HL7.TERMINOLOGY\RoleClassProgramEligible

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: RoleClassProgramEligible

Official URL: http://terminology.hl7.org/ValueSet/v3-RoleClassProgramEligible		Version: 2.0.0
Active as of 2014-03-26	Computable Name: RoleClassProgramEligible
Other Identifiers: : urn:oid:2.16.840.1.113883.1.11.20160

Description: A role played by a party that meets the eligibility criteria for coverage under a program. A program eligible may be either a person, non-person living subject, or an organization, or a group of persons, non-person living subjects, or organizations.

Discussion: A program as typically government administered coverage for parties determined eligible under the terms of the program.

Note: The party playing a program eligible is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants.

In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a “claim” under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits.

Example: A party meeting eligibility criteria related to health or financial status, e.g., in the U.S., persons meeting health, demographic, or financial criteria established by state and federal law are eligible for Medicaid.

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 PROG

Expansion

This value set contains 1 concepts

Expansion based on RoleClass v3.1.0 (CodeSystem)

Code	System	Display	Definition
PROG	http://terminology.hl7.org/CodeSystem/v3-RoleClass	program eligible	Description: A role played by a party that meets the eligibility criteria for coverage under a program. A program eligible may be either a person, non-person living subject, or an organization, or a group of persons, non-person living subjects, or organizations. Discussion: A program as typically government administered coverage for parties determined eligible under the terms of the program. Note: The party playing a program eligible is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants. In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits. Example: A party meeting eligibility criteria related to health or financial status, e.g., in the U.S., persons meeting health, demographic, or financial criteria established by state and federal law are eligible for Medicaid.

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