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Enrollment Responses

Enrollment Responses (FHIR EnrollmentResponse) capture the insurer’s decision on an enrollment request. Track whether enrollment was approved, queued for processing, or encountered an error.

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Record an Enrollment Approval

const { data: response } = await clinik.enrollmentResponses.create({
  requestId: 'enr_req_abc123',
  outcome: 'complete',
  disposition: 'Enrollment approved. Coverage effective 2024-04-01.',
  organizationId: 'org_bluecross456',
  requestProviderId: 'Practitioner/prac_dr789',
});

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Queued for Processing

const { data } = await clinik.enrollmentResponses.create({
  requestId: 'enr_req_def456',
  outcome: 'queued',
  disposition: 'Enrollment request received. Processing within 5 business days.',
  organizationId: 'org_aetna789',
});

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Record an Enrollment Denial

const { data } = await clinik.enrollmentResponses.create({
  requestId: 'enr_req_ghi789',
  outcome: 'error',
  disposition: 'Enrollment denied — patient does not meet eligibility criteria for selected plan.',
  organizationId: 'org_cigna001',
});

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Update Disposition

const { data } = await clinik.enrollmentResponses.update('enr_resp_abc123', {
  disposition: 'Updated: Enrollment approved after additional documentation received.',
});

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Search Enrollment Responses

// Filter by outcome
const { data } = await clinik.enrollmentResponses.search({
  outcome: 'complete',
});

// Filter by status
const { data: active } = await clinik.enrollmentResponses.search({
  status: 'active',
});