Polaris FHIR Implementation Guide
1.9.8 - ci-build

Polaris FHIR Implementation Guide - Local Development build (v1.9.8) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Extension: PayProgramExtension - FSH Source

Draft as of 2026-04-21

FSH source of the oscar-billing-pay-program-extension extension.

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Extension: PayProgramExtension
Id: oscar-billing-pay-program-extension
Title: "Pay Program Extension"
Description: "Oscar Pro pay_program code indicating the destination payer/program for this billing record. Values verified from multiple backend locations — see ValueSet description for per-code citations."
* ^url = "https://fhir.apps.health/StructureDefinition/oscar-billing-pay-program-extension"
* ^version = "1.0.0"
* ^status = #draft
* ^date = "2026-04-21"
* ^publisher = "Polaris FHIR Implementation Guide"
* ^contact.name = "Polaris FHIR Implementation Guide"
* ^contact.telecom.system = #url
* ^contact.telecom.value = "https://fhir.apps.health"
* ^jurisdiction = urn:iso:std:iso:3166#CA "Canada"
* ^context[0].type = #element
* ^context[0].expression = "Invoice"
* . ^short = "Oscar pay program code"
* . ^definition = """
The Oscar Pro pay_program code identifying the destination payer or program for this billing
record. Sourced from `billing_on_cheader1.pay_program`. Values with per-code citations:

- `HCP` — OHIP Health Care Program (default for Ontario patients; default value at `BillingONCHeader1.java:106`)
- `RMB` — Reciprocal Medical Billing (non-Ontario health card holders; set at `BillingONCHeader1Controller.java:162`)
- `PAT` — Patient (third-party / private pay; `BillingONCHeader1.java:74,76` — `BILLING_3RD_PARTY_TYPES` + `BILLING_PAY_PROGRAM_PAT`)
- `OCF` — Ontario Claim Form (`BillingONCHeader1.java:74`)
- `ODS` — ODS (`BillingONCHeader1.java:74`)
- `CPP` — Canada Pension Plan (`BillingONCHeader1.java:74` — note: distinct from Cumulative Patient Profile)
- `STD` — Short Term Disability (`BillingONCHeader1.java:74`)
- `IFH` — Interim Federal Health (`BillingONCHeader1.java:74,77` — `BILLING_PAY_PROGRAM_IFH`)
- `WCB` — Worker's Compensation Board (`BillingONCHeader1Repository.java:47`; also per `BillingStatus.BILL_WORKERS_COMPENSATION_BOARD` enum at `BillingONCHeader1.java:48`)

See MTG-071 v2.4 §4 for context and additional notes.
"""
* extension 0..0
* url 1..1
* value[x] 1..1 MS
* value[x] only code
* valueCode from OscarPayProgramVS (extensible)
* valueCode ^short = "Oscar pay_program code (one of the values in OscarPayProgramCS)"