DSTU2

This page is part of the FHIR Specification (v0.0.82: (v1.0.2: DSTU 1). 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

7.7 Resource EnrollmentRequest - Content

This resource maintained by the is marked as a draft .

Financial Management Work Group Maturity Level : 0 Compartments : Patient

This resource provides the insurance Enrollment 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 dependents to health insurance coverage.

Todo

This resource is referenced by [EnrollmentResponse] enrollmentresponse

7.7.2 Resource Content

Structure

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

doco Documentation for this format

UML Diagram

EnrollmentRequest ( DomainResource ) The Response Business Identifier business identifier identifier : Identifier 0..* [0..*] The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources ruleset : Coding 0..1 [0..1] « ( The static and dynamic model to which contents conform, which may be business version or standard and version. standard/version. (Strength=Example) Ruleset ) ?? » The style (standard) and version of the original material which was converted into this resource originalRuleset : Coding 0..1 [0..1] « ( The static and dynamic model to which contents conform, which may be business version or standard and version. standard/version. (Strength=Example) Ruleset ) ?? » The date when this resource was created created : dateTime 0..1 [0..1] The Insurer who is target of the request target : Reference ( [0..1] « Organization ) 0..1 » The practitioner who is responsible for the services rendered to the patient provider : Reference ( [0..1] « Practitioner ) 0..1 » The organization which is responsible for the services rendered to the patient organization : Reference ( [0..1] « Organization ) 0..1 » Patient Resource subject : Reference ( [1..1] « Patient ) 1..1 » Reference to the program or plan identification, underwriter or payor coverage : Reference ( [1..1] « Coverage ) 1..1 » The relationship of the patient to the subscriber relationship : Coding 1..1 [1..1] « ( The code for the relationship of the patient to the subscriber subscriber. (Strength=Example) Relationship Surface ) ?? »

XML Template 

<

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

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>

 <identifier><!-- 0..* Identifier Business Identifier --></identifier>

 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <
 <</target>
 <</provider>
 <</organization>
 <</subject>
 <</coverage>

 <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>

Structure

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

doco Documentation for this format

UML Diagram

EnrollmentRequest ( DomainResource ) The Response Business Identifier business identifier identifier : Identifier 0..* [0..*] The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources ruleset : Coding 0..1 [0..1] « ( The static and dynamic model to which contents conform, which may be business version or standard and version. standard/version. (Strength=Example) Ruleset ) ?? » The style (standard) and version of the original material which was converted into this resource originalRuleset : Coding 0..1 [0..1] « ( The static and dynamic model to which contents conform, which may be business version or standard and version. standard/version. (Strength=Example) Ruleset ) ?? » The date when this resource was created created : dateTime 0..1 [0..1] The Insurer who is target of the request target : Reference ( [0..1] « Organization ) 0..1 » The practitioner who is responsible for the services rendered to the patient provider : Reference ( [0..1] « Practitioner ) 0..1 » The organization which is responsible for the services rendered to the patient organization : Reference ( [0..1] « Organization ) 0..1 » Patient Resource subject : Reference ( [1..1] « Patient ) 1..1 » Reference to the program or plan identification, underwriter or payor coverage : Reference ( [1..1] « Coverage ) 1..1 » The relationship of the patient to the subscriber relationship : Coding 1..1 [1..1] « ( The code for the relationship of the patient to the subscriber subscriber. (Strength=Example) Relationship Surface ) ?? »

XML Template 

<

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

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>

 <identifier><!-- 0..* Identifier Business Identifier --></identifier>

 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <
 <</target>
 <</provider>
 <</organization>
 <</subject>
 <</coverage>

 <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>

 

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, which may be business version or standard and version. standard/version. Example http://hl7.org/fhir/vs/ruleset Ruleset Codes
EnrollmentRequest.relationship The code for the relationship of the patient to the subscriber subscriber. Example http://hl7.org/fhir/vs/relationship Surface Codes

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 )