FHIR Release 3 (STU) 4

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13.4.5 Resource EnrollmentRequest - Detailed Descriptions

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

Detailed Descriptions for the elements in the EnrollmentRequest resource.

EnrollmentRequest
Element Id EnrollmentRequest
Definition

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

Control Cardinality 1..1 0..*
Type DomainResource
EnrollmentRequest.identifier
Element Id EnrollmentRequest.identifier
Definition

The Response business identifier.

Note This is a business identifer, identifier, not a resource identifier (see discussion )
Control Cardinality 0..*
Type Identifier
EnrollmentRequest.status
Element Id EnrollmentRequest.status
Definition

The status of the resource instance.

Control Cardinality 0..1
Terminology Binding Financial Resource Status Codes ( Required )
Type code
Is Modifier true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summary true
Comments

This element is labeled as a modifier because the status contains codes that mark the request as not currently valid.

EnrollmentRequest.created
Element Id EnrollmentRequest.created
Definition

The date when this resource was created.

Control Cardinality 0..1
Type dateTime
EnrollmentRequest.insurer
Element Id EnrollmentRequest.insurer
Definition

The Insurer who is target of the request.

Control Cardinality 0..1
Type Reference ( Organization )
EnrollmentRequest.provider
Element Id EnrollmentRequest.provider
Definition

The practitioner who is responsible for the services rendered to the patient.

Control Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole | Organization )
EnrollmentRequest.organization EnrollmentRequest.candidate
Definition The organization which is responsible for the services rendered to the patient. Control 0..1 Type Element Id Reference ( Organization ) EnrollmentRequest.subject EnrollmentRequest.candidate
Definition

Patient Resource.

Control Cardinality 0..1
Type Reference ( Patient )
EnrollmentRequest.coverage
Element Id EnrollmentRequest.coverage
Definition

Reference to the program or plan identification, underwriter or payor.

Control Cardinality 0..1
Type Reference ( Coverage )
Requirements

Need to identify the issuer to target for processing and for coordination of benefit processing.