Finance and Insurance Service (FAIS)
1.0.0 - trial-use International flag

This page is part of the IHE ITI Finance and Insurance Services (v1.0.0: Publication) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: Example Enrollment Request - JSON Representation

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{
  "resourceType" : "EnrollmentRequest",
  "id" : "ex-enrollment-req",
  "meta" : {
    "profile" : [
      🔗 "https://profiles.ihe.net/ITI/FAIS/StructureDefinition/IHE.FAIS.EnrollmentRequest"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: EnrollmentRequest ex-enrollment-req</b></p><a name=\"ex-enrollment-req\"> </a><a name=\"hcex-enrollment-req\"> </a><a name=\"ex-enrollment-req-en-US\"> </a><p><b>status</b>: Active</p><p><b>created</b>: 2023-12-15</p><p><b>insurer</b>: <a href=\"Organization-ex-insurer.html\">Organization Example Public Insurance</a></p><p><b>candidate</b>: <a href=\"Patient-ex-beneficiary.html\">Jane Doe  Female, DoB: 2000-05-04</a></p><p><b>coverage</b>: <a href=\"Coverage-ex-coverage.html\">Coverage: status = active; type = public healthcare; subscriberId = a8978d4a-0c9f-11ef-9633-cb733e9641ef; relationship = Self; period = 2024-01-01 --&gt; 2024-12-31</a></p></div>"
  },
  "status" : "active",
  "created" : "2023-12-15",
  "insurer" : {
    🔗 "reference" : "Organization/ex-insurer"
  },
  "candidate" : {
    🔗 "reference" : "Patient/ex-beneficiary"
  },
  "coverage" : {
    🔗 "reference" : "Coverage/ex-coverage"
  }
}