benefits-cost-scope | in-and-out | In and out of network | An amount that applies to services both in and out of network. | ||
https://haau3.com/fhir/CodeSystem/plan-benefits-cost-scope | unstated | Network not stated | The plan's filing does not say which network the amount applies to. |
Explanation of the columns that may appear on this page:
| Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies |
| System | The source of the definition of the code (when the value set draws in codes defined elsewhere) |
| Code | The code (used as the code in the resource instance) |
| Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application |
| Definition | An explanation of the meaning of the concept |
| Comments | Additional notes about how to use the code |