Magentus Practice Management FHIR Implementation Guide
1.2.16 - ci-build

Magentus Practice Management FHIR Implementation Guide - Local Development build (v1.2.16) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## ValueSet: Genie Coverage Type and Self Pay codes

Official URL: http://fhir.geniesolutions.io/ValueSet/gs-coverage-type | Version: 1.2.16
Active as of 2024-08-15 | Computable Name: GSCoverageType

Genie Coverage Type and Self Pay codes

References

- Genie Coverage

### Logical Definition (CLD)

Generated Narrative: ValueSet gs-coverage-type

This value set includes codes based on the following rules:

- Include these codes as defined in `http://terminology.hl7.org/CodeSystem/coverage-selfpay`

  Code | Display | Definition
  pay | Pay | An individual or organization is paying directly for goods and services.

- Include these codes as defined in `http://terminology.hl7.org.au/CodeSystem/coverage-selfpay`

  Code | Display | Definition
  payconc | Concession | An individual or organisation is paying directly a concessional fee for goods and services.

- Include these codes as defined in `http://terminology.hl7.org/CodeSystem/v3-ActCode`

  Code | Display | Definition
  PUBLICPOL | public healthcare | Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service).
  WCBPOL | workers compensation | Insurance policy for injuries sustained in the work place or in the course of employment.
  HIP | health insurance plan policy | **Definition:** A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. *Discussion:* Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.
  VET | veteran health program | **Definition:** Services provided directly and through contracted and operated veteran health programs.
  AUTOPOL | automobile | Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.
  MILITARY | military health program | **Definition:** A government program that provides coverage for health services to military personnel, retirees, and dependents. A covered party who is a subscriber can choose from among Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Plans offering a Point of Service (POS) Product, or Health Maintenance Organizations. **Example:** In the U.S., TRICARE, CHAMPUS.

### Expansion

Generated Narrative: ValueSet

Expansion based on:

- codesystem Coverage SelfPay Codes AU v4.1.2-preview (CodeSystem)
- codesystem Coverage SelfPay Codes v1.0.1 (CodeSystem)
- codesystem ActCode v9.0.0 (CodeSystem)

This value set contains 8 concepts

Code | System | Display | Definition
pay | http://terminology.hl7.org/CodeSystem/coverage-selfpay | Pay | An individual or organization is paying directly for goods and services.
payconc | http://terminology.hl7.org.au/CodeSystem/coverage-selfpay | Concession | An individual or organisation is paying directly a concessional fee for goods and services.
PUBLICPOL | http://terminology.hl7.org/CodeSystem/v3-ActCode | public healthcare | Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service).
WCBPOL | http://terminology.hl7.org/CodeSystem/v3-ActCode | workers compensation | Insurance policy for injuries sustained in the work place or in the course of employment.
HIP | http://terminology.hl7.org/CodeSystem/v3-ActCode | health insurance plan policy | Definition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.
VET | http://terminology.hl7.org/CodeSystem/v3-ActCode | veteran health program | Definition: Services provided directly and through contracted and operated veteran health programs.
AUTOPOL | http://terminology.hl7.org/CodeSystem/v3-ActCode | automobile | Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.
MILITARY | http://terminology.hl7.org/CodeSystem/v3-ActCode | military health program | Definition: A government program that provides coverage for health services to military personnel, retirees, and dependents. A covered party who is a subscriber can choose from among Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Plans offering a Point of Service (POS) Product, or Health Maintenance Organizations. Example: In the U.S., TRICARE, CHAMPUS.

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