STU 3 Ballot

This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). 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

13.8 Resource EnrollmentResponse - Content

This resource is marked as a draft.

Financial Management

Work Group

Maturity Level: 0

Compartments: Not linked to any defined compartments

This resource provides enrollment and plan details from the processing of an Enrollment resource.

13.8.1 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 EnrollmentResponse resource provides enrollment and plan details from the processing of an Enrollment resource.

Structure

Name	Flags	Card.	Type	Description & Constraints
EnrollmentResponse			DomainResource	EnrollmentResponse resource
identifier		0..*	Identifier	Business Identifier
status	?!Σ	1..1	code	active \| cancelled \| draft \| entered-in-error EnrollmentResponseStatus (Required)
request[x]		0..1		Claim reference
requestIdentifier			Identifier
requestReference			Reference(EnrollmentRequest)
outcome		0..1	code	complete \| error \| partial RemittanceOutcome (Required)
disposition		0..1	string	Disposition Message
ruleset		0..1	Coding	Resource version Ruleset Codes (Example)
originalRuleset		0..1	Coding	Original version Ruleset Codes (Example)
created		0..1	dateTime	Creation date
organization[x]		0..1		Insurer
organizationIdentifier			Identifier
organizationReference			Reference(Organization)
requestProvider[x]		0..1		Responsible practitioner
requestProviderIdentifier			Identifier
requestProviderReference			Reference(Practitioner)
requestOrganization[x]		0..1		Responsible organization
requestOrganizationIdentifier			Identifier
requestOrganizationReference			Reference(Organization)
Documentation for this format

UML Diagram (Legend)

XML Template

<EnrollmentResponse 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]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <request[x]><!-- 0..1 Identifier|Reference(EnrollmentRequest) Claim reference --></request[x]>
 <outcome value="[code]"/><!-- 0..1 complete | error | partial -->
 <disposition value="[string]"/><!-- 0..1 Disposition Message -->
 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <organization[x]><!-- 0..1 Identifier|Reference(Organization) Insurer --></organization[x]>
 <requestProvider[x]><!-- 0..1 Identifier|Reference(Practitioner) Responsible practitioner --></requestProvider[x]>
 <requestOrganization[x]><!-- 0..1 Identifier|Reference(Organization) Responsible organization --></requestOrganization[x]>
</EnrollmentResponse>

JSON Template

{
  "resourceType" : "EnrollmentResponse",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  // request[x]: Claim reference. One of these 2:
  "requestIdentifier" : { Identifier },
  "requestReference" : { Reference(EnrollmentRequest) },
  "outcome" : "<code>", // complete | error | partial
  "disposition" : "<string>", // Disposition Message
  "ruleset" : { Coding }, // Resource version
  "originalRuleset" : { Coding }, // Original version
  "created" : "<dateTime>", // Creation date
  // organization[x]: Insurer. One of these 2:
  "organizationIdentifier" : { Identifier },
  "organizationReference" : { Reference(Organization) },
  // requestProvider[x]: Responsible practitioner. One of these 2:
  "requestProviderIdentifier" : { Identifier },
  "requestProviderReference" : { Reference(Practitioner) },
  // requestOrganization[x]: Responsible organization. One of these 2:
  "requestOrganizationIdentifier" : { Identifier }
  "requestOrganizationReference" : { Reference(Organization) }
}

Turtle Template

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


[ a fhir:EnrollmentResponse;
  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:EnrollmentResponse.identifier [ Identifier ], ... ; # 0..* Business Identifier
  fhir:EnrollmentResponse.status [ code ]; # 1..1 active | cancelled | draft | entered-in-error
  # EnrollmentResponse.request[x] : 0..1 Claim reference. One of these 2
    fhir:EnrollmentResponse.requestIdentifier [ Identifier ]
    fhir:EnrollmentResponse.requestReference [ Reference(EnrollmentRequest) ]
  fhir:EnrollmentResponse.outcome [ code ]; # 0..1 complete | error | partial
  fhir:EnrollmentResponse.disposition [ string ]; # 0..1 Disposition Message
  fhir:EnrollmentResponse.ruleset [ Coding ]; # 0..1 Resource version
  fhir:EnrollmentResponse.originalRuleset [ Coding ]; # 0..1 Original version
  fhir:EnrollmentResponse.created [ dateTime ]; # 0..1 Creation date
  # EnrollmentResponse.organization[x] : 0..1 Insurer. One of these 2
    fhir:EnrollmentResponse.organizationIdentifier [ Identifier ]
    fhir:EnrollmentResponse.organizationReference [ Reference(Organization) ]
  # EnrollmentResponse.requestProvider[x] : 0..1 Responsible practitioner. One of these 2
    fhir:EnrollmentResponse.requestProviderIdentifier [ Identifier ]
    fhir:EnrollmentResponse.requestProviderReference [ Reference(Practitioner) ]
  # EnrollmentResponse.requestOrganization[x] : 0..1 Responsible organization. One of these 2
    fhir:EnrollmentResponse.requestOrganizationIdentifier [ Identifier ]
    fhir:EnrollmentResponse.requestOrganizationReference [ Reference(Organization) ]
]

Changes since DSTU2

EnrollmentResponse

EnrollmentResponse.status

added

EnrollmentResponse.request[x]

Renamed from request to request[x]
Add Identifier

EnrollmentResponse.organization[x]

Renamed from organization to organization[x]
Add Identifier

EnrollmentResponse.requestProvider[x]

Renamed from requestProvider to requestProvider[x]
Add Identifier

EnrollmentResponse.requestOrganization[x]

Renamed from requestOrganization to requestOrganization[x]
Add Identifier

See the Full Difference for further information

Structure

Name	Flags	Card.	Type	Description & Constraints
EnrollmentResponse			DomainResource	EnrollmentResponse resource
identifier		0..*	Identifier	Business Identifier
status	?!Σ	1..1	code	active \| cancelled \| draft \| entered-in-error EnrollmentResponseStatus (Required)
request[x]		0..1		Claim reference
requestIdentifier			Identifier
requestReference			Reference(EnrollmentRequest)
outcome		0..1	code	complete \| error \| partial RemittanceOutcome (Required)
disposition		0..1	string	Disposition Message
ruleset		0..1	Coding	Resource version Ruleset Codes (Example)
originalRuleset		0..1	Coding	Original version Ruleset Codes (Example)
created		0..1	dateTime	Creation date
organization[x]		0..1		Insurer
organizationIdentifier			Identifier
organizationReference			Reference(Organization)
requestProvider[x]		0..1		Responsible practitioner
requestProviderIdentifier			Identifier
requestProviderReference			Reference(Practitioner)
requestOrganization[x]		0..1		Responsible organization
requestOrganizationIdentifier			Identifier
requestOrganizationReference			Reference(Organization)
Documentation for this format

UML Diagram (Legend)

XML Template

<EnrollmentResponse 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]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <request[x]><!-- 0..1 Identifier|Reference(EnrollmentRequest) Claim reference --></request[x]>
 <outcome value="[code]"/><!-- 0..1 complete | error | partial -->
 <disposition value="[string]"/><!-- 0..1 Disposition Message -->
 <ruleset><!-- 0..1 Coding Resource version --></ruleset>
 <originalRuleset><!-- 0..1 Coding Original version --></originalRuleset>
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <organization[x]><!-- 0..1 Identifier|Reference(Organization) Insurer --></organization[x]>
 <requestProvider[x]><!-- 0..1 Identifier|Reference(Practitioner) Responsible practitioner --></requestProvider[x]>
 <requestOrganization[x]><!-- 0..1 Identifier|Reference(Organization) Responsible organization --></requestOrganization[x]>
</EnrollmentResponse>

JSON Template

{
  "resourceType" : "EnrollmentResponse",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  // request[x]: Claim reference. One of these 2:
  "requestIdentifier" : { Identifier },
  "requestReference" : { Reference(EnrollmentRequest) },
  "outcome" : "<code>", // complete | error | partial
  "disposition" : "<string>", // Disposition Message
  "ruleset" : { Coding }, // Resource version
  "originalRuleset" : { Coding }, // Original version
  "created" : "<dateTime>", // Creation date
  // organization[x]: Insurer. One of these 2:
  "organizationIdentifier" : { Identifier },
  "organizationReference" : { Reference(Organization) },
  // requestProvider[x]: Responsible practitioner. One of these 2:
  "requestProviderIdentifier" : { Identifier },
  "requestProviderReference" : { Reference(Practitioner) },
  // requestOrganization[x]: Responsible organization. One of these 2:
  "requestOrganizationIdentifier" : { Identifier }
  "requestOrganizationReference" : { Reference(Organization) }
}

Turtle Template

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


[ a fhir:EnrollmentResponse;
  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:EnrollmentResponse.identifier [ Identifier ], ... ; # 0..* Business Identifier
  fhir:EnrollmentResponse.status [ code ]; # 1..1 active | cancelled | draft | entered-in-error
  # EnrollmentResponse.request[x] : 0..1 Claim reference. One of these 2
    fhir:EnrollmentResponse.requestIdentifier [ Identifier ]
    fhir:EnrollmentResponse.requestReference [ Reference(EnrollmentRequest) ]
  fhir:EnrollmentResponse.outcome [ code ]; # 0..1 complete | error | partial
  fhir:EnrollmentResponse.disposition [ string ]; # 0..1 Disposition Message
  fhir:EnrollmentResponse.ruleset [ Coding ]; # 0..1 Resource version
  fhir:EnrollmentResponse.originalRuleset [ Coding ]; # 0..1 Original version
  fhir:EnrollmentResponse.created [ dateTime ]; # 0..1 Creation date
  # EnrollmentResponse.organization[x] : 0..1 Insurer. One of these 2
    fhir:EnrollmentResponse.organizationIdentifier [ Identifier ]
    fhir:EnrollmentResponse.organizationReference [ Reference(Organization) ]
  # EnrollmentResponse.requestProvider[x] : 0..1 Responsible practitioner. One of these 2
    fhir:EnrollmentResponse.requestProviderIdentifier [ Identifier ]
    fhir:EnrollmentResponse.requestProviderReference [ Reference(Practitioner) ]
  # EnrollmentResponse.requestOrganization[x] : 0..1 Responsible organization. One of these 2
    fhir:EnrollmentResponse.requestOrganizationIdentifier [ Identifier ]
    fhir:EnrollmentResponse.requestOrganizationReference [ Reference(Organization) ]
]

Changes since DSTU2

EnrollmentResponse

EnrollmentResponse.status

added

EnrollmentResponse.request[x]

Renamed from request to request[x]
Add Identifier

EnrollmentResponse.organization[x]

Renamed from organization to organization[x]
Add Identifier

EnrollmentResponse.requestProvider[x]

Renamed from requestProvider to requestProvider[x]
Add Identifier

EnrollmentResponse.requestOrganization[x]

Renamed from requestOrganization to requestOrganization[x]
Add Identifier

See the Full Difference for further information

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle)

13.8.2.1 Terminology Bindings

Path	Definition	Type	Reference
EnrollmentResponse.status	A code specifying the state of the resource instance.	Required	EnrollmentResponseStatus
EnrollmentResponse.outcome	The outcome of the processing.	Required	RemittanceOutcome
EnrollmentResponse.ruleset EnrollmentResponse.originalRuleset	The static and dynamic model to which contents conform, which may be business version or standard/version.	Example	Ruleset Codes

Path

Definition

Type

Reference

EnrollmentResponse.status

A code specifying the state of the resource instance.

Required

EnrollmentResponseStatus

EnrollmentResponse.outcome

The outcome of the processing.

Required

RemittanceOutcome

EnrollmentResponse.ruleset
EnrollmentResponse.originalRuleset

The static and dynamic model to which contents conform, which may be business version or standard/version.

Example

Ruleset Codes

13.8.3 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 EnrollmentResponse	EnrollmentResponse.identifier