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.

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',
});

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',
});

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',
});

Update Disposition

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

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',
});