US Core Source of Payment Value Set - Health eData 1 Sandbox v0.1.0

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ValueSet: US Core Source of Payment Value Set

Official URL: http://hl7.org/fhir/us/core/ValueSet/us-core-source-of-payment		Version: 0.1.0
Standards status: Trial-use	Maturity Level: 2	Computable Name: USCoreSourceofPaymentValueSet
Copyright/Legal: The Source of Payment Typology is freely available for use and modification.

US Public Health Data Consortium Source of Payment Codes excluding specific payer organizations such as “BLUE CROSS/BLUE SHIELD” and limited to main categories for classification, type of plan and additional subcategories.

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

This value set includes codes based on the following rules:

Import all the codes that are contained in Payer

This value set excludes codes based on the following rules:

Exclude these codes as defined in https://nahdo.org/sopt

Code	Display
1111	Medicare Chronic Condition Special Needs Plan (C-SNP)
1112	Medicare Institutional Special Needs Plan (I-SNP)
3111	TRICARE Prime--HMO
3112	TRICARE Extra--PPO
3113	TRICARE Standard - Fee For Service
3114	TRICARE For Life--Medicare Supplement
3115	TRICARE Reserve Select
3116	Uniformed Services Family Health Plan (USFHP) -- HMO
3119	Department of Defense - (other)
3121	Enrolled Prime--HMO
3122	Non-enrolled Space Available
3123	TRICARE For Life (TFL)
3211	Direct Care-Care provided in VA facilities
3212	Indirect Care-Care provided outside VA facilities
32121	Fee Basis
32122	Foreign Fee/Foreign Medical Program (FMP)
32123	Contract Nursing Home/Community Nursing Home
32124	State Veterans Home
32125	Sharing Agreements
32126	Other Federal Agency
32127	Dental Care
32128	Vision Care
3221	Civilian Health and Medical Program for the VA (CHAMPVA)
3222	Spina Bifida Health Care Program (SB)
3223	Children of Women Vietnam Veterans (CWVV)
3229	Other non-veteran care
3711	HMO
3712	PPO
3713	POS
3811	Federal, State, Local not specified - HMO
3812	Federal, State, Local not specified - PPO
3813	Federal, State, Local not specified - POS
3819	Federal, State, Local not specified - not specified managed care
6	BLUE CROSS/BLUE SHIELD
61	BC Managed Care
611	BC Managed Care - HMO
612	BC Managed Care - PPO
613	BC Managed Care - POS
614	BC Managed Care - Dental
619	BC Managed Care - Other
62	BC Insurance Indemnity
621	BC Indemnity
622	BC Self-insured (ERISA) Administrative Services Only (ASO)Plan
623	BC Medicare Supplemental Plan
629	BC Indemnity - Dental

Expansion

Expansion based on:

codesystem https://nahdo.org/sopt version 9.2
valueset Payer v20180718 (ValueSet)

This value set has 162 codes in it. In order to keep the publication size manageable, only a selection (119 codes) of the whole set of codes is shown.

Code	System	Display
1	https://nahdo.org/sopt	MEDICARE
11	https://nahdo.org/sopt	Medicare Managed Care (Includes Medicare Advantage Plans)
111	https://nahdo.org/sopt	Medicare HMO
112	https://nahdo.org/sopt	Medicare PPO
113	https://nahdo.org/sopt	Medicare POS
119	https://nahdo.org/sopt	Medicare Managed Care Other
12	https://nahdo.org/sopt	Medicare (Non-managed Care)
121	https://nahdo.org/sopt	Medicare FFS
122	https://nahdo.org/sopt	Medicare Drug Benefit
123	https://nahdo.org/sopt	Medicare Medical Savings Account (MSA)
129	https://nahdo.org/sopt	Medicare Non-managed Care Other
13	https://nahdo.org/sopt	Medicare Hospice
14	https://nahdo.org/sopt	Dual Eligibility Medicare/Medicaid Organization
19	https://nahdo.org/sopt	Medicare Other
191	https://nahdo.org/sopt	Medicare Pharmacy Benefit Manager
2	https://nahdo.org/sopt	MEDICAID
21	https://nahdo.org/sopt	Medicaid (Managed Care)
211	https://nahdo.org/sopt	Medicaid HMO
212	https://nahdo.org/sopt	Medicaid PPO
213	https://nahdo.org/sopt	Medicaid PCCM (Primary Care Case Management)
219	https://nahdo.org/sopt	Medicaid Managed Care Other
22	https://nahdo.org/sopt	Medicaid (Non-managed Care Plan)
23	https://nahdo.org/sopt	Medicaid/SCHIP
25	https://nahdo.org/sopt	Medicaid - Out of State
26	https://nahdo.org/sopt	Medicaid - Long Term Care
29	https://nahdo.org/sopt	Medicaid Other
291	https://nahdo.org/sopt	Medicaid Pharmacy Benefit Manager
299	https://nahdo.org/sopt	Medicaid - Dental
3	https://nahdo.org/sopt	OTHER GOVERNMENT (Federal/State/Local) (excluding Department of Corrections)
31	https://nahdo.org/sopt	Department of Defense
311	https://nahdo.org/sopt	TRICARE (CHAMPUS)
312	https://nahdo.org/sopt	Military Treatment Facility
313	https://nahdo.org/sopt	Dental --Stand Alone
32	https://nahdo.org/sopt	Department of Veterans Affairs
321	https://nahdo.org/sopt	Veteran care-Care provided to Veterans
322	https://nahdo.org/sopt	Non-veteran care
33	https://nahdo.org/sopt	Indian Health Service or Tribe
331	https://nahdo.org/sopt	Indian Health Service - Regular
332	https://nahdo.org/sopt	Indian Health Service - Contract
333	https://nahdo.org/sopt	Indian Health Service - Managed Care
334	https://nahdo.org/sopt	Indian Tribe - Sponsored Coverage
34	https://nahdo.org/sopt	HRSA Program
341	https://nahdo.org/sopt	Title V (MCH Block Grant)
342	https://nahdo.org/sopt	Migrant Health Program
343	https://nahdo.org/sopt	Ryan White Act
349	https://nahdo.org/sopt	Other
35	https://nahdo.org/sopt	Black Lung
36	https://nahdo.org/sopt	State Government
361	https://nahdo.org/sopt	State SCHIP program (codes for individual states)
362	https://nahdo.org/sopt	Specific state programs (list/ local code)
369	https://nahdo.org/sopt	State, not otherwise specified (other state)
37	https://nahdo.org/sopt	Local Government
371	https://nahdo.org/sopt	Local - Managed care
372	https://nahdo.org/sopt	FFS/Indemnity
379	https://nahdo.org/sopt	Local, not otherwise specified (other local, county)
38	https://nahdo.org/sopt	Other Government (Federal, State, Local not specified)
381	https://nahdo.org/sopt	Federal, State, Local not specified managed care
382	https://nahdo.org/sopt	Federal, State, Local not specified - FFS
389	https://nahdo.org/sopt	Federal, State, Local not specified - Other
39	https://nahdo.org/sopt	Other Federal
391	https://nahdo.org/sopt	Federal Employee Health Plan - Use when known
4	https://nahdo.org/sopt	DEPARTMENTS OF CORRECTIONS
41	https://nahdo.org/sopt	Corrections Federal
42	https://nahdo.org/sopt	Corrections State
43	https://nahdo.org/sopt	Corrections Local
44	https://nahdo.org/sopt	Corrections Unknown Level
5	https://nahdo.org/sopt	PRIVATE HEALTH INSURANCE
51	https://nahdo.org/sopt	Managed Care (Private)
511	https://nahdo.org/sopt	Commercial Managed Care - HMO
512	https://nahdo.org/sopt	Commercial Managed Care - PPO
513	https://nahdo.org/sopt	Commercial Managed Care - POS
514	https://nahdo.org/sopt	Exclusive Provider Organization
515	https://nahdo.org/sopt	Gatekeeper PPO (GPPO)
516	https://nahdo.org/sopt	Commercial Managed Care - Pharmacy Benefit Manager
517	https://nahdo.org/sopt	Commercial Managed Care - Dental
519	https://nahdo.org/sopt	Managed Care, Other (non HMO)
52	https://nahdo.org/sopt	Private Health Insurance - Indemnity
521	https://nahdo.org/sopt	Commercial Indemnity
522	https://nahdo.org/sopt	Self-insured (ERISA) Administrative Services Only (ASO) plan
523	https://nahdo.org/sopt	Medicare supplemental policy (as second payer)
524	https://nahdo.org/sopt	Indemnity Insurance - Dental
529	https://nahdo.org/sopt	Private health insurance--other commercial Indemnity
53	https://nahdo.org/sopt	Managed Care (private) or private health insurance (indemnity), not otherwise specified
54	https://nahdo.org/sopt	Organized Delivery System
55	https://nahdo.org/sopt	Small Employer Purchasing Group
56	https://nahdo.org/sopt	Specialized Stand-Alone Plan
561	https://nahdo.org/sopt	Dental
562	https://nahdo.org/sopt	Vision
59	https://nahdo.org/sopt	Other Private Insurance
7	https://nahdo.org/sopt	MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)
71	https://nahdo.org/sopt	HMO
72	https://nahdo.org/sopt	PPO
73	https://nahdo.org/sopt	POS
79	https://nahdo.org/sopt	Other Managed Care
8	https://nahdo.org/sopt	NO PAYMENT from an Organization/Agency/Program/Private Payer Listed
81	https://nahdo.org/sopt	Self-pay (Includes applicants for insurance and Medicaid applicants)
82	https://nahdo.org/sopt	No Charge
821	https://nahdo.org/sopt	Charity
822	https://nahdo.org/sopt	Professional Courtesy
823	https://nahdo.org/sopt	Research/Clinical Trial
83	https://nahdo.org/sopt	Refusal to Pay/Bad Debt
84	https://nahdo.org/sopt	Hill Burton Free Care
85	https://nahdo.org/sopt	Research/Donor
89	https://nahdo.org/sopt	No Payment, Other
9	https://nahdo.org/sopt	MISCELLANEOUS/OTHER
91	https://nahdo.org/sopt	Foreign National
92	https://nahdo.org/sopt	Other (Non-government)
93	https://nahdo.org/sopt	Disability Insurance
94	https://nahdo.org/sopt	Long-term Care Insurance
95	https://nahdo.org/sopt	Worker's Compensation
951	https://nahdo.org/sopt	Worker's Comp HMO
953	https://nahdo.org/sopt	Worker's Comp Fee-for-Service
954	https://nahdo.org/sopt	Worker's Comp Other Managed Care
959	https://nahdo.org/sopt	Worker's Comp, Other unspecified
96	https://nahdo.org/sopt	Auto Insurance (includes no fault)
97	https://nahdo.org/sopt	Legal Liability / Liability Insurance
98	https://nahdo.org/sopt	Other specified but not otherwise classifiable (includes Hospice - Unspecified plan)
99	https://nahdo.org/sopt	No Typology Code available for payment source
9999	https://nahdo.org/sopt	Unavailable / No Payer Specified / Blank

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

IG © 2020+ Health eData Inc. Package healthedata1-sandbox#0.1.0 based on FHIR 4.0.1. Generated 2024-04-14
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