HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v6.0.2: Release) based on FHIR (HL7® FHIR® Standard) v5.0.0. This is the current published version. For a full list of available versions, see the Directory of published versions

: CoveredPartyRoleType - JSON Representation

Active as of 2014-03-26

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{
  "resourceType" : "ValueSet",
  "id" : "v3-CoveredPartyRoleType",
  "language" : "en",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet v3-CoveredPartyRoleType</b></p><a name=\"v3-CoveredPartyRoleType\"> </a><a name=\"hcv3-CoveredPartyRoleType\"> </a><a name=\"v3-CoveredPartyRoleType-en-US\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p></div><p>This value set includes codes based on the following rules:</p><ul><li>Include codes from<a href=\"CodeSystem-v3-RoleCode.html\"><code>http://terminology.hl7.org/CodeSystem/v3-RoleCode</code></a> where concept  is-a <a href=\"CodeSystem-v3-RoleCode.html#v3-RoleCode-_CoveredPartyRoleType\">_CoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href=\"ValueSet-v3-ClaimantCoveredPartyRoleType.html\">ClaimantCoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href=\"ValueSet-v3-ProgramEligibleCoveredPartyRoleType.html\">ProgramEligibleCoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href=\"ValueSet-v3-IndividualInsuredCoveredPartyRoleType.html\">IndividualInsuredCoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href=\"ValueSet-v3-SubscriberCoveredPartyRoleType.html\">SubscriberCoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href=\"ValueSet-v3-DependentCoveredPartyRoleType.html\">DependentCoveredPartyRoleType</a></li></ul><p>This value set excludes codes based on the following rules:</p><ul><li>Exclude these codes as defined in <a href=\"CodeSystem-v3-RoleCode.html\"><code>http://terminology.hl7.org/CodeSystem/v3-RoleCode</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-v3-RoleCode.html#v3-RoleCode-_ClaimantCoveredPartyRoleType\">_ClaimantCoveredPartyRoleType</a></td><td style=\"color: #cccccc\">ClaimantCoveredPartyRoleType</td><td>**Description**A role recognized through the eligibility of a party play a claimant for benefits covered or provided under an insurance policy.</td></tr></table></li><li>Exclude these codes as defined in <a href=\"CodeSystem-v3-RoleCode.html\"><code>http://terminology.hl7.org/CodeSystem/v3-RoleCode</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-v3-RoleCode.html#v3-RoleCode-_ProgramEligiblePartyRoleType\">_ProgramEligiblePartyRoleType</a></td><td style=\"color: #cccccc\">ProgramEligiblePartyRoleType</td><td>**Description:**A role recognized through the eligibility of a party to play a program eligible for benefits covered or provided under a program.</td></tr></table></li><li>Exclude these codes as defined in <a href=\"CodeSystem-v3-RoleCode.html\"><code>http://terminology.hl7.org/CodeSystem/v3-RoleCode</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-v3-RoleCode.html#v3-RoleCode-_IndividualInsuredPartyRoleType\">_IndividualInsuredPartyRoleType</a></td><td style=\"color: #cccccc\">IndividualInsuredPartyRoleType</td><td>A role recognized through the eligibility of a party to play an individual insured for benefits covered or provided under an insurance policy where the party is also the policy holder.</td></tr></table></li><li>Exclude these codes as defined in <a href=\"CodeSystem-v3-RoleCode.html\"><code>http://terminology.hl7.org/CodeSystem/v3-RoleCode</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-v3-RoleCode.html#v3-RoleCode-_SubscriberCoveredPartyRoleType\">_SubscriberCoveredPartyRoleType</a></td><td style=\"color: #cccccc\">SubscriberCoveredPartyRoleType</td><td>**Description:** A role recognized through the eligibility of a party to play a subscriber for benefits covered or provided under a health insurance policy.</td></tr></table></li><li>Exclude these codes as defined in <a href=\"CodeSystem-v3-RoleCode.html\"><code>http://terminology.hl7.org/CodeSystem/v3-RoleCode</code></a><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-v3-RoleCode.html#v3-RoleCode-_DependentCoveredPartyRoleType\">_DependentCoveredPartyRoleType</a></td><td style=\"color: #cccccc\">DependentCoveredPartyRoleType</td><td>**Description:** A role recognized through the eligibility of a party to play a dependent for benefits covered or provided under a health insurance policy because of an association with the subscriber that is recognized by the policy underwriter.</td></tr></table></li></ul></div>"
  },
  "url" : "http://terminology.hl7.org/ValueSet/v3-CoveredPartyRoleType",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.1.11.19805"
    }
  ],
  "version" : "3.0.0",
  "name" : "CoveredPartyRoleType",
  "title" : "CoveredPartyRoleType",
  "status" : "active",
  "experimental" : false,
  "date" : "2014-03-26",
  "publisher" : "Health Level Seven International",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org"
        },
        {
          "system" : "email",
          "value" : "hq@HL7.org"
        }
      ]
    }
  ],
  "description" : "A role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program. Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder.\r\n\r\n**Example:**An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent.\r\n\r\n**Discussion:** The Abstract Value Set \"CoverageRoleType\", which was developed for use in the Canadian realm \"pre-coordinate\" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., \"handicapped dependent\". Other codes in the Abstract Value Set CoveredPartyRoleType domain can be \"post-coordinated\" with the EligiblePartyRoleType codes to denote comparable concepts. Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.",
  "copyright" : "This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html",
  "compose" : {
    "include" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "filter" : [
          {
            "property" : "concept",
            "op" : "is-a",
            "value" : "_CoveredPartyRoleType"
          }
        ]
      },
      {
        "valueSet" : [
          🔗 "http://terminology.hl7.org/ValueSet/v3-ClaimantCoveredPartyRoleType"
        ]
      },
      {
        "valueSet" : [
          🔗 "http://terminology.hl7.org/ValueSet/v3-ProgramEligibleCoveredPartyRoleType"
        ]
      },
      {
        "valueSet" : [
          🔗 "http://terminology.hl7.org/ValueSet/v3-IndividualInsuredCoveredPartyRoleType"
        ]
      },
      {
        "valueSet" : [
          🔗 "http://terminology.hl7.org/ValueSet/v3-SubscriberCoveredPartyRoleType"
        ]
      },
      {
        "valueSet" : [
          🔗 "http://terminology.hl7.org/ValueSet/v3-DependentCoveredPartyRoleType"
        ]
      }
    ],
    "exclude" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "concept" : [
          {
            "code" : "_ClaimantCoveredPartyRoleType"
          }
        ]
      },
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "concept" : [
          {
            "code" : "_ProgramEligiblePartyRoleType"
          }
        ]
      },
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "concept" : [
          {
            "code" : "_IndividualInsuredPartyRoleType"
          }
        ]
      },
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "concept" : [
          {
            "code" : "_SubscriberCoveredPartyRoleType"
          }
        ]
      },
      {
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "concept" : [
          {
            "code" : "_DependentCoveredPartyRoleType"
          }
        ]
      }
    ]
  }
}