R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). 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

Financial Management Work GroupMaturity Level: 0 Draft Compartments: Patient

Detailed Descriptions for the elements in the EnrollmentRequest resource.

EnrollmentRequest
Definition

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

Control1..1
EnrollmentRequest.identifier
Definition

The Response business identifier.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
EnrollmentRequest.status
Definition

The status of the resource instance.

Control0..1
Terminology BindingFinancial Resource Status Codes (Required)
Typecode
Is Modifiertrue
Summarytrue
Comments

This element is labeled as a modifier because the status contains codes that mark the request as not currently valid.

EnrollmentRequest.created
Definition

The date when this resource was created.

Control0..1
TypedateTime
EnrollmentRequest.insurer
Definition

The Insurer who is target of the request.

Control0..1
TypeReference(Organization)
EnrollmentRequest.provider
Definition

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

Control0..1
TypeReference(Practitioner)
EnrollmentRequest.organization
Definition

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

Control0..1
TypeReference(Organization)
EnrollmentRequest.candidate
Definition

Patient Resource.

Control0..1
TypeReference(Patient)
EnrollmentRequest.coverage
Definition

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

Control0..1
TypeReference(Coverage)
Requirements

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