HL7 Terminology
2.0.0 - Publication
HL7 Terminology
2.0.0 - Publication
This page is part of the HL7 Terminology (v2.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions 
<ValueSet xmlns="http://hl7.org/fhir">
<id value="v3-CoveredPartyRoleType"/>
<language value="en"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><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">http://terminology.hl7.org/ValueSet/v3-ClaimantCoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href="ValueSet-v3-ProgramEligibleCoveredPartyRoleType.html">http://terminology.hl7.org/ValueSet/v3-ProgramEligibleCoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href="ValueSet-v3-IndividualInsuredCoveredPartyRoleType.html">http://terminology.hl7.org/ValueSet/v3-IndividualInsuredCoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href="ValueSet-v3-SubscriberCoveredPartyRoleType.html">http://terminology.hl7.org/ValueSet/v3-SubscriberCoveredPartyRoleType</a></li><li>Import all the codes that are contained in <a href="ValueSet-v3-DependentCoveredPartyRoleType.html">http://terminology.hl7.org/ValueSet/v3-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>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>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>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>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>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>
</text>
<url value="http://terminology.hl7.org/ValueSet/v3-CoveredPartyRoleType"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.1.11.19805"/>
</identifier>
<version value="2.0.0"/>
<name value="CoveredPartyRoleType"/>
<title value="CoveredPartyRoleType"/>
<status value="active"/>
<date value="2014-03-26"/>
<description
value="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.
**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.
**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."/>
<compose>
<include>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<filter>
<property value="concept"/>
<op value="is-a"/>
<value value="_CoveredPartyRoleType"/>
</filter>
</include>
<include>
<valueSet
value="http://terminology.hl7.org/ValueSet/v3-ClaimantCoveredPartyRoleType"/>
</include>
<include>
<valueSet
value="http://terminology.hl7.org/ValueSet/v3-ProgramEligibleCoveredPartyRoleType"/>
</include>
<include>
<valueSet
value="http://terminology.hl7.org/ValueSet/v3-IndividualInsuredCoveredPartyRoleType"/>
</include>
<include>
<valueSet
value="http://terminology.hl7.org/ValueSet/v3-SubscriberCoveredPartyRoleType"/>
</include>
<include>
<valueSet
value="http://terminology.hl7.org/ValueSet/v3-DependentCoveredPartyRoleType"/>
</include>
<exclude>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<concept>
<code value="_ClaimantCoveredPartyRoleType"/>
</concept>
</exclude>
<exclude>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<concept>
<code value="_ProgramEligiblePartyRoleType"/>
</concept>
</exclude>
<exclude>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<concept>
<code value="_IndividualInsuredPartyRoleType"/>
</concept>
</exclude>
<exclude>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<concept>
<code value="_SubscriberCoveredPartyRoleType"/>
</concept>
</exclude>
<exclude>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<concept>
<code value="_DependentCoveredPartyRoleType"/>
</concept>
</exclude>
</compose>
</ValueSet>
IG © 2020+ HL7 International - Vocabulary Work Group. Package hl7.terminology#2.0.0 based on FHIR 4.0.1. Generated 2020-11-07
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