FHIR Release 3 (STU) R4 Ballot #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.0.2: STU 3). (v3.5.0: 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

13.4 Resource EnrollmentRequest - Content

Financial Management Work Group Maturity Level : 0   Draft Trial Use Compartments : Patient

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

13.4.1 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 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 EnrollmentResponse

13.4.2 Resource Content

Structure

Name Flags Card. Type Description & Constraints doco
. . EnrollmentRequest TU DomainResource Enrollment request Enrol in coverage
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 )
. . . created 0..1 dateTime Creation date
. . . insurer 0..1 Reference ( Organization ) Target
. . . provider 0..1 Reference ( Practitioner ) Responsible practitioner organization 0..1 Reference | PractitionerRole ( | Organization ) Responsible organization practitioner
. . . subject candidate 0..1 Reference ( Patient ) The subject of the Products and Services to be enrolled
. . . coverage 0..1 Reference ( Coverage ) Insurance information

doco Documentation for this format

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>
 <
 <

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

 <insurer><!-- 0..1 Reference(Organization) Target --></insurer>
 <</provider>
 <</organization>
 <</subject>

 <provider><!-- 0..1 Reference(Practitioner|PractitionerRole|Organization) Responsible practitioner --></provider>
 <candidate><!-- 0..1 Reference(Patient) The subject to be enrolled --></candidate>

 <coverage><!-- 0..1 Reference(Coverage) Insurance information --></coverage>
</EnrollmentRequest>

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 ]; # 0..1 active | cancelled | draft | entered-in-error
  fhir:EnrollmentRequest.created [ dateTime ]; # 0..1 Creation date
  fhir:EnrollmentRequest.insurer [ Reference(Organization) ]; # 0..1 Target
  fhir:
  fhir:
  fhir:

  fhir:EnrollmentRequest.provider [ Reference(Practitioner|PractitionerRole|Organization) ]; # 0..1 Responsible practitioner
  fhir:EnrollmentRequest.candidate [ Reference(Patient) ]; # 0..1 The subject to be enrolled

  fhir:EnrollmentRequest.coverage [ Reference(Coverage) ]; # 0..1 Insurance information
]

Changes since DSTU2 R3

EnrollmentRequest.status Added Element EnrollmentRequest.insurer Added Element EnrollmentRequest.subject
EnrollmentRequest Min Cardinality changed from 1 to 0
EnrollmentRequest.coverage EnrollmentRequest.provider
  • Min Cardinality Type changed from 1 Reference(Practitioner) to 0 EnrollmentRequest.ruleset deleted Reference(Practitioner|PractitionerRole|Organization)
EnrollmentRequest.originalRuleset EnrollmentRequest.candidate
  • deleted Added Element
EnrollmentRequest.target EnrollmentRequest.organization
  • deleted
EnrollmentRequest.relationship EnrollmentRequest.subject
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. of which 1 fail round-trip testing and all r3 resources are valid.). to execute .)

Structure

Name Flags Card. Type Description & Constraints doco
. . EnrollmentRequest TU DomainResource Enrollment request Enrol in coverage
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 )
. . . created 0..1 dateTime Creation date
. . . insurer 0..1 Reference ( Organization ) Target
. . . provider 0..1 Reference ( Practitioner ) Responsible practitioner organization 0..1 Reference | PractitionerRole ( | Organization ) Responsible organization practitioner
. . . subject candidate 0..1 Reference ( Patient ) The subject of the Products and Services to be enrolled
. . . coverage 0..1 Reference ( Coverage ) Insurance information

doco Documentation for this format

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>
 <
 <

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

 <insurer><!-- 0..1 Reference(Organization) Target --></insurer>
 <</provider>
 <</organization>
 <</subject>

 <provider><!-- 0..1 Reference(Practitioner|PractitionerRole|Organization) Responsible practitioner --></provider>
 <candidate><!-- 0..1 Reference(Patient) The subject to be enrolled --></candidate>

 <coverage><!-- 0..1 Reference(Coverage) Insurance information --></coverage>
</EnrollmentRequest>

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 ]; # 0..1 active | cancelled | draft | entered-in-error
  fhir:EnrollmentRequest.created [ dateTime ]; # 0..1 Creation date
  fhir:EnrollmentRequest.insurer [ Reference(Organization) ]; # 0..1 Target
  fhir:
  fhir:
  fhir:

  fhir:EnrollmentRequest.provider [ Reference(Practitioner|PractitionerRole|Organization) ]; # 0..1 Responsible practitioner
  fhir:EnrollmentRequest.candidate [ Reference(Patient) ]; # 0..1 The subject to be enrolled

  fhir:EnrollmentRequest.coverage [ Reference(Coverage) ]; # 0..1 Insurance information
]

Changes since DSTU2 Release 3

EnrollmentRequest.status
EnrollmentRequest Added Element EnrollmentRequest.insurer Added Element EnrollmentRequest.subject Min Cardinality changed from 1 to 0
EnrollmentRequest.coverage EnrollmentRequest.provider
  • Min Cardinality Type changed from 1 Reference(Practitioner) to 0 EnrollmentRequest.ruleset deleted Reference(Practitioner|PractitionerRole|Organization)
EnrollmentRequest.originalRuleset EnrollmentRequest.candidate
  • deleted Added Element
EnrollmentRequest.target EnrollmentRequest.organization
  • deleted
EnrollmentRequest.relationship EnrollmentRequest.subject
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R2 <--> R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. of which 1 fail round-trip testing and all r3 resources are valid.). to execute .)

 

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

13.4.2.1 Terminology Bindings

Path Definition Type Reference
EnrollmentRequest.status A code specifying the state of the resource instance. Required Financial Resource Status Codes FinancialResourceStatusCodes

13.4.3 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 Enrollment EnrollmentRequest.identifier
organization patient reference The organization who generated this resource party to be enrolled EnrollmentRequest.organization EnrollmentRequest.candidate
( Organization Patient )
patient status reference token The party to be enrolled status fo the enrollment EnrollmentRequest.subject ( Patient ) EnrollmentRequest.status
subject reference The party to be enrolled EnrollmentRequest.subject EnrollmentRequest.candidate
( Patient )