DSTU2 STU 3 Candidate
This page is part of the FHIR Specification (v1.0.2: DSTU 2). The current version which supercedes this version is

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . For a full list of available versions, see the Directory of published versions . Page versions: . Page versions: R5 R4B R4 R3 R2

7.7 Resource EnrollmentRequest - Content Resource EnrollmentRequest - Content This resource is marked as a draft

This resource is marked as a draft .

This resource provides the insurance enrollment details to the insurer regarding a specified coverage.
Financial Management Financial Management Work Group Work Group Maturity Level : 0 Maturity Level : 0 Compartments : : Patient

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

7.7.1 Scope and Usage Scope and Usage

This resource has not yet undergone proper review by FM. At this time, it is to be considered as a draft. This resource has not yet undergone proper review by FM. At this time, it is to be considered as a draft. The EnrollmentRequest resource allows for the addition and removal of plan subscribers and their dependents to health insurance coverage. Todo This resource is referenced by

The EnrollmentRequest resource allows for the addition and removal of plan subscribers and their dependents to health insurance coverage.

Todo

This resource is referenced by enrollmentresponse

7.7.2 Resource Content Resource Content

Structure

Name Flags Card. Type Description & Constraints Description & Constraints doco
. . EnrollmentRequest Σ DomainResource Enrollment request Enrollment request
. . . identifier Σ 0..* Identifier Business Identifier Business Identifier
. . . ruleset Σ 0..1 Coding Resource version Resource version
Ruleset Codes ( Ruleset Codes ( Example )
. . . originalRuleset Σ 0..1 Coding Original version Original version
Ruleset Codes ( Ruleset Codes ( Example )
. . . created Σ 0..1 dateTime Creation date Creation date
. . . target Σ 0..1 Reference ( Organization ) Insurer
. . . provider Σ 0..1 Reference ( Practitioner ) Responsible practitioner Responsible practitioner
. . . organization Σ 0..1 Reference ( Organization ) Responsible organization Responsible organization
. . . subject Σ 1..1 Reference ( Patient ) The subject of the Products and Services The subject of the Products and Services
. . . coverage Σ 1..1 Reference ( Coverage ) Insurance information Insurance information
. . . relationship Σ 1..1 Coding Patient relationship to subscriber Patient relationship to subscriber
Surface Codes ( Beneficiary Relationship Codes ( Example )

Documentation for this format doco Documentation for this format

UML Diagram UML Diagram

EnrollmentRequest ( ( DomainResource ) The Response business identifier The Response business identifier identifier : : Identifier [0..*] [0..*] The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources ruleset : : Coding [0..1] « [0..1] « The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example) The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example) Ruleset ?? » Ruleset ?? » The style (standard) and version of the original material which was converted into this resource The style (standard) and version of the original material which was converted into this resource originalRuleset : : Coding [0..1] « [0..1] « The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example) The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example) Ruleset ?? » Ruleset ?? » The date when this resource was created The date when this resource was created created : : dateTime [0..1] [0..1] The Insurer who is target of the request The Insurer who is target of the request target : : Reference [0..1] « [0..1] « Organization » » The practitioner who is responsible for the services rendered to the patient The practitioner who is responsible for the services rendered to the patient provider : : Reference [0..1] « [0..1] « Practitioner » » The organization which is responsible for the services rendered to the patient The organization which is responsible for the services rendered to the patient organization : : Reference [0..1] « [0..1] « Organization » » Patient Resource Patient Resource subject : : Reference [1..1] « [1..1] « Patient » » Reference to the program or plan identification, underwriter or payor Reference to the program or plan identification, underwriter or payor coverage : : Reference [1..1] « [1..1] « Coverage » » The relationship of the patient to the subscriber The relationship of the patient to the subscriber relationship : : Coding [1..1] « [1..1] « The code for the relationship of the patient to the subscriber. (Strength=Example) The code for the relationship of the patient to the subscriber. (Strength=Example) Surface ?? » Beneficiary Relationship ?? »

XML Template XML Template 

<EnrollmentRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier --></identifier>
 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <target><!-- 0..1 Reference(Organization) Insurer --></target>
 <provider><!-- 0..1 Reference(Practitioner) Responsible practitioner --></provider>
 <organization><!-- 0..1 Reference(Organization) Responsible organization --></organization>
 <subject><!-- 1..1 Reference(Patient) The subject of the Products and Services --></subject>
 <coverage><!-- 1..1 Reference(Coverage) Insurance information --></coverage>
 <relationship><!-- 1..1 Coding Patient relationship to subscriber --></relationship>
</EnrollmentRequest>

Structure

Name Flags Card. Type Description & Constraints Description & Constraints doco
. . EnrollmentRequest Σ DomainResource Enrollment request Enrollment request
. . . identifier Σ 0..* Identifier Business Identifier Business Identifier
. . . ruleset Σ 0..1 Coding Resource version Resource version
Ruleset Codes ( Ruleset Codes ( Example )
. . . originalRuleset Σ 0..1 Coding Original version Original version
Ruleset Codes ( Ruleset Codes ( Example )
. . . created Σ 0..1 dateTime Creation date Creation date
. . . target Σ 0..1 Reference ( Organization ) Insurer
. . . provider Σ 0..1 Reference ( Practitioner ) Responsible practitioner Responsible practitioner
. . . organization Σ 0..1 Reference ( Organization ) Responsible organization Responsible organization
. . . subject Σ 1..1 Reference ( Patient ) The subject of the Products and Services The subject of the Products and Services
. . . coverage Σ 1..1 Reference ( Coverage ) Insurance information Insurance information
. . . relationship Σ 1..1 Coding Patient relationship to subscriber Patient relationship to subscriber
Surface Codes ( Beneficiary Relationship Codes ( Example )

Documentation for this format doco Documentation for this format

UML Diagram UML Diagram

EnrollmentRequest ( ( DomainResource ) The Response business identifier The Response business identifier identifier : : Identifier [0..*] [0..*] The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources ruleset : : Coding [0..1] « [0..1] « The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example) The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example) Ruleset ?? » Ruleset ?? » The style (standard) and version of the original material which was converted into this resource The style (standard) and version of the original material which was converted into this resource originalRuleset : : Coding [0..1] « [0..1] « The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example) The static and dynamic model to which contents conform, which may be business version or standard/version. (Strength=Example) Ruleset ?? » Ruleset ?? » The date when this resource was created The date when this resource was created created : : dateTime [0..1] [0..1] The Insurer who is target of the request The Insurer who is target of the request target : : Reference [0..1] « [0..1] « Organization » » The practitioner who is responsible for the services rendered to the patient The practitioner who is responsible for the services rendered to the patient provider : : Reference [0..1] « [0..1] « Practitioner » » The organization which is responsible for the services rendered to the patient The organization which is responsible for the services rendered to the patient organization : : Reference [0..1] « [0..1] « Organization » » Patient Resource Patient Resource subject : : Reference [1..1] « [1..1] « Patient » » Reference to the program or plan identification, underwriter or payor Reference to the program or plan identification, underwriter or payor coverage : : Reference [1..1] « [1..1] « Coverage » » The relationship of the patient to the subscriber The relationship of the patient to the subscriber relationship : : Coding [1..1] « [1..1] « The code for the relationship of the patient to the subscriber. (Strength=Example) The code for the relationship of the patient to the subscriber. (Strength=Example) Surface ?? » Beneficiary Relationship ?? »

XML Template XML Template 

<EnrollmentRequest xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier --></identifier>
 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <target><!-- 0..1 Reference(Organization) Insurer --></target>
 <provider><!-- 0..1 Reference(Practitioner) Responsible practitioner --></provider>
 <organization><!-- 0..1 Reference(Organization) Responsible organization --></organization>
 <subject><!-- 1..1 Reference(Patient) The subject of the Products and Services --></subject>
 <coverage><!-- 1..1 Reference(Coverage) Insurance information --></coverage>
 <relationship><!-- 1..1 Coding Patient relationship to subscriber --></relationship>
</EnrollmentRequest>

  Alternate definitions:

Alternate definitions: Schema / Schematron , Resource Profile ( , Resource Profile ( XML , , JSON ), ), Questionnaire

7.7.2.1 Terminology Bindings Terminology Bindings

EnrollmentRequest.relationship
Path Definition Type Reference
EnrollmentRequest.ruleset
EnrollmentRequest.originalRuleset EnrollmentRequest.originalRuleset 		The static and dynamic model to which contents conform, which may be business version or standard/version. The static and dynamic model to which contents conform, which may be business version or standard/version. Example Ruleset Codes Ruleset Codes
EnrollmentRequest.relationship The code for the relationship of the patient to the subscriber. The code for the relationship of the patient to the subscriber. Example Surface Codes Beneficiary Relationship Codes

7.7.3 Search Parameters Search Parameters Search parameters for this resource. The common parameters also apply. See

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services. for more information about searching in REST, messaging, and services.

© HL7.org 2011+. FHIR DSTU2 (v1.0.2-7202) generated on Sat, Oct 24, 2015 07:43+1100. Links: Search
Name Type Description Paths
identifier token The business identifier of the Enrollment The business identifier of the Enrollment EnrollmentRequest.identifier
patient reference The party to be enrolled The party to be enrolled EnrollmentRequest.subject
( Patient )
subject reference The party to be enrolled The party to be enrolled EnrollmentRequest.subject
( Patient )