HL7.TERMINOLOGY\RoleClassDependent

HL7 Terminology (THO)
5.0.0 - Publication International flag

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

ValueSet: RoleClassDependent

Official URL: http://terminology.hl7.org/ValueSet/v3-RoleClassDependent		Version: 2.0.0
Active as of 2014-03-26	Computable Name: RoleClassDependent
Other Identifiers: : urn:oid:2.16.840.1.113883.1.11.20128

Description: A role played by a person covered under a policy or program based on an association with a subscriber, which is recognized by the policy holder.

Note: The party playing the role of a dependent is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a dependent may make a claim under a policy, e.g., a dependent under a health insurance policy may become the claimant for coverage under that policy for wellness examines or if injured and there is no liable third party. In the case of a dependent making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that the dependent has filed a claim for services covered under the health insurance policy.

Example: The dependent has an association with the subscriber such as a financial dependency or personal relationship such as that of a spouse, or a natural or adopted child. The policy holder may be required by law to recognize certain associations or may have discretion about the associations. For example, a policy holder may dictate the criteria for the dependent status of adult children who are students, such as requiring full time enrollment, or may recognize domestic partners as dependents. Under certain circumstances, the dependent may be under the indirect authority of a responsible party acting as a surrogate for the subscriber, for example, if the subscriber is differently abled or deceased, a guardian ad Lidem or estate executor may be appointed to assume the subscriberaTMs legal standing in the relationship with the dependent.

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

Include codes from http://terminology.hl7.org/CodeSystem/v3-RoleClass where concept is-a DEPEN

Expansion

This value set contains 1 concepts

Expansion based on RoleClass v3.1.0 (CodeSystem)

Code	System	Display	Definition
DEPEN	http://terminology.hl7.org/CodeSystem/v3-RoleClass	dependent	Description: A role played by a person covered under a policy or program based on an association with a subscriber, which is recognized by the policy holder. Note: The party playing the role of a dependent is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a dependent may make a claim under a policy, e.g., a dependent under a health insurance policy may become the claimant for coverage under that policy for wellness examines or if injured and there is no liable third party. In the case of a dependent making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that the dependent has filed a claim for services covered under the health insurance policy. Example: The dependent has an association with the subscriber such as a financial dependency or personal relationship such as that of a spouse, or a natural or adopted child. The policy holder may be required by law to recognize certain associations or may have discretion about the associations. For example, a policy holder may dictate the criteria for the dependent status of adult children who are students, such as requiring full time enrollment, or may recognize domestic partners as dependents. Under certain circumstances, the dependent may be under the indirect authority of a responsible party acting as a surrogate for the subscriber, for example, if the subscriber is differently abled or deceased, a guardian ad Lidem or estate executor may be appointed to assume the subscriberaTMs legal standing in the relationship with the dependent.

Explanation of the columns that may appear on this page:

Level

A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies

System

The source of the definition of the code (when the value set draws in codes defined elsewhere)

Code

The code (used as the code in the resource instance)

Display

The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application

Definition

An explanation of the meaning of the concept

Comments

Additional notes about how to use the code

History

Date

Action

Author

Custodian

Comment

2022-10-18

revise