[WWW - 2023.07.31]

Data Element Detail

Episode of admitted patient care-health insurance fund code
Identifying and Definitional Attributes
QH 041524 v10
Data Element
Data Element
Draft
01-Dec-2015		Current
15-Feb-2016		Superseded
14-Aug-2016
Standard
01-Apr-2016
30-Jun-2016
The health insurance fund that the patient is a member of at the start of an episode of admitted patient care, as represented by a code.
Finance revenue - Private health insurance
Health insurance fund code
Health fund code
Representational Attributes
Numeric Character
Code
N(3)
3
3
For more codes contact Statistical Standards and Strategies, Statistical Services Branch (SSB).
Permissible Values

Permissible_values

A valid code from the Corporate Reference Data System (CRDS) Private health fund codes data set, version 10, maintained by Statistical Standards and Strategies, Health Statistics Unit.
Supplementary Values

Supplemenary_values

-
Collection and Usage Attributes
This data should be collected irrespective of whether the patient is admitted as a public or private patient or whether the patient intends to use the insurance for their admission.
A valid code for the patient's health insurance fund should be entered in HBCIS, particularly if their hospital insurance status is code 7 (Hospital insurance).
Health insurance fund information should only be provided where a patient has hospital level insurance with their health fund.

Queensland Hospital Admitted Patient Data Collection (QHAPDC):
Transmit via HBCIS extract: Enter the code for the health insurance fund which the patient is currently a member for their hospital insurance. At the time of admission to a facility, it is important to correctly identify and capture a patient's Hospital insurance status (appropriate hospital cover) and (where applicable) the Health insurance fund code.

Health insurance fund code is validated against the data item Hospital insurance status (Y/N).
- If Health insurance fund code is supplied from the range 001-888 or 998, then Hospital insurance status must be 'Y'.
- If Hospital insurance status is supplied as 'Y' then a valid Health insurance fund (001 - 888, 998) must be supplied.
- If Health insurance fund code is 997 (No private hospital insurance), then Hospital insurance status must be 'N'.
- If Hospital insurance status is supplied as 'N' then Health insurance fund code must be 997 (No private hospital insurance).

Hospital Based Corporate Information System (HBCIS):
When the code for 'Other health fund' is chosen, the "Please Specify" field becomes mandatory to enter free text. A space or spaces will not be acceptable as valid entry in the "Health Fund Code", however, are acceptable in the "Please Specify" field. Any health insurance fund identified through the use of code "other" will provide the opportunity to add new codes to the health insurance fund reference file in future versions.
The Revenue Strategy and Support Unit utilise health insurance fund information for the purpose of optimising health fund revenue.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 6
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
SupersedesData ElementData ElementEpisode of admitted patient care-health insurance fund codeQH 041524 Version 9Superseded
Has been superseded byData ElementData ElementEpisode of admitted patient care-health insurance fund codeQH 041524 Version 11Superseded
Is qualified byData ElementDerived Data ElementPatient-hospital insurance status (QHAPDC)QH 040020 Version 3Current
Is supplemented byData ElementData ElementEpisode of admitted patient care-health insurance fund abbreviationQH 041525 Version 9Superseded
Relates toData ElementData Element ConceptEpisode of admitted patient careQH 041604 Version 1Current
Relates toData ElementData Element ConceptHealth insurance fundQH 041530 Version 1Current
Implementation in Metadata Sets

Implemented

  • 1 - 1
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionQueensland Hospital Admitted Patient Data Collection (QHAPDC)QH 020001 Version 1ConditionalSuperseded01-Apr-201630-Jun-2016
Source and Reference Attributes
Funding; Health fund; Hospital insurance; Insurance fund;