Id2.16.840.1.113883.1.11.19853Effective Date2014‑03‑26
Statusfinal FinalVersion LabelDEFN=UV=VO=1360-20160323
NamePayorRoleTypeDisplay NamePayorRoleType
Description

History description 2014-03-26: Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26

description:

Description: PayorRoleType for a particular type of policy or program benefit package or plan where more detail about the coverage administration role of the Payor is required. The functions performed by a Payor qualified by a PayorRoleType may be specified by the PayorParticpationFunction value set.

Examples: A Payor that is a TPA may administer a managed care plan without underwriting the risk.

Source Code System
2.16.840.1.113883.5.111 - Role Code - FHIR: http://terminology.hl7.org/CodeSystem/v3-RoleCode - HL7 V2: ROLECODE
Level/ TypeCodeDisplay NameCode System
0‑A
_PayorRoleType
PayorRoleType
Role Code
1‑L
ENROLBKR
Enrollment Broker
Role Code
1‑L
TPA
Third party administrator
Role Code
1‑L
UMO
Utilization management organization
Role Code

Legenda: Type L=leaf, S=specializable, A=abstract, D=deprecated. NullFlavor OTH (other) suggests text in originalText. HL7 V3: NullFlavors to appear in @nullFlavor attribute instead of @code.
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