HL7 Terminology (THO)
5.0.0 - Publication
HL7 Terminology (THO)
5.0.0 - Publication
This page is part of the HL7 Terminology (v5.0.0: 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 
| Active as of 2014-03-26 |
{
"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>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>"
},
"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" : "2.0.0",
"name" : "CoveredPartyRoleType",
"title" : "CoveredPartyRoleType",
"status" : "active",
"experimental" : false,
"date" : "2014-03-26",
"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.",
"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"
}
]
}
]
}
}
IG © 2020+ HL7 International - Vocabulary Work Group. Package hl7.terminology#5.0.0 based on FHIR 4.0.1. Generated 2022-11-04
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