This case-sensitive code system http://terminology.hl7.org/CodeSystem/applicability defines the following codes: 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
Whether the cost applies to in-network or out-of-network providers.
This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license
Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates