DSTU2 FHIR Release 3 (STU)

This page is part of the FHIR Specification (v1.0.2: DSTU (v3.0.2: STU 2). 3). 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 R3 R2

7.7.5 13.4.5 Resource EnrollmentRequest - Detailed Descriptions

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

Detailed Descriptions for the elements in the EnrollmentRequest resource.

Summary true Summary true EnrollmentRequest.originalRuleset Summary true Summary true Summary true Summary true Summary true Summary true Summary true EnrollmentRequest.relationship Definition The relationship of the patient to the subscriber. Control 1..1 Binding Surface Codes: The code for the relationship of the patient to the subscriber. ( Example ) Type Coding Requirements To determine the relationship between the patient and the subscriber. Summary true
EnrollmentRequest
Definition

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

Control 1..1
EnrollmentRequest.identifier
Definition

The Response business identifier.

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

The version status of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources. instance.

Control 0..1
Terminology Binding Ruleset Codes: The static and dynamic model to which contents conform, which may be business version or standard/version. Financial Resource Status Codes ( Example Required )
Type Coding code
Summary Is Modifier true
Definition The style (standard) and version of the original material which was converted into this resource. Control 0..1 Binding Ruleset Codes: The static and dynamic model to which contents conform, which may be business version or standard/version. ( Example ) Type Summary Coding true
Requirements Comments

Knowledge of the original version can inform This element is labeled as a modifier because the processing of this instance so status contains codes that information which is processable by mark the originating system may be generated. request as not currently valid.

EnrollmentRequest.created
Definition

The date when this resource was created.

Control 0..1
Type dateTime
EnrollmentRequest.target EnrollmentRequest.insurer
Definition

The Insurer who is target of the request.

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

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

Control 0..1
Type Reference ( Practitioner )
EnrollmentRequest.organization
Definition

The organization which is responsible for the services rendered to the patient.

Control 0..1
Type Reference ( Organization )
EnrollmentRequest.subject
Definition

Patient Resource.

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

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

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

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