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Enrollment FHIR Resource Proposal

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Enrollment

Owning committee name

Financial Management

Contributing or Reviewing Work Groups

FHIR Resource Development Project Insight ID

994

Scope of coverage

Enrollment is used to request initial enrollment in and subsequent maintenance of coverage for one or more applicants/insureds under a public or private health insurance policy.

Enrollment records are the basis upon which verification of eligibility are made.

RIM scope

ActClass.COV in request mood.

Resource appropriateness

Enrollment is used to request initial enrollment in and subsequent maintenance of coverage for one or more applicants/insureds under a public healthcare program or private health insurance policy.

Expected implementations

Referenced by CCDA.

Content sources

  • v2 IN1, IN2, IN3 segments
  • v3 Eligibility and Coverage models
  • X12 270, 271, 834, 820
  • NCPDP


Example Scenarios

Initial, periodic, and yearly enrollment in public health programs (e.g., Medicaid/Medicare) or private health insurance in the individual or group insurance markets.

Resource Relationships

Timelines

Part of initial DSTU.

gForge Users

N/A