2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). 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

7.6 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.

7.6.1 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]

7.6.2 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. EnrollmentRequest DomainResourceEnrollment request
... identifier 0..*IdentifierBusiness Identifier
... ruleset 0..1CodingResource version
Ruleset (Example)
... originalRuleset 0..1CodingOriginal version
Ruleset (Example)
... created 0..1dateTimeCreation date
... target 0..1OrganizationInsurer
... provider 0..1PractitionerResponsible practitioner
... organization 0..1OrganizationResponsible organization
... subject 1..1PatientThe subject of the Products and Services
... coverage 1..1CoverageInsurance information
... relationship 1..1CodingPatient 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

NameFlagsCard.TypeDescription & Constraintsdoco
.. EnrollmentRequest DomainResourceEnrollment request
... identifier 0..*IdentifierBusiness Identifier
... ruleset 0..1CodingResource version
Ruleset (Example)
... originalRuleset 0..1CodingOriginal version
Ruleset (Example)
... created 0..1dateTimeCreation date
... target 0..1OrganizationInsurer
... provider 0..1PractitionerResponsible practitioner
... organization 0..1OrganizationResponsible organization
... subject 1..1PatientThe subject of the Products and Services
... coverage 1..1CoverageInsurance information
... relationship 1..1CodingPatient 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

7.6.2.1 Terminology Bindings

PathDefinitionTypeReference
EnrollmentRequest.ruleset
EnrollmentRequest.originalRuleset 		The static and dynamic model to which contents conform, may be business version or standard and version.Examplehttp://hl7.org/fhir/vs/ruleset
EnrollmentRequest.relationship The code for the relationship of the patient to the subscriberExamplehttp://hl7.org/fhir/vs/relationship

7.6.3 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionPaths
identifiertokenThe business identifier of the EnrollmentEnrollmentRequest.identifier
patientreferenceThe party to be enrolledEnrollmentRequest.subject
(Patient)
subjectreferenceThe party to be enrolledEnrollmentRequest.subject
(Patient)