HL7 Terminology (THO)
5.4.0 - Publication
This page is part of the HL7 Terminology (v5.4.0: Release) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Official URL: http://terminology.hl7.org/ValueSet/v3-xRoleClassPayeePolicyRelationship | Version: 3.0.0 | |||
Active as of 2014-03-26 | Responsible: Health Level Seven International | Computable Name: XRoleClassPayeePolicyRelationship | ||
Other Identifiers: id: Uniform Resource Identifier (URI)#urn:oid:2.16.840.1.113883.1.11.19395 | ||||
Copyright/Legal: 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 |
The specification of the relationship of the Payee to the invoice. Can be used in cases when an insurer is not directly paying the healthcare provider (as payee) but reimbursing the party that paid the invoice/claim.
References
This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)
http://terminology.hl7.org/CodeSystem/v3-RoleClass
Code | Display | Definition |
COVPTY | covered party | A role class played by a person who receives benefit coverage under the terms of a particular insurance policy. The underwriter of that policy is the scoping entity. The covered party receives coverage because of some contractual or other relationship with the holder of that policy. *Discussion:*This reason for coverage is captured in 'Role.code' and a relationship link with type code of indirect authority should be included using the policy holder role as the source, and the covered party role as the target. Note that a particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder. |
GUAR | guarantor | A person or organization (player) that serves as a financial guarantor for another person or organization (scoper). |
POLHOLD | policy holder | A role played by a person or organization that holds an insurance policy. The underwriter of that policy is the scoping entity. *Discussion:*The identifier of the policy is captured in 'Role.id' when the Role is a policy holder. A particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder. |
PROV | healthcare provider | An Entity (player) that is authorized to provide health care services by some authorizing agency (scoper). |
PRS | personal relationship | Links two entities with classCode PSN (person) in a personal relationship. The character of the relationship must be defined by a PersonalRelationshipRoleType code. The player and scoper are determined by PersonalRelationshipRoleType code as well. |
This value set contains 5 concepts
Expansion based on codesystem RoleClass v4.0.0 (CodeSystem)
Code | System | Display | Definition |
COVPTY | http://terminology.hl7.org/CodeSystem/v3-RoleClass | covered party | A role class played by a person who receives benefit coverage under the terms of a particular insurance policy. The underwriter of that policy is the scoping entity. The covered party receives coverage because of some contractual or other relationship with the holder of that policy. *Discussion:*This reason for coverage is captured in 'Role.code' and a relationship link with type code of indirect authority should be included using the policy holder role as the source, and the covered party role as the target. Note that a particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder. |
GUAR | http://terminology.hl7.org/CodeSystem/v3-RoleClass | guarantor | A person or organization (player) that serves as a financial guarantor for another person or organization (scoper). |
POLHOLD | http://terminology.hl7.org/CodeSystem/v3-RoleClass | policy holder | A role played by a person or organization that holds an insurance policy. The underwriter of that policy is the scoping entity. *Discussion:*The identifier of the policy is captured in 'Role.id' when the Role is a policy holder. A particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder. |
PROV | http://terminology.hl7.org/CodeSystem/v3-RoleClass | healthcare provider | An Entity (player) that is authorized to provide health care services by some authorizing agency (scoper). |
PRS | http://terminology.hl7.org/CodeSystem/v3-RoleClass | personal relationship | Links two entities with classCode PSN (person) in a personal relationship. The character of the relationship must be defined by a PersonalRelationshipRoleType code. The player and scoper are determined by PersonalRelationshipRoleType code as well. |
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 |
2023-11-14 | revise | Marc Duteau | TSMG | Add standard copyright and contact to internal content; up-476 |
2022-10-18 | revise | Marc Duteau | TSMG | Fixing missing metadata; up-349 |
2020-05-06 | revise | Ted Klein | Vocabulary WG | Migrated to the UTG maintenance environment and publishing tooling. |
2014-03-26 | revise | Vocabulary (Woody Beeler) (no record of original request) | 2014T1_2014-03-26_001283 (RIM release ID) | Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26 |