DSTU2 STU 3 Ballot
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 (v1.6.0: STU 3 Ballot 4). 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 13.7 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 13.7.1 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 a 'stub', is known to be incomplete, and 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 13.7.2 Resource Content

Structure

Σ Σ Σ Σ Insurer Σ Responsible practitioner Σ Responsible organization Σ Reference ( Patient ) 1..1 Insurance information Σ
Name Flags Card. Type Description & Constraints Description & Constraints doco
. . EnrollmentRequest DomainResource Enrollment request Enrollment request
. . . identifier 0..* Identifier Business Identifier Business Identifier
. . ruleset . status ?! Σ 0..1 1..1 Coding code Resource version active | cancelled | draft | entered-in-error
Ruleset Codes ( Example EnrollmentRequestStatus ( Required )
. . originalRuleset . ruleset 0..1 Coding Resource version
Σ Ruleset Codes ( Example )
... originalRuleset 0..1 Coding Original version Original version
Ruleset Codes ( Ruleset Codes ( Example )
. . . created 0..1 dateTime Creation date Creation date
. . target . insurer[x] 0..1 Target
.... insurerIdentifier 0..1 Identifier
. . . . insurerReference Reference ( Organization )
. . provider . provider[x] 0..1 Responsible practitioner
.... providerIdentifier 0..1 Identifier
. . . . providerReference Reference ( Practitioner )
. . organization . organization[x] 0..1 Responsible organization
.... organizationIdentifier 0..1 Identifier
. . . . organizationReference Reference ( Organization )
. . subject . subject[x] 1..1 The subject of the Products and Services The subject of the Products and Services
. . coverage . . subjectIdentifier Σ Identifier
. . . . subjectReference Reference ( Coverage Patient )
. . relationship . coverage 1..1 Coding Patient relationship to subscriber Surface Codes Reference ( Example Coverage ) Insurance information

Documentation for this format doco Documentation for this format

UML Diagram UML Diagram ( Legend )

EnrollmentRequest ( ( DomainResource ) The Response business identifier The Response business identifier identifier : : Identifier [0..*] [0..*] The status of the resource instance (this element modifies the meaning of other elements) status : code [1..1] « A code specifying the state of the resource instance. (Strength=Required) EnrollmentRequestStatus ! » 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 insurer[x] : Type [0..1] « Identifier : | Reference [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 provider[x] : Type [0..1] « Identifier : | Reference [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 organization[x] : Type [0..1] « Identifier : | Reference [0..1] « ( Organization » ) » Patient Resource Patient Resource subject subject[x] : Type [1..1] « Identifier : | Reference [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 relationship : Coding [1..1] « The code for the relationship of the patient to the subscriber. (Strength=Example) Surface ?? » »

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>
 <</ruleset>
 <</originalRuleset>
 <
 <</target>
 <</provider>
 <</organization>
 <</subject>
 <</coverage>
 <</relationship>

 <identifier><!-- 0..* Identifier Business Identifier --></identifier>
 <status value="[code]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <insurer[x]><!-- 0..1 Identifier|Reference(Organization) Target --></insurer[x]>
 <provider[x]><!-- 0..1 Identifier|Reference(Practitioner) Responsible practitioner --></provider[x]>
 <organization[x]><!-- 0..1 Identifier|Reference(Organization) Responsible organization --></organization[x]>
 <subject[x]><!-- 1..1 Identifier|Reference(Patient) The subject of the Products and Services --></subject[x]>
 <coverage><!-- 1..1 Reference(Coverage) Insurance information --></coverage>

</EnrollmentRequest>

JSON Template JSON Template { "resourceType" : "", 

{doco
  "resourceType" : "EnrollmentRequest",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "

  "identifier" : [{ Identifier }], // Business Identifier
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "ruleset" : { Coding }, // Resource version
  "originalRuleset" : { Coding }, // Original version
  "created" : "<dateTime>", // Creation date
  // insurer[x]: Target. One of these 2:

  "insurerIdentifier" : { Identifier },
  "insurerReference" : { Reference(Organization) },
  // provider[x]: Responsible practitioner. One of these 2:

  "providerIdentifier" : { Identifier },
  "providerReference" : { Reference(Practitioner) },
  // organization[x]: Responsible organization. One of these 2:

  "organizationIdentifier" : { Identifier },
  "organizationReference" : { Reference(Organization) },
  // subject[x]: The subject of the Products and Services. One of these 2:

  "subjectIdentifier" : { Identifier },
  "subjectReference" : { Reference(Patient) },
  "coverage" : { Reference(Coverage) } // R!  Insurance information

}

Turtle Template 


@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:EnrollmentRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:EnrollmentRequest.identifier [ Identifier ], ... ; # 0..* Business Identifier
  fhir:EnrollmentRequest.status [ code ]; # 1..1 active | cancelled | draft | entered-in-error
  fhir:EnrollmentRequest.ruleset [ Coding ]; # 0..1 Resource version
  fhir:EnrollmentRequest.originalRuleset [ Coding ]; # 0..1 Original version
  fhir:EnrollmentRequest.created [ dateTime ]; # 0..1 Creation date
  # EnrollmentRequest.insurer[x] : 0..1 Target. One of these 2
    fhir:EnrollmentRequest.insurerIdentifier [ Identifier ]
    fhir:EnrollmentRequest.insurerReference [ Reference(Organization) ]
  # EnrollmentRequest.provider[x] : 0..1 Responsible practitioner. One of these 2
    fhir:EnrollmentRequest.providerIdentifier [ Identifier ]
    fhir:EnrollmentRequest.providerReference [ Reference(Practitioner) ]
  # EnrollmentRequest.organization[x] : 0..1 Responsible organization. One of these 2
    fhir:EnrollmentRequest.organizationIdentifier [ Identifier ]
    fhir:EnrollmentRequest.organizationReference [ Reference(Organization) ]
  # EnrollmentRequest.subject[x] : 1..1 The subject of the Products and Services. One of these 2
    fhir:EnrollmentRequest.subjectIdentifier [ Identifier ]
    fhir:EnrollmentRequest.subjectReference [ Reference(Patient) ]
  fhir:EnrollmentRequest.coverage [ Reference(Coverage) ]; # 1..1 Insurance information
]

Changes since DSTU2

EnrollmentRequest
EnrollmentRequest.status added
EnrollmentRequest.insurer[x] added
EnrollmentRequest.provider[x] Renamed from provider to provider[x]
Add Identifier
EnrollmentRequest.organization[x] Renamed from organization to organization[x]
Add Identifier
EnrollmentRequest.subject[x] Renamed from subject to subject[x]
Add Identifier
EnrollmentRequest.target deleted
EnrollmentRequest.relationship deleted

See the Full Difference for further information

Structure

Σ Σ Σ Σ Insurer Σ Responsible practitioner Σ Responsible organization Σ Reference ( Patient ) 1..1 Insurance information Σ
Name Flags Card. Type Description & Constraints Description & Constraints doco
. . EnrollmentRequest DomainResource Enrollment request Enrollment request
. . . identifier 0..* Identifier Business Identifier Business Identifier
. . ruleset . status ?! Σ 0..1 1..1 Coding code Resource version active | cancelled | draft | entered-in-error
Ruleset Codes ( Example EnrollmentRequestStatus ( Required )
. . originalRuleset . ruleset 0..1 Coding Resource version
Σ Ruleset Codes ( Example )
... originalRuleset 0..1 Coding Original version Original version
Ruleset Codes ( Ruleset Codes ( Example )
. . . created 0..1 dateTime Creation date Creation date
. . target . insurer[x] 0..1 Target
.... insurerIdentifier 0..1 Identifier
. . . . insurerReference Reference ( Organization )
. . provider . provider[x] 0..1 Responsible practitioner
.... providerIdentifier 0..1 Identifier
.... providerReference Reference ( Practitioner )
. . organization . organization[x] 0..1 Responsible organization
.... organizationIdentifier 0..1 Identifier
. . . . organizationReference Reference ( Organization )
. . subject . subject[x] 1..1 The subject of the Products and Services The subject of the Products and Services
. . coverage . . subjectIdentifier Σ Identifier
. . . . subjectReference Reference ( Coverage Patient )
. . relationship . coverage 1..1 Coding Patient relationship to subscriber Surface Codes Reference ( Example Coverage ) Insurance information

Documentation for this format doco Documentation for this format

UML Diagram UML Diagram ( Legend )

EnrollmentRequest ( ( DomainResource ) The Response business identifier The Response business identifier identifier : : Identifier [0..*] [0..*] The status of the resource instance (this element modifies the meaning of other elements) status : code [1..1] « A code specifying the state of the resource instance. (Strength=Required) EnrollmentRequestStatus ! » 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 insurer[x] : Type [0..1] « Identifier : | Reference [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 provider[x] : Type [0..1] « Identifier : | Reference [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 organization[x] : Type [0..1] « Identifier : | Reference [0..1] « ( Organization » ) » Patient Resource Patient Resource subject subject[x] : Type [1..1] « Identifier : | Reference [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 relationship : Coding [1..1] « The code for the relationship of the patient to the subscriber. (Strength=Example) Surface ?? » »

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>
 <</ruleset>
 <</originalRuleset>
 <
 <</target>
 <</provider>
 <</organization>
 <</subject>
 <</coverage>
 <</relationship>

 <identifier><!-- 0..* Identifier Business Identifier --></identifier>
 <status value="[code]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <insurer[x]><!-- 0..1 Identifier|Reference(Organization) Target --></insurer[x]>
 <provider[x]><!-- 0..1 Identifier|Reference(Practitioner) Responsible practitioner --></provider[x]>
 <organization[x]><!-- 0..1 Identifier|Reference(Organization) Responsible organization --></organization[x]>
 <subject[x]><!-- 1..1 Identifier|Reference(Patient) The subject of the Products and Services --></subject[x]>
 <coverage><!-- 1..1 Reference(Coverage) Insurance information --></coverage>

</EnrollmentRequest>

JSON Template JSON Template { "resourceType" : "", 

{doco
  "resourceType" : "EnrollmentRequest",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "
  "
  "
  "
  "
  "
  "
  "
  "
  "

  "identifier" : [{ Identifier }], // Business Identifier
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "ruleset" : { Coding }, // Resource version
  "originalRuleset" : { Coding }, // Original version
  "created" : "<dateTime>", // Creation date
  // insurer[x]: Target. One of these 2:

  "insurerIdentifier" : { Identifier },
  "insurerReference" : { Reference(Organization) },
  // provider[x]: Responsible practitioner. One of these 2:

  "providerIdentifier" : { Identifier },
  "providerReference" : { Reference(Practitioner) },
  // organization[x]: Responsible organization. One of these 2:

  "organizationIdentifier" : { Identifier },
  "organizationReference" : { Reference(Organization) },
  // subject[x]: The subject of the Products and Services. One of these 2:

  "subjectIdentifier" : { Identifier },
  "subjectReference" : { Reference(Patient) },
  "coverage" : { Reference(Coverage) } // R!  Insurance information

}
 
Alternate
definitions:

Turtle Template 


@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:EnrollmentRequest;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:EnrollmentRequest.identifier [ Identifier ], ... ; # 0..* Business Identifier
  fhir:EnrollmentRequest.status [ code ]; # 1..1 active | cancelled | draft | entered-in-error
  fhir:EnrollmentRequest.ruleset [ Coding ]; # 0..1 Resource version
  fhir:EnrollmentRequest.originalRuleset [ Coding ]; # 0..1 Original version
  fhir:EnrollmentRequest.created [ dateTime ]; # 0..1 Creation date
  # EnrollmentRequest.insurer[x] : 0..1 Target. One of these 2
    fhir:EnrollmentRequest.insurerIdentifier [ Identifier ]
    fhir:EnrollmentRequest.insurerReference [ Reference(Organization) ]
  # EnrollmentRequest.provider[x] : 0..1 Responsible practitioner. One of these 2
    fhir:EnrollmentRequest.providerIdentifier [ Identifier ]
    fhir:EnrollmentRequest.providerReference [ Reference(Practitioner) ]
  # EnrollmentRequest.organization[x] : 0..1 Responsible organization. One of these 2
    fhir:EnrollmentRequest.organizationIdentifier [ Identifier ]
    fhir:EnrollmentRequest.organizationReference [ Reference(Organization) ]
  # EnrollmentRequest.subject[x] : 1..1 The subject of the Products and Services. One of these 2
    fhir:EnrollmentRequest.subjectIdentifier [ Identifier ]
    fhir:EnrollmentRequest.subjectReference [ Reference(Patient) ]
  fhir:EnrollmentRequest.coverage [ Reference(Coverage) ]; # 1..1 Insurance information
]

Changes since DSTU2

EnrollmentRequest
EnrollmentRequest.status added
EnrollmentRequest.insurer[x] added
EnrollmentRequest.provider[x] Renamed from provider to provider[x]
Add Identifier
EnrollmentRequest.organization[x] Renamed from organization to organization[x]
Add Identifier
EnrollmentRequest.subject[x] Renamed from subject to subject[x]
Add Identifier
EnrollmentRequest.target deleted
EnrollmentRequest.relationship deleted

See the Full Difference for further information

 

Alternate definitions: Master Definition ( XML , JSON ), XML Schema / Schematron , Resource Profile ( XML , (for ) + JSON Schema , ShEx (for Turtle ), Questionnaire )

7.7.2.1 Terminology Bindings 13.7.2.1 Terminology Bindings

EnrollmentRequest.ruleset EnrollmentRequest.originalRuleset EnrollmentRequest.relationship
Path Definition Type Reference
EnrollmentRequest.status The static and dynamic model to which contents conform, which may be business version or standard/version. A code specifying the state of the resource instance. Example Required Ruleset Codes EnrollmentRequestStatus
EnrollmentRequest.ruleset
EnrollmentRequest.originalRuleset 		The code for the relationship of the patient to the subscriber. The static and dynamic model to which contents conform, which may be business version or standard/version. Example Surface Codes Ruleset Codes

7.7.3 Search Parameters 13.7.3 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 | Version History | Table of Contents | Compare to DSTU1
Name Type Description Paths
identifier token The business identifier of the Enrollment The business identifier of the Enrollment EnrollmentRequest.identifier
patient patient-identifier token The party to be enrolled EnrollmentRequest.subjectidentifier
patient-reference reference The party to be enrolled The party to be enrolled EnrollmentRequest.subject EnrollmentRequest.subjectreference
( Patient )
subject subject-identifier token The party to be enrolled EnrollmentRequest.subjectidentifier
subject-reference reference The party to be enrolled The party to be enrolled EnrollmentRequest.subject EnrollmentRequest.subjectreference
( Patient )