Magentus Practice Management FHIR Implementation Guide
1.2.35 - ci-build
Magentus Practice Management FHIR Implementation Guide
1.2.35 - ci-build
Magentus Practice Management FHIR Implementation Guide - Local Development build (v1.2.35) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
| Active as of 2025-03-02 |
{
"resourceType" : "ValueSet",
"id" : "gs-coverage-type",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet gs-coverage-type</b></p><a name=\"gs-coverage-type\"> </a><a name=\"hcgs-coverage-type\"> </a><a name=\"gs-coverage-type-en-US\"> </a><p>This value set includes codes based on the following rules:</p><ul><li>Include these codes as defined in <a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-coverage-selfpay.html\"><code>http://terminology.hl7.org/CodeSystem/coverage-selfpay</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-coverage-selfpay.html#coverage-selfpay-pay\">pay</a></td><td>Pay</td><td>An individual or organization is paying directly for goods and services.</td></tr></table></li><li>Include these codes as defined in <a href=\"http://hl7.org.au/fhir/4.1.2-preview/CodeSystem-au-coverage-selfpay.html\"><code>http://terminology.hl7.org.au/CodeSystem/coverage-selfpay</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"http://hl7.org.au/fhir/4.1.2-preview/CodeSystem-au-coverage-selfpay.html#au-coverage-selfpay-payconc\">payconc</a></td><td>Concession</td><td>An individual or organisation is paying directly a concessional fee for goods and services.</td></tr></table></li><li>Include these codes as defined in <a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-v3-ActCode.html\"><code>http://terminology.hl7.org/CodeSystem/v3-ActCode</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-v3-ActCode.html#v3-ActCode-PUBLICPOL\">PUBLICPOL</a></td><td>public healthcare</td><td>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).</td></tr><tr><td><a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-v3-ActCode.html#v3-ActCode-WCBPOL\">WCBPOL</a></td><td>workers compensation</td><td>Insurance policy for injuries sustained in the work place or in the course of employment.</td></tr><tr><td><a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-v3-ActCode.html#v3-ActCode-HIP\">HIP</a></td><td>health insurance plan policy</td><td>**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.<br/><br/>*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.</td></tr><tr><td><a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-v3-ActCode.html#v3-ActCode-VET\">VET</a></td><td>veteran health program</td><td>**Definition:** Services provided directly and through contracted and operated veteran health programs.</td></tr><tr><td><a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-v3-ActCode.html#v3-ActCode-AUTOPOL\">AUTOPOL</a></td><td>automobile</td><td>Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.</td></tr><tr><td><a href=\"http://terminology.hl7.org/6.2.0/CodeSystem-v3-ActCode.html#v3-ActCode-MILITARY\">MILITARY</a></td><td>military health program</td><td>**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.<br/><br/>**Example:** In the U.S., TRICARE, CHAMPUS.</td></tr></table></li></ul></div>"
},
"url" : "http://fhir.geniesolutions.io/ValueSet/gs-coverage-type",
"version" : "1.2.35",
"name" : "GSCoverageType",
"title" : "Genie Coverage Type and Self Pay codes",
"status" : "active",
"experimental" : false,
"date" : "2025-03-02T12:29:52+10:00",
"publisher" : "Magentus Practice Management",
"contact" : [
{
"name" : "Magentus Practice Management",
"telecom" : [
{
"system" : "url",
"value" : "https://www.magentus.com/practice-management"
},
{
"system" : "email",
"value" : "andy.bond@magentus.com"
}
]
},
{
"name" : "Magentus Practice Management",
"telecom" : [
{
"system" : "url",
"value" : "https://www.magentus.com/practice-management",
"use" : "work"
}
]
}
],
"description" : "Genie Coverage Type and Self Pay codes",
"compose" : {
"include" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-selfpay",
"concept" : [
{
"code" : "pay",
"display" : "Pay"
}
]
},
{
"system" : "http://terminology.hl7.org.au/CodeSystem/coverage-selfpay",
"concept" : [
{
"code" : "payconc",
"display" : "Concession"
}
]
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"concept" : [
{
"code" : "PUBLICPOL",
"display" : "public healthcare"
},
{
"code" : "WCBPOL",
"display" : "workers compensation"
},
{
"code" : "HIP",
"display" : "health insurance plan policy"
},
{
"code" : "VET",
"display" : "veteran health program"
},
{
"code" : "AUTOPOL",
"display" : "automobile"
},
{
"code" : "MILITARY",
"display" : "military health program"
}
]
}
]
}
}