|
| The source of payment (SOP) code from an external billing or registration system. |
| May contain organization-specific values: No |
| Category Entries: |
| MEDICARE |
| MEDICAID |
| OTHER GOVERNMENT (Federal/State/Local) (excluding Department of Corrections) |
| DEPARTMENTS OF CORRECTIONS |
| PRIVATE HEALTH INSURANCE |
| BLUE CROSS/BLUE SHIELD |
| MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private) |
| NO PAYMENT from an Organization/Agency/Program/Private Payer Listed |
| MISCELLANEOUS/OTHER |
| Medicare (Managed Care) |
| Medicare (Non-managed Care) |
| Medicare Hospice |
| Dual Eligibility Medicare/Medicaid Organization |
| Medicare Other |
| Medicaid (Managed Care) |
| Medicaid (Non-managed Care Plan) |
| Medicaid/SCHIP |
| Medicaid Applicant |
| Medicaid - Out of State |
| Medicaid - Long Term Care |
| Medicaid Other |
| Department of Defense |
| Department of Veterans Affairs |
| Indian Health Service or Tribe |
| HRSA Program |
| Black Lung |
| State Government |
| Local Government |
| Other Government (Federal, State, Local not specified) |
| Other Federal |
| Corrections Federal |
| Corrections State |
| Corrections Local |
| Corrections Unknown Level |
| Managed Care (Private) |
| Private Health Insurance - Indemnity |
| Managed Care (private) or PHI (indemnity), not specified |
| Organized Delivery System |
| Small Employer Purchasing Group |
| Specialized Stand Alone Plan |
| Other Private Insurance |
| BC Managed Care |
| BC Insurance Indemnity |
| BC (Indemnity or Managed Care) - Out of State |
| BC (Indemnity or Managed Care) - Unspecified |
| BC (Indemnity or Managed Care) - Other |
| Managed Care - HMO |
| Managed Care - PPO |
| Managed Care - POS |
| Other Managed Care |
| Self-pay (Includes applicants for insurance and Medicaid applicants) |
| No Charge |
| Refusal to Pay/Bad Debt |
| Hill Burton Free Care |
| Research/Donor |
| No Payment, Other |
| Foreign National |
| Other (Non-government) |
| Disability Insurance |
| Long-term Care Insurance |
| Worker's Compensation |
| Auto Insurance (includes no fault) |
| Legal Liability / Liability Insurance |
| Other specified but not otherwise classifiable (includes Hospice - Unspecified plan) |
| No Typology Code available for payment source |
| Medicare HMO |
| Medicare PPO |
| Medicare POS |
| Medicare Managed Care Other |
| Medicare FFS |
| Medicare Drug Benefit |
| Medicare Medical Savings Account (MSA) |
| Medicare Non-managed Care Other |
| Dual Eligible Special Needs Plan |
| Fully Integrated Dual Eligible Special Needs Plan |
| Medicare Pharmacy Benefit Manager |
| Medicaid HMO |
| Medicaid PPO |
| Medicaid PCCM (Primary Care Case Management) |
| Medicaid Managed Care Other |
| Medicaid Pharmacy Benefit Manager |
| Medicaid - Dental |
| TRICARE (CHAMPUS) |
| Military Treatment Facility |
| Dental --Stand Alone |
| Veteran care--Care provided to Veterans |
| Non-veteran care |
| Indian Health Service - Regular |
| Indian Health Service - Contract |
| Indian Health Service - Managed Care |
| Indian Tribe - Sponsored Coverage |
| Title V (MCH Block Grant) |
| Migrant Health Program |
| Ryan White Act |
| Disaster-related (includes Covid-19) |
| Other |
| State SCHIP program (codes for individual states) |
| Specific state programs (list/ local code) |
| State, not otherwise specified (other state) |
| Local - Managed care |
| FFS/Indemnity |
| Local, not otherwise specified (other local, county) |
| Federal, State, Local not specified managed care |
| Federal, State, Local not specified - FFS |
| Federal, State, Local not specified - Other |
| Federal Employee Health Plan - Use when known |
| Commercial Managed Care - HMO |
| Commercial Managed Care - PPO |
| Commercial Managed Care - POS |
| Exclusive Provider Organization |
| Gatekeeper PPO (GPPO) |
| Commercial Managed Care - Pharmacy Benefit Manager |
| Commercial Managed Care - Dental |
| Managed Care, Other (non HMO) |
| Commercial Indemnity |
| Self-insured (ERISA) Administrative Services Only (ASO) plan |
| Medicare supplemental policy (as second payer) |
| Indemnity Insurance - Dental |
| Private health insurance--other commercial Indemnity |
| Dental |
| Vision |
| BC Managed Care - HMO |
| BC Managed Care - PPO |
| BC Managed Care - POS |
| BC Managed Care - Dental |
| BC Managed Care - Other |
| BC Indemnity |
| BC Self-insured (ERISA) Administrative Services Only (ASO)Plan |
| BC Medicare Supplemental Plan |
| BC Indemnity - Dental |
| Charity |
| Professional Courtesy |
| Research/Clinical Trial |
| Worker's Comp HMO |
| Worker's Comp Fee-for-Service |
| Worker's Comp Other Managed Care |
| Worker's Comp, Other unspecified |
| Medicare Chronic Condition Special Needs Plan |
| Medicare Institutional Special Needs Plan |
| TRICARE Prime--HMO |
| TRICARE Extra--PPO |
| TRICARE Standard - Fee For Service |
| TRICARE For Life--Medicare Supplement |
| TRICARE Reserve Select |
| Uniformed Services Family Health Plan (USFHP) -- HMO |
| Department of Defense - (other) |
| Enrolled Prime--HMO |
| Non-enrolled Space Available |
| TRICARE For Life (TFL) |
| Direct Care--Care provided in VA facilities |
| Indirect Care--Care provided outside VA facilities |
| Civilian Health and Medical Program for the VA (CHAMPVA) |
| Spina Bifida Health Care Program (SB) |
| Children of Women Vietnam Veterans (CWVV) |
| Other non-veteran care |
| Local Government - HMO |
| Local Government - PPO |
| Local Government - POS |
| Federal, State, Local not specified - HMO |
| Federal, State, Local not specified - PPO |
| Federal, State, Local not specified - POS |
| Federal, State, Local not specified - not specified managed care |
| Unavailable / No Payer Specified / Blank |
| Fee Basis |
| Foreign Fee/Foreign Medical Program (FMP) |
| Contract Nursing Home/Community Nursing Home |
| State Veterans Home |
| Sharing Agreements |
| Other Federal Agency |
| Dental Care |
| Vision Care |
