Id2.16.840.1.113883.1.11.19906Effective Date2011‑07‑26
Statusfinal FinalVersion LabelDEFN=UV=VO=1099-20110726
NamePayorParticipationFunctionDisplay NamePayorParticipationFunction
Descriptiondescription:

Definition: Set of codes indicating the manner in which payors participate in a policy or program.</

Source Code System
2.16.840.1.113883.5.88 - Participation Function - FHIR: http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction
Level/ TypeCodeDisplay NameCode System
0‑A
_PayorParticipationFunction
PayorParticipationFunction
Participation Function
1‑L
CLMADJ
claims adjudication
Participation Function
1‑L
ENROLL
enrollment broker
Participation Function
1‑L
FFSMGT
ffs management
Participation Function
1‑L
MCMGT
managed care management
Participation Function
1‑L
PROVMGT
provider management
Participation Function
1‑L
UMGT
utilization management
Participation Function
Legenda: Type L=leaf, S=specializable, A=abstract, D=deprecated. NullFlavor OTH (other) suggests text in originalText. HL7 V3: NullFlavors to appear in @nullFlavor attribute instead of @code.
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