NES Entitlements FHIR API

Entitlements is a resource available from within the National Enrolment Service. The National Enrolment Service (NES) is a registry designed to provide a single source of truth for patient enrolments, entitlements and newborn enrolment nominations.   

The NES system also has the capability to store and disseminate details relating to a patient’s entitlements. At the current time two such entitlements are recorded in NES – the High Use Health Card (HUHC) and the Community Services Card (CSC). 

This FHIR API has two resources: 

• Patient entitlements, derived from the HL7 FHIR coverage resource. 
• Patient enrolments, derived from the HL7 FHIR episode of care resource. 

The NES entitlement API holds the following information: 

• identifier – external entitlement ID 
• beneficiary – NHI number 
• entitlement type 
• entitlement status 
• relationship – the relationship between the subscriber and the beneficiary (e.g. child, parent, spouse, common law spouse, other, self or injured party). 
• entitlement start date 
• entitlement end date 
• organisation approving the entitlement. 

Health providers listed in Schedule 2 of the Health Information Privacy Code may access the information in the NHI. 

This includes:  

• Accident Compensation Corporation (ACC)  
• Department of Corrections Health Services   
• Health New Zealand | Te Whatu Ora
• Health practitioners  
• Hospitals  
• Independent practitioner associations   
• MedicAlert Foundation — New Zealand Incorporated   
• Manatū Hauora — Ministry of Health    
• New Zealand Blood and Organ Service   
• New Zealand Defense Force Health Services 
• Pharmaceutical Management Agency of New Zealand  
• Primary health organisations (PHOs) 
• Whaikaha - Ministry of Disabled People  
• Any health agency that has a contract or is funded by any of the above to provide health and disability services. 

Health New Zealand assigns appropriate permissions and monitors and audits the actions of health provider use of the NHI. 

The below are some example outcomes from using the NHI API. 

System to system 

• Search the entitlement details using known entitlement ID 
• Look up what entitlements a patient has subscribed to 
• Create a new entitlement for a patient  

Patient 

• A person can view their entitlement details 
  

To begin the onboarding process for this API, please visit the Consumer onboarding page.

For information on integrating, view the Implementation guide.

FHIR API

All FHIR API endpoints adhere to Fast Healthcare Interoperable Resources (FHIR) interoperability standards and follow REST protocols.