Release 4 5

This page is part of the FHIR Specification ~~(v4.0.1: R4~~ (v5.0.0: R5 - ~~Mixed Normative and~~ STU ) ). This is the current published version in it's permanent home (it will always be available at this URL). ~~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 icon

Work Group

Maturity Level : 0

Trial Use

Security Category : Patient

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~~

13.4.2 References to this Resource

Implements: Request
Resource References: DocumentReference , EnrollmentResponse and GuidanceResponse

Structure

Name	Flags	Card.	Type	Description & Constraints
EnrollmentRequest	TU		DomainResource	Enroll 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 Binding: Financial Resource Status Codes ( Required )
created		0..1	dateTime	Creation date
insurer		0..1	Reference ( Organization )	Target
provider		0..1	Reference ( Practitioner \| PractitionerRole \| Organization )	Responsible practitioner
candidate		0..1	Reference ( Patient )	The subject to be enrolled
coverage		0..1	Reference ( Coverage )	Insurance information
Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

XML Template

<EnrollmentRequest xmlns="http://hl7.org/fhir"> 
 <!-- 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>

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

 <candidate><!-- 0..1 Reference(Patient) The subject to be enrolled --></candidate>
 <coverage><!-- 0..1 Reference(Coverage) Insurance information --></coverage>
</EnrollmentRequest>

JSON Template

{
  "resourceType" : "EnrollmentRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  "status" : "<code>", // active | cancelled | draft | entered-in-error
  "created" : "<dateTime>", // Creation date
  "insurer" : { Reference(Organization) }, // Target
  "

  "provider" : { Reference(Organization|Practitioner|PractitionerRole) }, // Responsible practitioner

  "candidate" : { Reference(Patient) }, // The subject to be enrolled
  "coverage" : { Reference(Coverage) } // Insurance information
}

Turtle Template

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


[ 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:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier
  fhir:status [ code ] ; # 0..1 active | cancelled | draft | entered-in-error
  fhir:created [ dateTime ] ; # 0..1 Creation date
  fhir:insurer [ Reference(Organization) ] ; # 0..1 Target
  fhir:provider [ Reference(Organization|Practitioner|PractitionerRole) ] ; # 0..1 Responsible practitioner
  fhir:candidate [ Reference(Patient) ] ; # 0..1 The subject to be enrolled
  fhir:coverage [ Reference(Coverage) ] ; # 0..1 Insurance information

]

Changes ~~since R3~~ from both R4 and R4B

EnrollmentRequest.status Change value set from http://hl7.org/fhir/ValueSet/fm-status to http://hl7.org/fhir/ValueSet/fm-status|4.0.1 EnrollmentRequest.provider Type Reference: Added Target Types PractitionerRole, Organization EnrollmentRequest.candidate Renamed from subject to candidate EnrollmentRequest.organization

EnrollmentRequest

~~deleted~~ No Changes

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

See ~~R3 <-->~~ R4 <--> R5 Conversion Maps (status = ~~1 test that all execute ok. 1 fail round-trip testing and all r3 resources are valid.)~~ See Conversions Summary .)

Structure

Name	Flags	Card.	Type	Description & Constraints
EnrollmentRequest	TU		DomainResource	Enroll 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 Binding: Financial Resource Status Codes ( Required )
created		0..1	dateTime	Creation date
insurer		0..1	Reference ( Organization )	Target
provider		0..1	Reference ( Practitioner \| PractitionerRole \| Organization )	Responsible practitioner
candidate		0..1	Reference ( Patient )	The subject to be enrolled
coverage		0..1	Reference ( Coverage )	Insurance information
Documentation for this format

See the Extensions for this resource

UML Diagram ( Legend )

XML Template

<EnrollmentRequest xmlns="http://hl7.org/fhir"> 
 <!-- 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>

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

 <candidate><!-- 0..1 Reference(Patient) The subject to be enrolled --></candidate>
 <coverage><!-- 0..1 Reference(Coverage) Insurance information --></coverage>
</EnrollmentRequest>

JSON Template

{
  "resourceType" : "EnrollmentRequest",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  "status" : "<code>", // active | cancelled | draft | entered-in-error
  "created" : "<dateTime>", // Creation date
  "insurer" : { Reference(Organization) }, // Target
  "

  "provider" : { Reference(Organization|Practitioner|PractitionerRole) }, // Responsible practitioner

  "candidate" : { Reference(Patient) }, // The subject to be enrolled
  "coverage" : { Reference(Coverage) } // Insurance information
}

Turtle Template

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


[ 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:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Business Identifier
  fhir:status [ code ] ; # 0..1 active | cancelled | draft | entered-in-error
  fhir:created [ dateTime ] ; # 0..1 Creation date
  fhir:insurer [ Reference(Organization) ] ; # 0..1 Target
  fhir:provider [ Reference(Organization|Practitioner|PractitionerRole) ] ; # 0..1 Responsible practitioner
  fhir:candidate [ Reference(Patient) ] ; # 0..1 The subject to be enrolled
  fhir:coverage [ Reference(Coverage) ] ; # 0..1 Insurance information

]

Changes ~~since Release 3~~ from both R4 and R4B

EnrollmentRequest.status Change value set from http://hl7.org/fhir/ValueSet/fm-status to http://hl7.org/fhir/ValueSet/fm-status|4.0.1 EnrollmentRequest.provider Type Reference: Added Target Types PractitionerRole, Organization EnrollmentRequest.candidate Renamed from subject to candidate EnrollmentRequest.organization

EnrollmentRequest

~~deleted~~ No Changes

See the Full Difference for further information

This analysis is available for R4 as XML or JSON and for R4B as XML or JSON .

See ~~R3 <-->~~ R4 <--> R5 Conversion Maps (status = ~~1 test that all execute ok. 1 fail round-trip testing and all r3 resources are valid.)~~ See Conversions Summary .)

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

13.4.2.1 13.4.3.1 Terminology Bindings

Path	~~Definition~~ ValueSet	Type	~~Reference~~ Documentation
EnrollmentRequest.status	~~A code specifying the state of the resource instance.~~ FinancialResourceStatusCodes	Required	~~FinancialResourceStatusCodes~~ This value set includes Status codes.

Path

~~Definition~~ ValueSet

Type

~~Reference~~ Documentation

EnrollmentRequest.status

~~A code specifying the state of the resource instance.~~ FinancialResourceStatusCodes

Required

~~FinancialResourceStatusCodes~~

This value set includes Status codes.

13.4.3 13.4.4 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to 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	65 Resources
patient	reference	The party to be enrolled	EnrollmentRequest.candidate ( Patient )	66 Resources
status	token	The status of the enrollment	EnrollmentRequest.status
subject	reference	The party to be enrolled	EnrollmentRequest.candidate ( Patient )