FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5
0.0.1-snapshot-2 - informative International flag

FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 - Version 0.0.1-snapshot-2. See the Directory of published versions

ValueSet: Cross-version VS for R5.XRoleClassPayeePolicyRelationship for use in FHIR R4

Official URL: http://hl7.org/fhir/5.0/ValueSet/R5-v3-xRoleClassPayeePolicyRelationship-for-R4 Version: 0.0.1-snapshot-2
Standards status: Informative Maturity Level: 0 Computable Name: R5_v3_xRoleClassPayeePolicyRelationship_for_R4

This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-xRoleClassPayeePolicyRelationship 2.0.0 for use in FHIR R4. Concepts not present here have direct equivalent mappings crossing all versions from R5 to R4.

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 these codes as defined in http://terminology.hl7.org/CodeSystem/v3-RoleClass version 3.1.0
    CodeDisplayDefinition
    COVPTYcovered partyA 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.
    GUARguarantorA person or organization (player) that serves as a financial guarantor for another person or organization (scoper).
    POLHOLDpolicy holderA 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.
    PROVhealthcare providerAn Entity (player) that is authorized to provide health care services by some authorizing agency (scoper).
    PRSpersonal relationshipLinks 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.

 

Expansion

This value set expansion contains 5 concepts.

CodeSystemDisplayDefinition
  COVPTYhttp://terminology.hl7.org/CodeSystem/v3-RoleClasscovered 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.

  GUARhttp://terminology.hl7.org/CodeSystem/v3-RoleClassguarantor

A person or organization (player) that serves as a financial guarantor for another person or organization (scoper).

  POLHOLDhttp://terminology.hl7.org/CodeSystem/v3-RoleClasspolicy 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.

  PROVhttp://terminology.hl7.org/CodeSystem/v3-RoleClasshealthcare provider

An Entity (player) that is authorized to provide health care services by some authorizing agency (scoper).

  PRShttp://terminology.hl7.org/CodeSystem/v3-RoleClasspersonal 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