draft
1 bindingBenefit cost applicability
http://hl7.org/fhir/ValueSet/insuranceplan-applicability
Whether the cost applies to in-network or out-of-network providers.
Official specComposition
| Code | Display | Definition |
|---|---|---|
| in-network | In Network | Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates |
| out-of-network | Out of Network | Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates |
| other | Other | Other applicability |
Bound by
| Resource | Path | Strength |
|---|---|---|
| InsurancePlan | InsurancePlan.plan.specificCost.benefit.cost.applicability | required |