FHIR Release 3 (STU) R4 Ballot #1 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.0.2: STU 3). (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

13.5 Resource EnrollmentResponse - Content

Financial Management Work Group Maturity Level : 0   Draft Compartments : Not linked to any defined compartments

This resource provides enrollment and plan details from the processing of an Enrollment resource.

13.5.1 Scope and Usage

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 EnrollmentResponse resource provides enrollment and plan details from the processing of an Enrollment resource.

13.5.2 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . EnrollmentResponse D DomainResource EnrollmentResponse resource
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier Business Identifier
. . . status ?! Σ 0..1 code active | cancelled | draft | entered-in-error
Financial Resource Status Codes ( Required )
. . . request 0..1 Reference ( EnrollmentRequest ) Claim reference
. . . outcome 0..1 CodeableConcept code queued | complete | error | partial
RemittanceOutcome ( Required )
. . . disposition 0..1 string Disposition Message
. . . created 0..1 dateTime Creation date
. . . organization 0..1 Reference ( Organization ) Insurer
. . . requestProvider 0..1 Reference ( Practitioner ) Responsible practitioner requestOrganization 0..1 Reference | PractitionerRole ( | Organization ) Responsible organization practitioner

doco Documentation for this format

XML Template 

<

<EnrollmentResponse 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>
 <

 <status value="[code]"/><!-- 0..1 active | cancelled | draft | entered-in-error -->

 <request><!-- 0..1 Reference(EnrollmentRequest) Claim reference --></request>
 <</outcome>
 <
 <

 <outcome value="[code]"/><!-- 0..1 queued | complete | error | partial -->
 <disposition value="[string]"/><!-- 0..1 Disposition Message -->
 <created value="[dateTime]"/><!-- 0..1 Creation date -->

 <organization><!-- 0..1 Reference(Organization) Insurer --></organization>
 <</requestProvider>
 <</requestOrganization>

 <requestProvider><!-- 0..1 Reference(Practitioner|PractitionerRole|Organization) Responsible practitioner --></requestProvider>

</EnrollmentResponse>

Turtle Template 

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


[ a fhir:EnrollmentResponse;
  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:EnrollmentResponse.identifier [ Identifier ], ... ; # 0..* Business Identifier
  fhir:EnrollmentResponse.status [ code ]; # 0..1 active | cancelled | draft | entered-in-error
  fhir:EnrollmentResponse.request [ Reference(EnrollmentRequest) ]; # 0..1 Claim reference
  fhir:

  fhir:EnrollmentResponse.outcome [ code ]; # 0..1 queued | complete | error | partial

  fhir:EnrollmentResponse.disposition [ string ]; # 0..1 Disposition Message
  fhir:EnrollmentResponse.created [ dateTime ]; # 0..1 Creation date
  fhir:EnrollmentResponse.organization [ Reference(Organization) ]; # 0..1 Insurer
  fhir:
  fhir:

  fhir:EnrollmentResponse.requestProvider [ Reference(Practitioner|PractitionerRole|Organization) ]; # 0..1 Responsible practitioner

]

Changes since DSTU2 R3

EnrollmentResponse.status
EnrollmentResponse Added Element
EnrollmentResponse.outcome
  • Type changed from code to CodeableConcept to code
EnrollmentResponse.ruleset EnrollmentResponse.requestProvider
  • deleted Type changed from Reference(Practitioner) to Reference(Practitioner|PractitionerRole|Organization)
EnrollmentResponse.originalRuleset EnrollmentResponse.requestOrganization
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 Conversion Maps (status = 1 test that all execute ok. 1 fail round-trip testing and all r3 resources are valid.). Note: these have note yet been updated to be R3 to R4

Structure

Name Flags Card. Type Description & Constraints doco
. . EnrollmentResponse D DomainResource EnrollmentResponse resource
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier Business Identifier
. . . status ?! Σ 0..1 code active | cancelled | draft | entered-in-error
Financial Resource Status Codes ( Required )
. . . request 0..1 Reference ( EnrollmentRequest ) Claim reference
. . . outcome 0..1 CodeableConcept code queued | complete | error | partial
RemittanceOutcome ( Required )
. . . disposition 0..1 string Disposition Message
. . . created 0..1 dateTime Creation date
. . . organization 0..1 Reference ( Organization ) Insurer
. . . requestProvider 0..1 Reference ( Practitioner ) Responsible practitioner requestOrganization 0..1 Reference | PractitionerRole ( | Organization ) Responsible organization practitioner

doco Documentation for this format

XML Template 

<

<EnrollmentResponse 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>
 <

 <status value="[code]"/><!-- 0..1 active | cancelled | draft | entered-in-error -->

 <request><!-- 0..1 Reference(EnrollmentRequest) Claim reference --></request>
 <</outcome>
 <
 <

 <outcome value="[code]"/><!-- 0..1 queued | complete | error | partial -->
 <disposition value="[string]"/><!-- 0..1 Disposition Message -->
 <created value="[dateTime]"/><!-- 0..1 Creation date -->

 <organization><!-- 0..1 Reference(Organization) Insurer --></organization>
 <</requestProvider>
 <</requestOrganization>

 <requestProvider><!-- 0..1 Reference(Practitioner|PractitionerRole|Organization) Responsible practitioner --></requestProvider>

</EnrollmentResponse>

Turtle Template 

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


[ a fhir:EnrollmentResponse;
  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:EnrollmentResponse.identifier [ Identifier ], ... ; # 0..* Business Identifier
  fhir:EnrollmentResponse.status [ code ]; # 0..1 active | cancelled | draft | entered-in-error
  fhir:EnrollmentResponse.request [ Reference(EnrollmentRequest) ]; # 0..1 Claim reference
  fhir:

  fhir:EnrollmentResponse.outcome [ code ]; # 0..1 queued | complete | error | partial

  fhir:EnrollmentResponse.disposition [ string ]; # 0..1 Disposition Message
  fhir:EnrollmentResponse.created [ dateTime ]; # 0..1 Creation date
  fhir:EnrollmentResponse.organization [ Reference(Organization) ]; # 0..1 Insurer
  fhir:
  fhir:

  fhir:EnrollmentResponse.requestProvider [ Reference(Practitioner|PractitionerRole|Organization) ]; # 0..1 Responsible practitioner

]

Changes since DSTU2

EnrollmentResponse.status
EnrollmentResponse Added Element
EnrollmentResponse.outcome
  • Type changed from code to CodeableConcept to code
EnrollmentResponse.ruleset EnrollmentResponse.requestProvider
  • deleted Type changed from Reference(Practitioner) to Reference(Practitioner|PractitionerRole|Organization)
EnrollmentResponse.originalRuleset EnrollmentResponse.requestOrganization
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 Conversion Maps (status = 1 test that all execute ok. 1 fail round-trip testing and all r3 resources are valid.). Note: these have note yet been updated to be R3 to R4

 

Alternate definitions: Master Definition ( XML , + JSON ), , XML Schema / Schematron (for ) + JSON Schema , ShEx (for Turtle ) + see the extensions & the dependency analysis

13.5.2.1 Terminology Bindings

Path Definition Type Reference
EnrollmentResponse.status A code specifying the state of the resource instance. Required Financial Resource Status Codes
EnrollmentResponse.outcome The outcome of the processing. Required RemittanceOutcome

13.5.3 Search Parameters

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

Name Type Description Expression In Common
identifier token The business identifier of the EnrollmentResponse EnrollmentResponse.identifier
organization request reference The organization who generated this resource reference to the claim EnrollmentResponse.organization EnrollmentResponse.request
( Organization EnrollmentRequest )
request status reference token The reference to status of the claim enrollment response EnrollmentResponse.request ( EnrollmentRequest ) EnrollmentResponse.status