EnrollEligCOB

Enrollment, Eligibility, and Coordination of Benefits Domain

EnrollEligCOB
priorAuthorization Property priorAuthorization Property priorAuthorization priorAuthorization Property Property Association Polyline coordinates describing hotspot on the image responsibleParty Property responsibleParty Property responsibleParty responsibleParty Property Property Association Polyline coordinates describing hotspot on the image priorAuthorization Property priorAuthorization Property priorAuthorization priorAuthorization Property Property Association Polyline coordinates describing hotspot on the image healthcarePolicy Property healthcarePolicy Property healthcarePolicy healthcarePolicy Property Property Association Polyline coordinates describing hotspot on the image assessmentResponse Property assessmentResponse Property assessmentResponse assessmentResponse Property Property Association Polyline coordinates describing hotspot on the image assessmentInstrumentQuestion Property assessmentInstrumentQuestion Property assessmentInstrumentQuestion assessmentInstrumentQuestion Property Property assessmentResponse_assessmentInstrumentQuestion Polyline coordinates describing hotspot on the image benefitStage Property benefitStage Property benefitStage benefitStage Property Property Association Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image subject Property subject Property subject subject Property Property humanPatient_subject Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image asPerson Property asPerson Property asPerson asPerson Property Property Association Polyline coordinates describing hotspot on the image patientCaseManagement Property patientCaseManagement Property patientCaseManagement patientCaseManagement Property Property Association Polyline coordinates describing hotspot on the image certificateOfMedicalNecessity Property certificateOfMedicalNecessity Property certificateOfMedicalNecessity certificateOfMedicalNecessity Property Property Association Polyline coordinates describing hotspot on the image priorAuthorizationRequest Property priorAuthorizationRequest Property priorAuthorizationRequest priorAuthorizationRequest Property Property Association Polyline coordinates describing hotspot on the image payee Property payee Property payee payee Property Property Association Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image billableProcedure Property billableProcedure Property billableProcedure billableProcedure Property Property billableService_procedure Polyline coordinates describing hotspot on the image clinicalInformation Property clinicalInformation Property clinicalInformation clinicalInformation Property Property Association Polyline coordinates describing hotspot on the image otherAmount Property otherAmount Property otherAmount otherAmount Property Property Association Polyline coordinates describing hotspot on the image otherAmount Property otherAmount Property otherAmount otherAmount Property Property Association Polyline coordinates describing hotspot on the image benefitStage Property benefitStage Property benefitStage benefitStage Property Property Association Polyline coordinates describing hotspot on the image billingResponse Property billingResponse Property billingResponse billingResponse Property Property Association Polyline coordinates describing hotspot on the image billingSubmission Property billingSubmission Property billingSubmission billingSubmission Property Property Association Polyline coordinates describing hotspot on the image previousPayment Property previousPayment Property previousPayment previousPayment Property Property Association Polyline coordinates describing hotspot on the image previousPatientResponsibility Property previousPatientResponsibility Property previousPatientResponsibility previousPatientResponsibility Property Property Association Polyline coordinates describing hotspot on the image billingSequence Property billingSequence Property billingSequence billingSequence Property Property Association Polyline coordinates describing hotspot on the image previousRejection Property previousRejection Property previousRejection previousRejection Property Property Association Polyline coordinates describing hotspot on the image coordinationOfBenefits Property coordinationOfBenefits Property coordinationOfBenefits coordinationOfBenefits Property Property Association Polyline coordinates describing hotspot on the image billingEvent Property billingEvent Property billingEvent billingEvent Property Property Association Polyline coordinates describing hotspot on the image processor Property processor Property processor processor Property Property Association Polyline coordinates describing hotspot on the image billingSequence Property billingSequence Property billingSequence billingSequence Property Property Association Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image diagnosisRelatedGroup Property diagnosisRelatedGroup Property diagnosisRelatedGroup diagnosisRelatedGroup Property Property Association Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image feeSchedule Property feeSchedule Property feeSchedule feeSchedule Property Property Association Polyline coordinates describing hotspot on the image healthPlan financialArrangement healthPlan financialArrangement healthPlan healthPlan financialArrangement financialArrangement Association Polyline coordinates describing hotspot on the image diagnosis Property diagnosis Property diagnosis diagnosis Property Property diagnosisList_diagnosis Polyline coordinates describing hotspot on the image diagnosisList Property diagnosisList Property diagnosisList diagnosisList Property Property Association Polyline coordinates describing hotspot on the image patient Property patient Property patient patient Property Property Association Polyline coordinates describing hotspot on the image otherPolicyInfo Property otherPolicyInfo Property otherPolicyInfo otherPolicyInfo Property Property Association Polyline coordinates describing hotspot on the image organization Property organization Property organization organization Property Property organizationLocation_organization Polyline coordinates describing hotspot on the image serviceDeliveryLocation Property serviceDeliveryLocation Property serviceDeliveryLocation serviceDeliveryLocation Property Property Association Polyline coordinates describing hotspot on the image PayerOrAgent payer PayerOrAgent payer PayerOrAgent PayerOrAgent payer payer Association Polyline coordinates describing hotspot on the image organization Property organization Property organization organization Property Property Association Polyline coordinates describing hotspot on the image healthPlan group healthPlan group healthPlan healthPlan group group Association Polyline coordinates describing hotspot on the image healthPlan healthcarePolicy healthPlan healthcarePolicy healthPlan healthPlan healthcarePolicy healthcarePolicy Association Polyline coordinates describing hotspot on the image healthPlan payer healthPlan payer healthPlan healthPlan payer payer Association Polyline coordinates describing hotspot on the image couponRedemption Property couponRedemption Property couponRedemption couponRedemption Property Property outpatientMedicationDispense_couponRedemption Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image medicationDispense Property medicationDispense Property medicationDispense medicationDispense Property Property Association Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image serviceProvision Property serviceProvision Property serviceProvision serviceProvision Property Property Association Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image group planSponsor group planSponsor group group planSponsor planSponsor Association Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image group subscriber group subscriber group group subscriber subscriber Association Polyline coordinates describing hotspot on the image subscriber Property subscriber Property subscriber subscriber Property Property Association Polyline coordinates describing hotspot on the image subscriber Property subscriber Property subscriber subscriber Property Property Association Polyline coordinates describing hotspot on the image healthcarePolicy subscriber healthcarePolicy subscriber healthcarePolicy healthcarePolicy subscriber subscriber Association Polyline coordinates describing hotspot on the image patientSubscriber Property patientSubscriber Property patientSubscriber patientSubscriber Property Property Association Polyline coordinates describing hotspot on the image dependent Property dependent Property dependent dependent Property Property Association Polyline coordinates describing hotspot on the image patient Property patient Property patient patient Property Property Association Polyline coordinates describing hotspot on the image coveredBenefit Property coveredBenefit Property coveredBenefit coveredBenefit Property Property Association Polyline coordinates describing hotspot on the image location kind date Accident Comment status quantityAccumulated nbrOfRefillsAuthorized moneyAuthorized maximumQuantity id effectiveDateRange dateProcessed category PriorAuthorization telephone name address FinanciallyResponsibleParty Observation response AssessmentResponse HumanPatient employerGroupName employerGroupId EmployerSponsor Person name id billingType address Payee employerPointOfContact employerPhone employerName employerId employerAddress dateOfInjury WorkersCompClaim questionText possibleResponse assessmentQuestionId assessmentQuestion AssessmentInstrumentQuestion Procedure supportingDocumentation requestType requestBasis previousAuthorizationId effectiveDateRange authorizedRepresentative authorizationId PriorAuthorizationRequest code amount OtherAmount benefitStageType amount BenefitStage taxExemptCategory spendingAccountAmountRemaining remainingDeductibleAmount remainingBenefitAmount professionalServiceFee planSalesTaxAmount percentageSalesTaxRate percentageSalesTaxBasis percentageSalesTaxAmount patientSalesTaxAmount patientPayAmount otherPayerAmountRecognized otherAmountPaidCount ingredientCostAmount ingredientCost incentiveAmount healthPlanFundedAssistanceAmount flatSalesTaxAmount estimatedGenericSavings dispensingFeeAmount dispensingFee benefitStageCount basisOfReimbursementDetermination basisOfCalculationPercentageSalesTax basisOfCalculationFlatSalesTax basisOfCalculationDispensingFee basisOfCalculationCopay basisOfCalculationCoInsurance amountOfProcessingFee amountOfCopay amountOfCoinsurance amountExceedingBenefitMaximum amountAttributedToProviderNetworkSelection amountAttributedToNonFormularySelection amountAttributedToCoverageGap amountAttributedToBrandNonFormularySelection amountAttributedToBrandSelection amountAttributableToSalesTax amountAppliedToDeductible accumulatedDeductibleAmount BillingResponse otherAmountSubmittedCount usualAndCustomaryCharge professionalServiceFee percentageSalesTaxRate percentageSalesTaxBasis percentageSalesTaxAmount patientPaidAmount narrative medicaidPaidAmount ingredientCost incentiveAmount flatSalesTaxAmount dispensingFee basisOfCostDetermination BillingSubmission rejectCode PreviousRejection benefitStageCount previousPatientResponsibilityCount previousRejectionCount previousPaymentCount otherPayerId internalControlId dateAdjudicated CoordinationOfBenefits paymentType amount PreviousPayment patientResponsibilityType amount PreviousPatientResponsibility amountSubmitted amountPaid BillingEvent sequenceNbr BillingSequence AmbulatoryPatientGroup DiagnosisRelatedGroup code amount DiagnosisWeightedPayment CapitationArrangement DrugFormulary billableAct amount FeeSchedule FeeForServiceArrangement effectivePeriod contractId FinancialArrangement precedence DiagnosisListEntry diagnosisModifier diagnosisCode contextCode Diagnosis isResidentOfCmsQualifiedFacility dateRange caseId PatientCaseManagement medigapId medicaidState medicaidId medicaidAgencyId OtherPolicyInfo telecom serviceType name id dateRange category address ServiceDeliveryLocation processorControlNumber planId bankIdNumber Processor telecom name kind isActive alias address Organization pointOfContact phone name id address Payer sendsReportOfEligibility requiresNoticeOfAdmission planName insuranceType id homePlan effectivePeriod deductibleAmount HealthPlan requestStatus questionCount narrative lengthOfNeed category dateSigned dateRevisedOrRecertified dateBegin CertificateOfMedicalNecessity value id category CouponRedemption wasPatientCounseled salesTransactionTime salesTransactionId paymentType deliveryModality OutpatientMedicationDispense pharmacist filler dispenser substitutionCode specialPackaging quantityDispensed productSelectionCode needsHumanReview isCompound id fillSequenceNumber dispensingInstructions dispenseNotes dispenseMethod dispenseCategory daysSupply dateTimeFilled dateTimeDispensed actualStrength PharmacyDispense ProfessionalServiceProvision pharmacyType levelOfService intermediaryAuthorizationId intermediaryAuthorizationCategory claimDelayReason billingUnitOfMeasure benefitLimitationOverrideId benefitLimitationOverrideCategory DrugProvision DmeProvision hospitalization transactionId submissionClarificationCode serviceDate otherCoverageCode medicaidTransactionId employmentImpacted eligibilityClarificationCode doesProviderAcceptAssignment doesPatientAssignBenefits productServiceId canBenefitsBeCoordinated associatedTransactionId associatedTransactionDate BillableService PlanSponsor EntitlementProgramAdministrator groupName groupId address GroupCoverage coverageType coverageTerm id Subscriber relationshipToPatient PatientSubscriber relationshipToPatient Dependent personCode patientResidenceType id CoveredPatient status patientId mothersIdentifier endDate beginDate Patient copaymentAmount coinsuranceAmount code CoveredBenefit policyTerm policyId HealthcarePolicy Comment Comment Comment Comment Comment

Classifiers

Diagrams

Properties:

Alias
Keywords
NameEnrollEligCOB
Name Expression
NamespaceFHIM
Nesting PackageFHIM
Owned Template Signature
OwnerFHIM
Owning Template Parameter
Qualified NameFHIM::EnrollEligCOB
Stereotype
Template Parameter
VisibilityPublic