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13.4.5 13.4.6 Resource EnrollmentRequest - Detailed Descriptions

Responsible Owner: Financial Management icon Work Group   Trial Use Maturity Level : 0   Draft Security Category : Patient Compartments : Group , Patient

Detailed Descriptions for the elements in the EnrollmentRequest resource.

Control Control Control Control EnrollmentRequest.subject Control
EnrollmentRequest
Definition Element Id EnrollmentRequest
Definition

This resource provides the insurance enrollment details to the insurer regarding a specified coverage.

Short Display Enroll in coverage
Cardinality 0..*
1..1 Type DomainResource
Summary false
EnrollmentRequest.identifier
Definition Element Id EnrollmentRequest.identifier
Definition

The Response business identifier.

Note Short Display Business Identifier
Note This is a business identifer, identifier, not a resource identifier (see discussion )
Control Cardinality 0..*
Type Identifier
Summary false
EnrollmentRequest.status
Definition Element Id EnrollmentRequest.status
Definition

The status of the resource instance.

Short Display active | cancelled | draft | entered-in-error
Cardinality 0..1
Terminology Binding Financial Resource Status Codes ( Required )
Type code
Is Modifier true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summary true
Comments

This element is labeled as a modifier because the status contains codes that mark the request as not currently valid.

EnrollmentRequest.created
Definition Element Id EnrollmentRequest.created
Definition

The date when this resource was created.

Short Display Creation date
Control Cardinality 0..1
Type dateTime
Summary false
EnrollmentRequest.insurer
Definition Element Id EnrollmentRequest.insurer
Definition

The Insurer who is target of the request.

Short Display Target
Cardinality 0..1
Type Reference ( Organization )
Summary false
EnrollmentRequest.provider
Definition Element Id EnrollmentRequest.provider
Definition

The practitioner who is responsible for the services rendered to the patient.

Short Display Responsible practitioner
Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole | Organization )
Summary EnrollmentRequest.organization Definition The organization which is responsible for the services rendered to the patient. false
Control 0..1 EnrollmentRequest.candidate Type Reference ( Organization )
Element Id EnrollmentRequest.candidate
Definition

Patient Resource. The subject or group of subjects to be enrolled.

Short Display The subject(s)to be enrolled
Cardinality 0..1
Type Reference ( Patient | Group )
Summary false
EnrollmentRequest.coverage
Definition Element Id EnrollmentRequest.coverage
Definition

Reference to the program or plan identification, underwriter or payor.

Short Display Insurance information
Control Cardinality 0..1
Type Reference ( Coverage )
Requirements

Need to identify the issuer to target for processing and for coordination of benefit processing.

Summary false