OverviewTopPackageElement
EnrollEligCOB UML Documentation

EnrollEligCOB

Enrollment, Eligibility, and Coordination of Benefits Domain

EnrollEligCOB
coverageLimit Property coverageLimit Property coverageLimit coverageLimit Property Property healthPlanCoverage_coverageLimit Polyline coordinates describing hotspot on the image coverage Property coverage Property coverage coverage Property Property healthPlan_coverage Polyline coordinates describing hotspot on the image generalCost Property generalCost Property generalCost generalCost Property Property healthPlan_generalCost Polyline coordinates describing hotspot on the image priceComponent Property priceComponent Property priceComponent priceComponent Property Property invoiceLineItem_priceComponent Polyline coordinates describing hotspot on the image priceComponent Property priceComponent Property priceComponent priceComponent Property Property invoice_priceComponent Polyline coordinates describing hotspot on the image invoiceLineItem Property invoiceLineItem Property invoiceLineItem invoiceLineItem Property Property invoice_invoiceLineItem Polyline coordinates describing hotspot on the image item Property item Property item item Property Property coverageEligibilityRequest_item Polyline coordinates describing hotspot on the image requestedInsurance Property requestedInsurance Property requestedInsurance requestedInsurance Property Property coverageEligibilityRequest_requestedInsurance Polyline coordinates describing hotspot on the image supportingInformation Property supportingInformation Property supportingInformation supportingInformation Property Property coverageEligibilityRequest_supportingInformation Polyline coordinates describing hotspot on the image exception Property exception Property exception exception Property Property costToBeneficiary_exception Polyline coordinates describing hotspot on the image costToBeneficiary Property costToBeneficiary Property costToBeneficiary costToBeneficiary Property Property coverage_costToBeneficiary Polyline coordinates describing hotspot on the image partOf Property partOf Property partOf partOf Property Property billableService_partOf Polyline coordinates describing hotspot on the image partOf Property partOf Property partOf partOf Property Property account_partOf Polyline coordinates describing hotspot on the image endpoint Property endpoint Property endpoint endpoint Property Property healthPlan_endpoint Polyline coordinates describing hotspot on the image managingOrganization Property managingOrganization Property managingOrganization managingOrganization Property Property endpoint_managingOrganization Polyline coordinates describing hotspot on the image endpoint Property endpoint Property endpoint endpoint Property Property pointOfContact_endpoint Polyline coordinates describing hotspot on the image contact Property contact Property contact contact Property Property healthPlan_contact Polyline coordinates describing hotspot on the image pointOfContact Property pointOfContact Property pointOfContact pointOfContact Property Property organization_pointOfContact Polyline coordinates describing hotspot on the image administeredBy Property administeredBy Property administeredBy administeredBy Property Property planOrPolicy_administeredBy Polyline coordinates describing hotspot on the image diagnosis Property diagnosis Property diagnosis diagnosis Property Property diagnosisList_diagnosis Polyline coordinates describing hotspot on the image accident Property accident Property accident accident Property Property claim_accident Polyline coordinates describing hotspot on the image detail Property detail Property detail detail Property Property paymentReconciliation_detail Polyline coordinates describing hotspot on the image processNote Property processNote Property processNote processNote Property Property paymentReconciliation_processNote Polyline coordinates describing hotspot on the image request Property request Property request request Property Property enrollmentResponse_request Polyline coordinates describing hotspot on the image error Property error Property error error Property Property coverageEligibilityResponse__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 item Property item Property item item Property Property insurance_benefitBalance Polyline coordinates describing hotspot on the image insurance Property insurance Property insurance insurance Property Property coverageEligibilityResponse_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 coverageEligibilityResponse__request Polyline coordinates describing hotspot on the image service Property service Property service service 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 specificCost Property specificCost Property specificCost specificCost Property Property healthPlan_specificCost 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 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 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 value kind CoverageLimit requirement network kind benefitType PlanCoverage kind groupSize cost comment PlanGeneralCost Comment totalNet kind category amount PriceComponent sequence chargeItemReference chargeItemCode InvoiceLineItem totalNet totalGross subject status recipient paymentTerms participant note kind issuer identifier date cancelledReason account Invoice unitPrice sequence quantity provider productOrService modifier facility diagnosisReference diagnosisCode detail category RequestItem isFocal coverage businessArrangement RequestedInsurance sequence information appliesToAll SupportingInformation period kind Exception valuePercent valueMoney kind CostToBeneficiary Contract status preferredMethod period payloadType payloadMimeType name integrationProfileVersion integrationProfileOptions integrationProfile identifier header contact connectionType address ElectronicServiceEndpoint telecom name effectiveDateRange contactCategory address PointOfContact vision substanceAbuse shortTerm mental medical longTerm hospice home drug dental PlanType diagnosisModifier diagnosisCode contextCode Diagnosis use type total subType status requestProvider requestOrganization priority periodHospitalized periodEmploymentImpacted identifier fundsReserve enterer diagnosis dateCreated billablePeriod Claim submitter response request payee kind date amount Detail text kind ProcessNote total status requestProvider requestOrganization request period outcome organization identifier form disposition dateCreated PaymentReconciliation status response request recipient provider paymentStatus paymentDate payment payee identifier dateCreated amount PaymentNotice status requestProvider outcome organization identifier disposition dateCreated EnrollmentResponse status provider insurer identifier dateCreated coverage candidate EnrollmentRequest kind Error used kind allowed Benefit unit term provider productOrService network name modifier isExcluded isAuthorizationRequired description category authorizationUrl authorizationSupporting ResponseItem isInForce coverage benefitPeriod ResponseInsurance OrganizationalPayer Self-pay BenefitsProvider status requestor purpose preAuthRef patient outcome insurer identifier form disposition datesOfService dateCreated CoverageEligibilityResponse status purpose provider priority patient insurer identifier facility enterer datesOfService dateCreated CoverageEligibilityRequest ActionPerformed Answer ObservationStatement precedence DiagnosisListEntry employerPointOfContact employerPhone employerName employerId employerAddress dateOfInjury WorkersCompClaim ProfessionalServiceProvision supportingDocumentation requestType requestBasis previousAuthorizationId effectiveDateRange authorizedRepresentative authorizationId PriorAuthorizationRequest status quantityAccumulated nbrOfRefillsAuthorized moneyAuthorized maximumQuantity identifier effectiveDateRange dateProcessed category PriorAuthorization PlanSponsor processorControlNumber planId bankIdNumber Processor partyType party 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 value qualifiers kind category benefitType applicability PlanSpecificCost OutpatientMedicationDispense PharmacyDispense value identifier 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 supportingInformation submissionClarificationCode status requestingOrganization reason quantity productServiceCode product priceOverride performingOrganization overrideReason otherCoverageCode note medicaidTransactionId location identifier hospitalization factorOverride enterer encounter employmentImpacted eligibilityClarificationCode doesProviderAcceptAssignment doesPatientAssignBenefits definitionUri definitionCanonical dateOfService dateEntered costCenter canBenefitsBeCoordinated bodysite associatedTransactionId associatedTransactionDate account BillableService benefitStageType amount BenefitStage AmbulatoryPatientGroup location kind date Accident priority AccountCoverage status period owner name kind identifier description balance active Account networkIdentifier ProviderNetwork status subPlanName subPlanId sendsReportOfEligibility requiresNoticeOfAdmission planName planId period kind insuranceType homePlan effectivePeriod deductibleAmount coverageArea alias HealthPlan policyTerm policyId HealthcarePolicy PlanOrPolicy subGroupName subGroupId subClassName subClassId groupName groupId className classId GroupCoverage pointOfContact phone name identifier address Payer status sequence policyHolder period order kind isSubrogated identifier Coverage coverageType coverageTerm subscriberIdentifier Subscriber dependentIdentifier relationshipToSubscriber Dependent HumanPatient personCode patientResidenceType identifier CoveredPatient Comment Person telecom name kind isActive alias address Organization Patient Comment Comment

Classifiers
Accident Accident
Account Account
AccountCoverage AccountCoverage
AmbulatoryPatientGroup AmbulatoryPatientGroup
Benefit Benefit
BenefitsProvider BenefitsProvider
BenefitStage BenefitStage
BillableService BillableService
BillingEvent BillingEvent
BillingResponse BillingResponse
BillingSequence BillingSequence
BillingSubmission BillingSubmission
CapitationArrangement CapitationArrangement
CertificateOfMedicalNecessity CertificateOfMedicalNecessity
Claim Claim
CoordinationOfBenefits CoordinationOfBenefits
CostToBeneficiary CostToBeneficiary
CouponRedemption CouponRedemption
Coverage Coverage
CoverageEligibilityRequest CoverageEligibilityRequest
CoverageEligibilityResponse CoverageEligibilityResponse
CoverageLimit CoverageLimit
CoveredPatient CoveredPatient
Dependent Dependent
Detail Detail
DiagnosisRelatedGroup DiagnosisRelatedGroup
DiagnosisWeightedPayment DiagnosisWeightedPayment
DmeProvision DmeProvision
DrugFormulary DrugFormulary
DrugProvision DrugProvision
EmployerSponsor EmployerSponsor
EnrollmentRequest EnrollmentRequest
EnrollmentResponse EnrollmentResponse
EntitlementProgramAdministrator EntitlementProgramAdministrator
Error Error
Exception Exception
FeeForServiceArrangement FeeForServiceArrangement
FeeSchedule FeeSchedule
FinancialArrangement FinancialArrangement
FinanciallyResponsibleParty FinanciallyResponsibleParty
GroupCoverage GroupCoverage
HealthcarePolicy HealthcarePolicy
HealthPlan HealthPlan
Invoice Invoice
InvoiceLineItem InvoiceLineItem
OrganizationalPayer OrganizationalPayer
OtherAmount OtherAmount
OtherPolicyInfo OtherPolicyInfo
PatientCaseManagement PatientCaseManagement
Payee Payee
Payer Payer
PaymentNotice PaymentNotice
PaymentReconciliation PaymentReconciliation
PlanCoverage PlanCoverage
PlanGeneralCost PlanGeneralCost
PlanOrPolicy PlanOrPolicy
PlanSpecificCost PlanSpecificCost
PlanSponsor PlanSponsor
PlanType PlanType
PreviousPatientResponsibility PreviousPatientResponsibility
PreviousPayment PreviousPayment
PreviousRejection PreviousRejection
PriceComponent PriceComponent
PriorAuthorization PriorAuthorization
PriorAuthorizationRequest PriorAuthorizationRequest
ProcessNote ProcessNote
Processor Processor
ProfessionalServiceProvision ProfessionalServiceProvision
RequestedInsurance RequestedInsurance
RequestItem RequestItem
ResponseInsurance ResponseInsurance
ResponseItem ResponseItem
Self-pay Self-pay
Subscriber Subscriber
SupportingInformation SupportingInformation
VocabContext VocabContext
WorkersCompClaim WorkersCompClaim

Diagrams
EnrollEligCOB EnrollEligCOB

Properties:

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