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kenyaClaimsIG - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: KNHTS.CLMSRSP CodeSystem for claim response status - XML Representation

Draft as of 2024-09-06

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="KNHTS.CLMSRSPSTS"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem KNHTS.CLMSRSPSTS</b></p><a name="KNHTS.CLMSRSPSTS"> </a><a name="hcKNHTS.CLMSRSPSTS"> </a><a name="KNHTS.CLMSRSPSTS-en-US"> </a><p>This case-insensitive code system <code>https://shr.tiberbuapps.com/fhir/CodeSystem/KNHTS.CLMSRSPSTS</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">STS01<a name="KNHTS.CLMSRSPSTS-STS01"> </a></td><td>NEW</td><td>New Claims response</td></tr><tr><td style="white-space:nowrap">STS02<a name="KNHTS.CLMSRSPSTS-STS02"> </a></td><td>NOTIFIED</td><td>Identification done and payor notified</td></tr><tr><td style="white-space:nowrap">STS03<a name="KNHTS.CLMSRSPSTS-STS03"> </a></td><td>PREAUTHORIZED</td><td>Pre-authorization done.*</td></tr><tr><td style="white-space:nowrap">STS04<a name="KNHTS.CLMSRSPSTS-STS04"> </a></td><td>COMPLETE</td><td>Provider has checked that all requirements are met and the claim is ready for submission. Done at the end of a visit / after discharge.</td></tr><tr><td style="white-space:nowrap">STS05<a name="KNHTS.CLMSRSPSTS-STS05"> </a></td><td>CANCELLED</td><td>Cancelled at provider, before submission.</td></tr><tr><td style="white-space:nowrap">STS06<a name="KNHTS.CLMSRSPSTS-STS06"> </a></td><td>SUBMITTED</td><td>Submitted to payer.</td></tr><tr><td style="white-space:nowrap">STS07<a name="KNHTS.CLMSRSPSTS-STS07"> </a></td><td>RECEIVED</td><td>Received at payer.</td></tr><tr><td style="white-space:nowrap">STS08<a name="KNHTS.CLMSRSPSTS-STS08"> </a></td><td>APPROVED</td><td>Approved</td></tr><tr><td style="white-space:nowrap">STS09<a name="KNHTS.CLMSRSPSTS-STS09"> </a></td><td>REJECTED</td><td>The payer has indicated that the claim will not be paid.</td></tr><tr><td style="white-space:nowrap">STS10<a name="KNHTS.CLMSRSPSTS-STS10"> </a></td><td>PAID</td><td>The claim has been paid and the payee should expect to receive or have received  a remittance.</td></tr><tr><td style="white-space:nowrap">STS11<a name="KNHTS.CLMSRSPSTS-STS11"> </a></td><td>EXPIRED</td><td>Expired</td></tr><tr><td style="white-space:nowrap">STS12<a name="KNHTS.CLMSRSPSTS-STS12"> </a></td><td>QA</td><td>The claim is undergoing review.</td></tr></table></div>
  </text>
  <url value="https://shr.tiberbuapps.com/fhir/CodeSystem/KNHTS.CLMSRSPSTS"/>
  <version value="0.1.0"/>
  <name value="KNHTS_CLMS_RSP"/>
  <title value="KNHTS.CLMSRSP CodeSystem for claim response status"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2024-09-06T09:59:02+00:00"/>
  <publisher value="intellisoftkenya"/>
  <contact>
    <name value="intellisoftkenya"/>
    <telecom>
      <system value="url"/>
      <value value="http://example.org/example-publisher"/>
    </telecom>
  </contact>
  <description value="CodeSystem for KNHTS Claim status"/>
  <caseSensitive value="false"/>
  <content value="complete"/>
  <count value="12"/>
  <concept>
    <code value="STS01"/>
    <display value="NEW"/>
    <definition value="New Claims response"/>
  </concept>
  <concept>
    <code value="STS02"/>
    <display value="NOTIFIED"/>
    <definition value="Identification done and payor notified"/>
  </concept>
  <concept>
    <code value="STS03"/>
    <display value="PREAUTHORIZED"/>
    <definition value="Pre-authorization done.*"/>
  </concept>
  <concept>
    <code value="STS04"/>
    <display value="COMPLETE"/>
    <definition
                value="Provider has checked that all requirements are met and the claim is ready for submission. Done at the end of a visit / after discharge."/>
  </concept>
  <concept>
    <code value="STS05"/>
    <display value="CANCELLED"/>
    <definition value="Cancelled at provider, before submission."/>
  </concept>
  <concept>
    <code value="STS06"/>
    <display value="SUBMITTED"/>
    <definition value="Submitted to payer."/>
  </concept>
  <concept>
    <code value="STS07"/>
    <display value="RECEIVED"/>
    <definition value="Received at payer."/>
  </concept>
  <concept>
    <code value="STS08"/>
    <display value="APPROVED"/>
    <definition value="Approved"/>
  </concept>
  <concept>
    <code value="STS09"/>
    <display value="REJECTED"/>
    <definition
                value="The payer has indicated that the claim will not be paid."/>
  </concept>
  <concept>
    <code value="STS10"/>
    <display value="PAID"/>
    <definition
                value="The claim has been paid and the payee should expect to receive or have received  a remittance."/>
  </concept>
  <concept>
    <code value="STS11"/>
    <display value="EXPIRED"/>
    <definition value="Expired"/>
  </concept>
  <concept>
    <code value="STS12"/>
    <display value="QA"/>
    <definition value="The claim is undergoing review."/>
  </concept>
</CodeSystem>