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7.7 Resource EnrollmentRequest - Content

This resource maintained by the Financial Management Work Group

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

7.7.1 Scope and Usage

This resource has not yet undergone proper review by FM. At this time, it is to be considered as a draft.

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

Todo

This resource is referenced by [EnrollmentResponse]

7.7.2 Resource Content

Structure

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

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>

JSON Template 

{doco
  "resourceType" : "EnrollmentRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  "ruleset" : { Coding }, // Resource version
  "originalRuleset" : { Coding }, // Original version
  "created" : "<dateTime>", // Creation date
  "target" : { Reference(Organization) }, // Insurer
  "provider" : { Reference(Practitioner) }, // Responsible practitioner
  "organization" : { Reference(Organization) }, // Responsible organization
  "subject" : { Reference(Patient) }, // R!  The subject of the Products and Services
  "coverage" : { Reference(Coverage) }, // R!  Insurance information
  "relationship" : { Coding } // R!  Patient relationship to subscriber
}

Structure

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

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>

JSON Template 

{doco
  "resourceType" : "EnrollmentRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  "ruleset" : { Coding }, // Resource version
  "originalRuleset" : { Coding }, // Original version
  "created" : "<dateTime>", // Creation date
  "target" : { Reference(Organization) }, // Insurer
  "provider" : { Reference(Practitioner) }, // Responsible practitioner
  "organization" : { Reference(Organization) }, // Responsible organization
  "subject" : { Reference(Patient) }, // R!  The subject of the Products and Services
  "coverage" : { Reference(Coverage) }, // R!  Insurance information
  "relationship" : { Coding } // R!  Patient relationship to subscriber
}

 

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

7.7.2.1 Terminology Bindings

Path Definition Type Reference
EnrollmentRequest.ruleset
EnrollmentRequest.originalRuleset 		The static and dynamic model to which contents conform, may be business version or standard and version. Example http://hl7.org/fhir/vs/ruleset
EnrollmentRequest.relationship The code for the relationship of the patient to the subscriber Example http://hl7.org/fhir/vs/relationship

7.7.3 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 Paths
identifier token The business identifier of the Enrollment EnrollmentRequest.identifier
patient reference The party to be enrolled EnrollmentRequest.subject
( Patient )
subject reference The party to be enrolled EnrollmentRequest.subject
( Patient )