Payer Typology Sub-Committee

Purpose

The Source of Payment Typology was developed and is maintained by the Public Health Data Standards Consortium's Payer Type Subcommittee. The purpose of the Payer Typology Subcommittee is to create and refine a standard to allow consistent reporting of payer data to public health agencies for health care services and research. The existing system of payer categories for claims data still exist and can be used for billing needs. However, these are currently neither mutually exclusive nor comprehensive because they were not created for research or policy purposes. With the development of the Source of Payment Typology there is an additional standard for use by those collecting data or analyzing health care information. The Source of Payment Typology is accepted by the following major standard setting organizations:

• The Source of Payment Typology is referenced as an external code list to the ANSI X12 standards. This value set will be included for reporting in all 837 guides starting with the publication of the draft set of ANSI X12 implementation guides (6020).
  • However, until the publication of the next set of guides, organizations that need or want to implement the Source of Payment Typology in 4010 and 5010 guides can use the File Information (K3) segment.
• Health Level 7 (HL7) recognizes the Source of Payment Typology with an Object Identifier Definition (OID) of 2.16.840.1.113883.221.5, for use in HL7 messaging standards.
• The Source of Payment Typology is recognized as an external value set in the HL7 standards with an Object Identifier Definition (OID) of 2.16.840.1.113883.221.5, for use in HL7 messaging standards.
• The Source of Payment Typology was adopted by the National Uniform Billing Committee (NUBC) and the UB-04 specification's document has been updated to include reference to the Source of Payment Typology in the part of the UB form that identifies external code lists. This was effective July 1, 2009.

Activities

Source of Payment Typology Code Set Implementation by States

Source of Payment Typology 3.0

Source of Payment Typology 4.0

Source of Payment Typology Guide 4.0

Payer Typology Implementation Pilot Projects

Events

Coordination and Maintenance Committee for the Source of Payment Typology Teleconferences

Products

The New York State Department of Health is now using the PHDSC Payer Typology. Read the letter here

Source of Payment Typology Code Set Implementation by States

Source of Payment Typology 3.0

Source of Payment Typology 4.0

Source of Payment Typology Guide 4.0

Users Guide for Source of Payment Typology

Archives

Chair

Amy Bernstein, ScD
Chief
Analytic Studies Branch, Office of Analysis & Epidemiology
National Center for Health Statistics
ABernstein@cdc.gov

Committee Members

Committee Wiki Pages

Become a Committee Member

Please e-mail the chair
with a request to become a committee member.

Important Terms¹

ACCREDITED STANDARDS COMMITTEE X12 develops standards to facilitate electronic interchange relating to business transactions data associated with the provision of products and services

HEALTH CARE CLAIM 837 supports the administrative reimbursement processing as it relates to the submission of health care claims for both health care products and services.

¹ adapted from HIPAAnet.com, 2008