Release 4 5 Preview #2
This page is part of the FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

13.4 Resource EnrollmentRequest - Content

Financial Management Work Group Maturity Level : 0   Trial Use Security Category : Patient Compartments : Patient

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

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 EnrollmentRequest resource allows for the addition and removal of plan subscribers and their dependents to health insurance coverage.

Todo

This resource is referenced by EnrollmentResponse .

This resource implements the Request pattern.

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>
 <status value="[code]"/><!-- 0..1 active | cancelled | draft | entered-in-error -->
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <insurer><!-- 0..1 Reference(Organization) Target --></insurer>
 <</provider>

 <provider><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Responsible practitioner --></provider>

 <candidate><!-- 0..1 Reference(Patient) The subject to be enrolled --></candidate>
 <coverage><!-- 0..1 Reference(Coverage) Insurance information --></coverage>
</EnrollmentRequest>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:EnrollmentRequest;
  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:EnrollmentRequest.identifier [ Identifier ], ... ; # 0..* Business Identifier
  fhir:EnrollmentRequest.status [ code ]; # 0..1 active | cancelled | draft | entered-in-error
  fhir:EnrollmentRequest.created [ dateTime ]; # 0..1 Creation date
  fhir:EnrollmentRequest.insurer [ Reference(Organization) ]; # 0..1 Target
  fhir:

  fhir:EnrollmentRequest.provider [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Responsible practitioner

  fhir:EnrollmentRequest.candidate [ Reference(Patient) ]; # 0..1 The subject to be enrolled
  fhir:EnrollmentRequest.coverage [ Reference(Coverage) ]; # 0..1 Insurance information
]

Changes since R3

EnrollmentRequest
EnrollmentRequest.status
  • Change value set from http://hl7.org/fhir/ValueSet/fm-status to http://hl7.org/fhir/ValueSet/fm-status|4.0.1 EnrollmentRequest.provider Type Reference: Added Target Types PractitionerRole, Organization EnrollmentRequest.candidate Renamed from subject http://hl7.org/fhir/ValueSet/fm-status|4.0.0 to candidate EnrollmentRequest.organization deleted http://hl7.org/fhir/ValueSet/fm-status|4.4.0

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. 1 fail round-trip testing and all r3 resources are valid.)

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>
 <status value="[code]"/><!-- 0..1 active | cancelled | draft | entered-in-error -->
 <created value="[dateTime]"/><!-- 0..1 Creation date -->
 <insurer><!-- 0..1 Reference(Organization) Target --></insurer>
 <</provider>

 <provider><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Responsible practitioner --></provider>

 <candidate><!-- 0..1 Reference(Patient) The subject to be enrolled --></candidate>
 <coverage><!-- 0..1 Reference(Coverage) Insurance information --></coverage>
</EnrollmentRequest>

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco
[ a fhir:EnrollmentRequest;
  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:EnrollmentRequest.identifier [ Identifier ], ... ; # 0..* Business Identifier
  fhir:EnrollmentRequest.status [ code ]; # 0..1 active | cancelled | draft | entered-in-error
  fhir:EnrollmentRequest.created [ dateTime ]; # 0..1 Creation date
  fhir:EnrollmentRequest.insurer [ Reference(Organization) ]; # 0..1 Target
  fhir:

  fhir:EnrollmentRequest.provider [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Responsible practitioner

  fhir:EnrollmentRequest.candidate [ Reference(Patient) ]; # 0..1 The subject to be enrolled
  fhir:EnrollmentRequest.coverage [ Reference(Coverage) ]; # 0..1 Insurance information
]

Changes since Release 3

EnrollmentRequest
EnrollmentRequest.status
  • Change value set from http://hl7.org/fhir/ValueSet/fm-status to http://hl7.org/fhir/ValueSet/fm-status|4.0.1 EnrollmentRequest.provider Type Reference: Added Target Types PractitionerRole, Organization EnrollmentRequest.candidate Renamed from subject http://hl7.org/fhir/ValueSet/fm-status|4.0.0 to candidate EnrollmentRequest.organization deleted http://hl7.org/fhir/ValueSet/fm-status|4.4.0

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. 1 fail round-trip testing and all r3 resources are valid.)

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a

Path Definition Type Reference
EnrollmentRequest.status A code specifying the state of the resource instance. Required FinancialResourceStatusCodes

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 Expression In Common
identifier token The business identifier of the Enrollment EnrollmentRequest.identifier
patient reference The party to be enrolled EnrollmentRequest.candidate
( Patient )
status N token The status of the enrollment EnrollmentRequest.status
subject reference The party to be enrolled EnrollmentRequest.candidate
( Patient )