EnrollEligCOB

Enrollment, Eligibility, and Coordination of Benefits Domain

EnrollEligCOB
error Property error Property error error Property Property eligibilityResponse_error Polyline coordinates describing hotspot on the image benefit Property benefit Property benefit benefit Property Property benefitBalance_benefit Polyline coordinates describing hotspot on the image benefitBalance Property benefitBalance Property benefitBalance benefitBalance Property Property insurance_benefitBalance Polyline coordinates describing hotspot on the image insurance Property insurance Property insurance insurance Property Property eligibilityResponse_insurance Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image organization Property organization Property organization organization Property Property benefitsProvider_organization Polyline coordinates describing hotspot on the image request Property request Property request request Property Property eligibilityResponse_request Polyline coordinates describing hotspot on the image billableProcedure Property billableProcedure Property billableProcedure billableProcedure Property Property billableService_procedure Polyline coordinates describing hotspot on the image assessmentResponse Property assessmentResponse Property assessmentResponse assessmentResponse Property Property certificateOfMedicalNecessity_assessmentResponse Polyline coordinates describing hotspot on the image clinicalInformation Property clinicalInformation Property clinicalInformation clinicalInformation Property Property patientCaseManagement_clinicalInformation Polyline coordinates describing hotspot on the image diagnosisList Property diagnosisList Property diagnosisList diagnosisList Property Property patientCaseManagement_diagnosisList Polyline coordinates describing hotspot on the image healthcarePolicy Property healthcarePolicy Property healthcarePolicy healthcarePolicy Property Property workersCompClaim_healthcarePolicy Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image serviceProvision Property serviceProvision Property serviceProvision serviceProvision Property Property drugProvision_serviceProvision Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image priorAuthorizationRequest Property priorAuthorizationRequest Property priorAuthorizationRequest priorAuthorizationRequest Property Property billableService_priorAuthorizationRequest Polyline coordinates describing hotspot on the image priorAuthorization Property priorAuthorization Property priorAuthorization priorAuthorization Property Property patientCaseManagement_priorAuthorization Polyline coordinates describing hotspot on the image priorAuthorization Property priorAuthorization Property priorAuthorization priorAuthorization Property Property drugProvision_priorAuthorization Polyline coordinates describing hotspot on the image group planSponsor group planSponsor group group planSponsor planSponsor planSponsor_group Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image processor Property processor Property processor processor Property Property billingEvent_processor Polyline coordinates describing hotspot on the image payerOrAgent payer payerOrAgent payer payerOrAgent payerOrAgent payer payer payer_payerOrAgent Polyline coordinates describing hotspot on the image payee Property payee Property payee payee Property Property billingEvent_payee Polyline coordinates describing hotspot on the image patientCaseManagement Property patientCaseManagement Property patientCaseManagement patientCaseManagement Property Property billableService_patientCaseManagement Polyline coordinates describing hotspot on the image otherPolicyInfo Property otherPolicyInfo Property otherPolicyInfo otherPolicyInfo Property Property subscriber_otherPolicyInfo Polyline coordinates describing hotspot on the image responsibleParty Property responsibleParty Property responsibleParty responsibleParty Property Property coveredPatient_responsibleParty Polyline coordinates describing hotspot on the image guarantor Property guarantor Property guarantor guarantor Property Property account_guarantor Polyline coordinates describing hotspot on the image feeSchedule Property feeSchedule Property feeSchedule feeSchedule Property Property feeForServiceArrangement_feeSchedule Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image diagnosisRelatedGroup Property diagnosisRelatedGroup Property diagnosisRelatedGroup diagnosisRelatedGroup Property Property feeForServiceArrangement_diagnosisRelatedGroup Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image healthPlan financialArrangement healthPlan financialArrangement healthPlan healthPlan financialArrangement financialArrangement financialArrangement_healthPlan Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image medicationDispense Property medicationDispense Property medicationDispense medicationDispense Property Property drugProvision_medicationDispense 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 coveredBenefit Property coveredBenefit Property coveredBenefit coveredBenefit Property Property healthPlan_coveredBenefit 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 dispenseToLocation Property dispenseToLocation Property dispenseToLocation dispenseToLocation Property Property pharmacydispense_dispenseToLocation Polyline coordinates describing hotspot on the image certificateOfMedicalNecessity Property certificateOfMedicalNecessity Property certificateOfMedicalNecessity certificateOfMedicalNecessity Property Property billableService_certificateOfMedicalNecessity Polyline coordinates describing hotspot on the image billingSequence Property billingSequence Property billingSequence billingSequence Property Property coordinationOfBenefits_billingSequence Polyline coordinates describing hotspot on the image previousPatientResponsibility Property previousPatientResponsibility Property previousPatientResponsibility previousPatientResponsibility Property Property coordinationOfBenefits_previousPatientResponsibility Polyline coordinates describing hotspot on the image previousRejection Property previousRejection Property previousRejection previousRejection Property Property coordinationOfBenefits_previousRejection Polyline coordinates describing hotspot on the image benefitStage Property benefitStage Property benefitStage benefitStage Property Property coordinationOfBenefits_benefitStage Polyline coordinates describing hotspot on the image previousPayment Property previousPayment Property previousPayment previousPayment Property Property coordinationOfBenefits_previousPayment Polyline coordinates describing hotspot on the image coordinationOfBenefits Property coordinationOfBenefits Property coordinationOfBenefits coordinationOfBenefits Property Property billingEvent_coordinationOfBenefits Polyline coordinates describing hotspot on the image otherAmount Property otherAmount Property otherAmount otherAmount Property Property billingResponse_otherAmount Polyline coordinates describing hotspot on the image otherAmount Property otherAmount Property otherAmount otherAmount Property Property billingSubmission_otherAmount Polyline coordinates describing hotspot on the image billingSubmission Property billingSubmission Property billingSubmission billingSubmission Property Property billingEvent_billingSubmission Polyline coordinates describing hotspot on the image billingEvent Property billingEvent Property billingEvent billingEvent Property Property billingSequence_billingEvent Polyline coordinates describing hotspot on the image billingSequence Property billingSequence Property billingSequence billingSequence Property Property billableService_billingSequence Polyline coordinates describing hotspot on the image billingResponse Property billingResponse Property billingResponse billingResponse Property Property billingEvent_billingResponse Polyline coordinates describing hotspot on the image benefitStage Property benefitStage Property benefitStage benefitStage Property Property billingResponse_benefitStage Polyline coordinates describing hotspot on the image serviceDeliveryLocation Property serviceDeliveryLocation Property serviceDeliveryLocation serviceDeliveryLocation Property Property billableService_serviceDeliveryLocation Polyline coordinates describing hotspot on the image patient Property patient Property patient patient Property Property billableService_patient Polyline coordinates describing hotspot on the image coverage Property coverage Property coverage coverage Property Property accountCoverage_coverage Polyline coordinates describing hotspot on the image accountCoverage Property accountCoverage Property accountCoverage accountCoverage Property Property account_accountCoverage Polyline coordinates describing hotspot on the image contract Property contract Property contract contract Property Property coverage_contract Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image network Property network Property network network Property Property planOrPolicy_network Polyline coordinates describing hotspot on the image organization Property organization Property organization organization Property Property network_organization Polyline coordinates describing hotspot on the image planOrPolicy Property planOrPolicy Property planOrPolicy planOrPolicy Property Property coverage_planOrPolicy Polyline coordinates describing hotspot on the image dependent Property dependent Property dependent dependent Property Property coverage_dependent Polyline coordinates describing hotspot on the image planOrPolicy payer planOrPolicy payer planOrPolicy planOrPolicy payer payer payer_planOrPolicy Polyline coordinates describing hotspot on the image healthPlan healthcarePolicy healthPlan healthcarePolicy healthPlan healthPlan healthcarePolicy healthcarePolicy healthcarePolicy_healthPlan Polyline coordinates describing hotspot on the image healthPlan group healthPlan group healthPlan healthPlan group group group_healthPlan Polyline coordinates describing hotspot on the image healthcarePolicy subscriber healthcarePolicy subscriber healthcarePolicy healthcarePolicy subscriber subscriber subscriber_healthcarePolicy Polyline coordinates describing hotspot on the image groupCoverage Property groupCoverage Property groupCoverage groupCoverage Property Property coverage_groupCoverage Polyline coordinates describing hotspot on the image group subscriber group subscriber group group subscriber subscriber subscriber_group Polyline coordinates describing hotspot on the image organization Property organization Property organization organization Property Property payer_organization Polyline coordinates describing hotspot on the image coverage Property coverage Property coverage coverage Property Property coveredPatient_coverage Polyline coordinates describing hotspot on the image coveredPatient Property coveredPatient Property coveredPatient coveredPatient Property Property coverage_coveredPatient Polyline coordinates describing hotspot on the image subscriber Property subscriber Property subscriber subscriber Property Property coverage_subscriber Polyline coordinates describing hotspot on the image subscriber Property subscriber Property subscriber subscriber Property Property dependent_subscriber Polyline coordinates describing hotspot on the image Generalization Polyline coordinates describing hotspot on the image asPerson Property asPerson Property asPerson asPerson Property Property subscriber_asPerson 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 patient Property patient Property patient patient Property Property coveredPatient_patient Polyline coordinates describing hotspot on the image kind Error used kind allowed Benefit term unit network name isExcluded description subCategory category BenefitBalance coverage contract Insurance OrganizationalPayer Self-pay BenefitsProvider status requestProvider requestOrganization outcome isInForce insurer identifier form disposition dateCreated EligibilityResponse status provider priority patient organization insurer identifier facility enterer datesOfService dateCreated coverage businessArrangement benefitSubCategory benefitCategory EligibilityRequest Procedure Answer Observation DiagnosisListEntry employerPointOfContact employerPhone employerName employerId employerAddress dateOfInjury WorkersCompClaim ProfessionalServiceProvision supportingDocumentation requestType requestBasis previousAuthorizationId effectiveDateRange authorizedRepresentative authorizationId PriorAuthorizationRequest status quantityAccumulated nbrOfRefillsAuthorized moneyAuthorized maximumQuantity id effectiveDateRange dateProcessed category PriorAuthorization PlanSponsor processorControlNumber planId bankIdNumber Processor name identifier billingType address Payee isResidentOfCmsQualifiedFacility dateRange caseId PatientCaseManagement medigapId medicaidState medicaidId medicaidAgencyId OtherPolicyInfo telephone name period party isOnHold address FinanciallyResponsibleParty EntitlementProgramAdministrator employerGroupName employerGroupId EmployerSponsor FeeForServiceArrangement billableAct amount FeeSchedule effectivePeriod contractId FinancialArrangement pharmacyType levelOfService intermediaryAuthorizationId intermediaryAuthorizationCategory claimDelayReason billingUnitOfMeasure benefitLimitationOverrideId benefitLimitationOverrideCategory DrugProvision DmeProvision DrugFormulary code amount DiagnosisWeightedPayment DiagnosisRelatedGroup copaymentAmount coinsuranceAmount code CoveredBenefit OutpatientMedicationDispense PharmacyDispense value id category CouponRedemption requestStatus questionCount narrative lengthOfNeed category dateSigned dateRevisedOrRecertified dateBegin CertificateOfMedicalNecessity CapitationArrangement benefitStageCount previousPatientResponsibilityCount previousRejectionCount previousPaymentCount otherPayerId internalControlId dateAdjudicated CoordinationOfBenefits patientResponsibilityType amount PreviousPatientResponsibility paymentType amount PreviousPayment rejectCode PreviousRejection code amount OtherAmount otherAmountSubmittedCount usualAndCustomaryCharge professionalServiceFee percentageSalesTaxRate percentageSalesTaxBasis percentageSalesTaxAmount patientPaidAmount narrative medicaidPaidAmount ingredientCost incentiveAmount flatSalesTaxAmount dispensingFee basisOfCostDetermination BillingSubmission sequenceNbr BillingSequence 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 amountSubmitted amountPaid BillingEvent hospitalization transactionId submissionClarificationCode serviceDate otherCoverageCode medicaidTransactionId employmentImpacted eligibilityClarificationCode doesProviderAcceptAssignment doesPatientAssignBenefits productServiceId canBenefitsBeCoordinated associatedTransactionId associatedTransactionDate BillableService benefitStageType amount BenefitStage AmbulatoryPatientGroup location kind date Accident priority AccountCoverage status period owner name kind identifier description balance active Account Contract networkIdentifier Network subPlanName subPlanId sendsReportOfEligibility requiresNoticeOfAdmission planName planId insuranceType homePlan effectivePeriod deductibleAmount HealthPlan policyTerm policyId HealthcarePolicy PlanOrPolicy subGroupName subGroupId subClassName subClassId groupName groupId className classId GroupCoverage pointOfContact phone name identifier address Payer order sequence period kind status identifier Coverage coverageType coverageTerm subscriberIdentifier Subscriber dependentIdentifier relationshipToSubscriber Dependent HumanPatient personCode patientResidenceType identifier CoveredPatient Comment Person telecom serviceType name id dateRange category address ServiceDeliveryLocation telecom name kind isActive alias address Organization Patient 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