Advanced Beneficiary Notice Code (2.3.1 - 1.0.0) Released for Managing Payment Consent Status
CodeSystem: Advanced Beneficiary Notice Code (2.3.1 - 1.0.0) (Experimental) hl7.eu
HL7 published an experimental CodeSystem for the Advanced Beneficiary Notice Code (2.3.1 - 1.0.0).
Summary
HL7 has released a new code system, the "Advanced Beneficiary Notice Code (2.3.1 - 1.0.0)", designed to specify the consent status of patients or their representatives regarding payment responsibility. This aims to satisfy medical necessity requirements for outpatient services in the United States.
Key Players
Details
This code system defines concepts specifying the status of a patient's or representative's consent for financial responsibility concerning potentially uninsured services. It addresses key elements such as whether associated diagnosis codes are subject to medical necessity procedures, if the patient has been informed about potential payment responsibility, and if they agree to be billed for the service. This information is intended for use in HL7 Version 2.x messaging within the ORC and FT1 segments. The system was introduced specifically to meet CMS Medical Necessity requirements for outpatient services in the United States. The defined codes include statuses such as 'Service is subject to medical necessity procedures' and 'Patient has been informed of responsibility, and agrees to pay for service.' By standardizing this process, it helps electronically record the financial and legal agreement before care delivery, thereby enhancing continuity of care and billing accuracy. This technical reference provides a structured way to manage complex patient consent and payment agreements within interoperable healthcare systems.
Technology Note
FHIR（Fast Healthcare Interoperability Resources）は医療データ交換の国際標準。このエントリの関連技術: HL7
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