{ "description": "Describes the various amount fields used when payers receive and adjudicate a claim. It complements the values defined in http://terminology.hl7.org/CodeSystem/adjudication.", "_filename": "CodeSystem-PCTAdjudication.json", "package_name": "hl7.fhir.us.davinci-pct", "date": "2023-03-30T13:34:22+00:00", "publisher": "HL7 International - Financial Management Work Group", "jurisdiction": [ { "coding": [ { "code": "US", "system": "urn:iso:std:iso:3166" } ] } ], "content": "complete", "name": "PCTAdjudication", "copyright": "This CodeSystem is not copyrighted.", "type": null, "experimental": "false", "resourceType": "CodeSystem", "title": "PCT Adjudication Code System", "package_version": "1.0.0", "status": "active", "id": "91c38291-3dff-4982-bbba-0298a7d71524", "kind": null, "count": 4, "url": "http://hl7.org/fhir/us/davinci-pct/CodeSystem/PCTAdjudication", "concept": [ { "code": "coinsurance", "display": "Co-insurance", "definition": "The amount the insured individual pays, as a set percentage of the cost of covered medical services, as an out-of-pocket payment to the provider. Example: Insured pays 20% and the insurer pays 80%." }, { "code": "noncovered", "display": "Noncovered", "definition": "The portion of the cost of this service that was deemed not eligible by the insurer because the service or member was not covered by the subscriber contract." }, { "code": "memberliability", "display": "Member liability", "definition": "The amount of the member's liability." }, { "code": "discount", "display": "Discount", "definition": "The amount of the discount" } ], "caseSensitive": true, "version": "1.0.0", "contact": [ { "name": "HL7 International - Financial Management Work Group", "telecom": [ { "value": "http://hl7.org/Special/committees/fm", "system": "url" }, { "value": "fmlists@lists.hl7.org", "system": "email" } ] } ] }