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HS.SDA3.MedicalClaim

serial class HS.SDA3.MedicalClaim extends HS.SDA3.SuperClass, HS.SDA3.AbstractClaim

MedicalClaim is neither parsed from HL7, nor is it stored to the Viewer Cache.

Property Inventory

Properties

property AccidentIndicator as %String (DISPLAYLIST = ",Yes,No,Unknown,Other,NotApplicable", VALUELIST = ",1,2,3,4,5");
Numeric indicator that reports if the claim line procedure was performed due to an accident (not employment based).
Property methods: AccidentIndicatorDisplayToLogical(), AccidentIndicatorGet(), AccidentIndicatorIsValid(), AccidentIndicatorLogicalToDisplay(), AccidentIndicatorLogicalToOdbc(), AccidentIndicatorNormalize(), AccidentIndicatorSet()
property AdmissionDate as HS.SDA3.TimeStamp;
The date that the Patient was admitted into an inpatient setting at the facility.
Property methods: AdmissionDateDisplayToLogical(), AdmissionDateGet(), AdmissionDateIsValid(), AdmissionDateLogicalToDisplay(), AdmissionDateLogicalToTimeStamp(), AdmissionDateLogicalToXSD(), AdmissionDateNormalize(), AdmissionDateOdbcToLogical(), AdmissionDateSet(), AdmissionDateXSDToLogical()
deprecated property AdmissionDiagnosis as HS.SDA3.CodeTableDetail.Diagnosis;
Deprecated
Diagnostic code assigned by the provider to support admission into an inpatient setting at the
facility reported in Plan Rendering Provider ID and Provider Location.
This property is deprecated and has been replaced by the Diagnoses property where "admitting" may be
specified as a value in the DiagnosisType property in the HS.SDA3.Diagnosis class.
Property methods: AdmissionDiagnosisGet(), AdmissionDiagnosisGetObject(), AdmissionDiagnosisGetObjectId(), AdmissionDiagnosisGetSwizzled(), AdmissionDiagnosisIsEmpty(), AdmissionDiagnosisIsValid(), AdmissionDiagnosisNewObject(), AdmissionDiagnosisSet(), AdmissionDiagnosisSetObject(), AdmissionDiagnosisSetObjectId(), AdmissionDiagnosisUnSwizzle()
property AdmissionSource as HS.SDA3.CodeTableDetail.AdmissionSource;
A standardized code that reports the admission source of the Patient into an inpatient setting/facility
and indicates how the Patient was referred into the inpatient setting.
Property methods: AdmissionSourceGet(), AdmissionSourceGetObject(), AdmissionSourceGetObjectId(), AdmissionSourceGetSwizzled(), AdmissionSourceIsEmpty(), AdmissionSourceIsValid(), AdmissionSourceNewObject(), AdmissionSourceSet(), AdmissionSourceSetObject(), AdmissionSourceSetObjectId(), AdmissionSourceUnSwizzle()
property AdmissionType as HS.SDA3.CodeTableDetail.AdmissionType;
A standardized, numeric code that reports the type of admission into an inpatient setting.
Property methods: AdmissionTypeGet(), AdmissionTypeGetObject(), AdmissionTypeGetObjectId(), AdmissionTypeGetSwizzled(), AdmissionTypeIsEmpty(), AdmissionTypeIsValid(), AdmissionTypeNewObject(), AdmissionTypeSet(), AdmissionTypeSetObject(), AdmissionTypeSetObjectId(), AdmissionTypeUnSwizzle()
property AttendingProvider as HS.SDA3.CodeTableDetail.CareProvider;
Property methods: AttendingProviderGet(), AttendingProviderGetObject(), AttendingProviderGetObjectId(), AttendingProviderGetSwizzled(), AttendingProviderIsEmpty(), AttendingProviderIsValid(), AttendingProviderNewObject(), AttendingProviderSet(), AttendingProviderSetObject(), AttendingProviderSetObjectId(), AttendingProviderUnSwizzle()
property CapitatedEncounterFlag as %String (DISPLAYLIST = ",Yes,No,Unknown,Other,NotApplicable", VALUELIST = ",1,2,3,4,5");
Numeric indicator that reports if a claim line is covered under a capitation arrangement.
Property methods: CapitatedEncounterFlagDisplayToLogical(), CapitatedEncounterFlagGet(), CapitatedEncounterFlagIsValid(), CapitatedEncounterFlagLogicalToDisplay(), CapitatedEncounterFlagLogicalToOdbc(), CapitatedEncounterFlagNormalize(), CapitatedEncounterFlagSet()
property ClaimStatus as HS.SDA3.CodeTableDetail.ClaimStatus;
Numeric indicator that reports if the claim line was paid by the carrier or its designee, and the COB order of the payment.
Property methods: ClaimStatusGet(), ClaimStatusGetObject(), ClaimStatusGetObjectId(), ClaimStatusGetSwizzled(), ClaimStatusIsEmpty(), ClaimStatusIsValid(), ClaimStatusNewObject(), ClaimStatusSet(), ClaimStatusSetObject(), ClaimStatusSetObjectId(), ClaimStatusUnSwizzle()
deprecated property DRG as %String (MAXLEN = 50);
Deprecated
CMS methodology when available. When the CMS methodology for DRGs is not available, but the All Payer DRG system
is used, the insurer shall format the DRG and the complexity level within the same field with an "A" prefix, and
with a hyphen separating the DRG and the complexity level (e.g. AXXX-XX).
This property is deprecated and has been replaced by the DiagnosisRelatedGroup property that is a coded representation of the data.
Property methods: DRGDisplayToLogical(), DRGGet(), DRGIsValid(), DRGLevelDisplayToLogical(), DRGLevelGet(), DRGLevelIsValid(), DRGLevelLogicalToDisplay(), DRGLevelLogicalToOdbc(), DRGLevelNormalize(), DRGLevelSet(), DRGLogicalToDisplay(), DRGLogicalToOdbc(), DRGNormalize(), DRGSet(), DRGVersionDisplayToLogical(), DRGVersionGet(), DRGVersionIsValid(), DRGVersionLogicalToDisplay(), DRGVersionLogicalToOdbc(), DRGVersionNormalize(), DRGVersionSet()
deprecated property DRGLevel as %String (MAXLEN = 50);
Deprecated
Severity adjustment level when applicable.
This property is deprecated and has been replaced by the DiagnosisRelatedGroup property that is a coded
representation of the data.
Property methods: DRGLevelDisplayToLogical(), DRGLevelGet(), DRGLevelIsValid(), DRGLevelLogicalToDisplay(), DRGLevelLogicalToOdbc(), DRGLevelNormalize(), DRGLevelSet()
deprecated property DRGVersion as %String (MAXLEN = 50);
Deprecated
Version identifier of the DRG Grouper used.
This property is deprecated and has been replaced by the DiagnosisRelatedGroup property that is a coded representation of the data.
Property methods: DRGVersionDisplayToLogical(), DRGVersionGet(), DRGVersionIsValid(), DRGVersionLogicalToDisplay(), DRGVersionLogicalToOdbc(), DRGVersionNormalize(), DRGVersionSet()
property DelegatedBenefitAdminOrgID as %String (MAXLEN = 50);
Property methods: DelegatedBenefitAdminOrgIDDisplayToLogical(), DelegatedBenefitAdminOrgIDGet(), DelegatedBenefitAdminOrgIDIsValid(), DelegatedBenefitAdminOrgIDLogicalToDisplay(), DelegatedBenefitAdminOrgIDLogicalToOdbc(), DelegatedBenefitAdminOrgIDNormalize(), DelegatedBenefitAdminOrgIDSet()
property Diagnoses as list of HS.SDA3.Diagnosis;
Information about diagnoses relevant to the claim items. ICD-10 or ICD-9.
Property methods: DiagnosesBuildValueArray(), DiagnosesCollectionToDisplay(), DiagnosesCollectionToOdbc(), DiagnosesDisplayToCollection(), DiagnosesGet(), DiagnosesGetObject(), DiagnosesGetObjectId(), DiagnosesGetSwizzled(), DiagnosesIsValid(), DiagnosesOdbcToCollection(), DiagnosesSet(), DiagnosesSetObject(), DiagnosesSetObjectId()
property DiagnosisRelatedGroup as HS.SDA3.CodeTableDetail.DiagnosisRelatedGroup;
Claim diagnosis related group (DRG). This is a coded representation of the data and should be used in place of DRG, DRGLevel, and DRGVersion which are retained for compatibility with previous versions of HealthShare.
Property methods: DiagnosisRelatedGroupGet(), DiagnosisRelatedGroupGetObject(), DiagnosisRelatedGroupGetObjectId(), DiagnosisRelatedGroupGetSwizzled(), DiagnosisRelatedGroupIsEmpty(), DiagnosisRelatedGroupIsValid(), DiagnosisRelatedGroupNewObject(), DiagnosisRelatedGroupSet(), DiagnosisRelatedGroupSetObject(), DiagnosisRelatedGroupSetObjectId(), DiagnosisRelatedGroupUnSwizzle()
property DischargeDate as HS.SDA3.TimeStamp;
End date of the inpatient stay
Property methods: DischargeDateDisplayToLogical(), DischargeDateGet(), DischargeDateIsValid(), DischargeDateLogicalToDisplay(), DischargeDateLogicalToTimeStamp(), DischargeDateLogicalToXSD(), DischargeDateNormalize(), DischargeDateOdbcToLogical(), DischargeDateSet(), DischargeDateXSDToLogical()
deprecated property DischargeDiagnosis as HS.SDA3.CodeTableDetail.Diagnosis;
Deprecated
The ICD9 diagnosis code assigned to the Patient upon discharge.
This property is deprecated and has been replaced by the Diagnoses property where "discharge" may be specified as
a value in the DiagnosisType property in the HS.SDA3.Diagnosis class.
Property methods: DischargeDiagnosisGet(), DischargeDiagnosisGetObject(), DischargeDiagnosisGetObjectId(), DischargeDiagnosisGetSwizzled(), DischargeDiagnosisIsEmpty(), DischargeDiagnosisIsValid(), DischargeDiagnosisNewObject(), DischargeDiagnosisSet(), DischargeDiagnosisSetObject(), DischargeDiagnosisSetObjectId(), DischargeDiagnosisUnSwizzle()
property DischargeStatus as HS.SDA3.CodeTableDetail.DischargeStatus;
A standardized, numeric code that reports the discharge status of the Patient.
Property methods: DischargeStatusGet(), DischargeStatusGetObject(), DischargeStatusGetObjectId(), DischargeStatusGetSwizzled(), DischargeStatusIsEmpty(), DischargeStatusIsValid(), DischargeStatusNewObject(), DischargeStatusSet(), DischargeStatusSetObject(), DischargeStatusSetObjectId(), DischargeStatusUnSwizzle()
property EmploymentRelatedIndicator as %String (DISPLAYLIST = ",Yes,No,Unknown,Other,NotApplicable", VALUELIST = ",1,2,3,4,5");
Numeric indicator that reports if the claim line procedure was performed due to an employment related accident.
837apP: loop2300().CLM:RelatedCausesInformation.RelatedCausesCode
Property methods: EmploymentRelatedIndicatorDisplayToLogical(), EmploymentRelatedIndicatorGet(), EmploymentRelatedIndicatorIsValid(), EmploymentRelatedIndicatorLogicalToDisplay(), EmploymentRelatedIndicatorLogicalToOdbc(), EmploymentRelatedIndicatorNormalize(), EmploymentRelatedIndicatorSet()
property Extension as HS.Local.SDA3.MedicalClaimExtension;
Property methods: ExtensionGet(), ExtensionGetObject(), ExtensionGetObjectId(), ExtensionGetSwizzled(), ExtensionIsEmpty(), ExtensionIsValid(), ExtensionNewObject(), ExtensionSet(), ExtensionSetObject(), ExtensionSetObjectId(), ExtensionUnSwizzle()
deprecated property FormerClaimNumber as %String (MAXLEN = 50);
Deprecated
The Payer Claim Control Number previously assigned to this claim line in a prior reporting period.
This property is deprecated and has been replaced by the RelatedClaim property that provides for greater variety and specificity of how claims are related.
Property methods: FormerClaimNumberDisplayToLogical(), FormerClaimNumberGet(), FormerClaimNumberIsValid(), FormerClaimNumberLogicalToDisplay(), FormerClaimNumberLogicalToOdbc(), FormerClaimNumberNormalize(), FormerClaimNumberSet()
property GlobalPaymentFlag as %String (DISPLAYLIST = ",Yes,No,Unknown,Other,NotApplicable", VALUELIST = ",1,2,3,4,5");
Numeric indicator that reports if a claim line was processed / paid under a global payment arrangement.
837apP: loop2300().CN1:ContractTypeCode
Property methods: GlobalPaymentFlagDisplayToLogical(), GlobalPaymentFlagGet(), GlobalPaymentFlagIsValid(), GlobalPaymentFlagLogicalToDisplay(), GlobalPaymentFlagLogicalToOdbc(), GlobalPaymentFlagNormalize(), GlobalPaymentFlagSet()
property MedicalClaimLines as list of HS.SDA3.MedicalClaimLine;
Property methods: MedicalClaimLinesBuildValueArray(), MedicalClaimLinesCollectionToDisplay(), MedicalClaimLinesCollectionToOdbc(), MedicalClaimLinesDisplayToCollection(), MedicalClaimLinesGet(), MedicalClaimLinesGetObject(), MedicalClaimLinesGetObjectId(), MedicalClaimLinesGetSwizzled(), MedicalClaimLinesIsValid(), MedicalClaimLinesOdbcToCollection(), MedicalClaimLinesSet(), MedicalClaimLinesSetObject(), MedicalClaimLinesSetObjectId()
property MedicalClaimNumber as %String (MAXLEN = 450);
Unique identifier within the payer's system that applies to the entire claim.
837apP: loop2300().CLM:ClaimSubmittersIdentifier
Property methods: MedicalClaimNumberDisplayToLogical(), MedicalClaimNumberGet(), MedicalClaimNumberIsValid(), MedicalClaimNumberLogicalToDisplay(), MedicalClaimNumberLogicalToOdbc(), MedicalClaimNumberNormalize(), MedicalClaimNumberSet()
property MedicareIndicator as %String (DISPLAYLIST = ",Yes,No,Unknown,Other,NotApplicable", VALUELIST = ",1,2,3,4,5");
Numeric indicator that reports if the claim line has any Medicare payments applied towards it as a Prior Payer on the claim.
Property methods: MedicareIndicatorDisplayToLogical(), MedicareIndicatorGet(), MedicareIndicatorIsValid(), MedicareIndicatorLogicalToDisplay(), MedicareIndicatorLogicalToOdbc(), MedicareIndicatorNormalize(), MedicareIndicatorSet()
deprecated property OtherDiagnoses as list of HS.SDA3.CodeTableDetail.Diagnosis;
Deprecated
Other ICD9 Diagnosis Codes.
837apP: loop2300().HI():HealthCareCodeInformation2
This property is deprecated and has been replaced by the Diagnoses property where a greater granularity of diagnosis type may be specified as a
value in the DiagnosisType property in the HS.SDA3.Diagnosis class.
Property methods: OtherDiagnosesBuildValueArray(), OtherDiagnosesCollectionToDisplay(), OtherDiagnosesCollectionToOdbc(), OtherDiagnosesDisplayToCollection(), OtherDiagnosesGet(), OtherDiagnosesGetObject(), OtherDiagnosesGetObjectId(), OtherDiagnosesGetSwizzled(), OtherDiagnosesIsValid(), OtherDiagnosesOdbcToCollection(), OtherDiagnosesSet(), OtherDiagnosesSetObject(), OtherDiagnosesSetObjectId()
property PatientAccount as %String (MAXLEN = 50);
Property methods: PatientAccountDisplayToLogical(), PatientAccountGet(), PatientAccountIsValid(), PatientAccountLogicalToDisplay(), PatientAccountLogicalToOdbc(), PatientAccountNormalize(), PatientAccountSet()
property PerformingNetworkContractingStatus as HS.SDA3.CodeTableDetail.PayerProviderContractingStatus;
Indicates that the Performing Provider has a contract with the Plan (regardless of the network) as of the effective date of service.
Property methods: PerformingNetworkContractingStatusGet(), PerformingNetworkContractingStatusGetObject(), PerformingNetworkContractingStatusGetObjectId(), PerformingNetworkContractingStatusGetSwizzled(), PerformingNetworkContractingStatusIsEmpty(), PerformingNetworkContractingStatusIsValid(), PerformingNetworkContractingStatusNewObject(), PerformingNetworkContractingStatusSet(), PerformingNetworkContractingStatusSetObject(), PerformingNetworkContractingStatusSetObjectId(), PerformingNetworkContractingStatusUnSwizzle()
property PlaceOfService as HS.SDA3.CodeTableDetail.PlaceOfService;
Identifies the place of service related to the location at which a health care service was rendered. X12 source: 837 loop2300().CLM:HealthCareServiceLocationInf.FacilityCodeValue
Property methods: PlaceOfServiceGet(), PlaceOfServiceGetObject(), PlaceOfServiceGetObjectId(), PlaceOfServiceGetSwizzled(), PlaceOfServiceIsEmpty(), PlaceOfServiceIsValid(), PlaceOfServiceNewObject(), PlaceOfServiceSet(), PlaceOfServiceSetObject(), PlaceOfServiceSetObjectId(), PlaceOfServiceUnSwizzle()
deprecated property PrincipalDiagnosis as HS.SDA3.CodeTableDetail.Diagnosis;
Deprecated
Primary ICD9 Diagnosis Code.
837apP: loop2300().HI():HealthCareCodeInformation2
This property is deprecated and has been replaced by the Diagnoses property where "principal"
may be specified as a value in the DiagnosisType property in the HS.SDA3.Diagnosis class.
Property methods: PrincipalDiagnosisGet(), PrincipalDiagnosisGetObject(), PrincipalDiagnosisGetObjectId(), PrincipalDiagnosisGetSwizzled(), PrincipalDiagnosisIsEmpty(), PrincipalDiagnosisIsValid(), PrincipalDiagnosisNewObject(), PrincipalDiagnosisSet(), PrincipalDiagnosisSetObject(), PrincipalDiagnosisSetObjectId(), PrincipalDiagnosisUnSwizzle()
property RecordType as %String (MAXLEN = 50);
The APCD filing-type identifier that defines the data contained within the file.
Property methods: RecordTypeDisplayToLogical(), RecordTypeGet(), RecordTypeIsValid(), RecordTypeLogicalToDisplay(), RecordTypeLogicalToOdbc(), RecordTypeNormalize(), RecordTypeSet()
property ServiceFacility as HS.SDA3.CodeTableDetail.Organization;
The name of the facility where the service occurred. Examples include hospitals, nursing homes, laboratories or homeless shelters.
Property methods: ServiceFacilityGet(), ServiceFacilityGetObject(), ServiceFacilityGetObjectId(), ServiceFacilityGetSwizzled(), ServiceFacilityIsEmpty(), ServiceFacilityIsValid(), ServiceFacilityNewObject(), ServiceFacilitySet(), ServiceFacilitySetObject(), ServiceFacilitySetObjectId(), ServiceFacilityUnSwizzle()
property SiteNumber as %String (MAXLEN = 50);
Property methods: SiteNumberDisplayToLogical(), SiteNumberGet(), SiteNumberIsValid(), SiteNumberLogicalToDisplay(), SiteNumberLogicalToOdbc(), SiteNumberNormalize(), SiteNumberSet()
property Submitter as %String (MAXLEN = 50);
Report CHIA defined, unique Submitter ID here. TR002 must match the Submitter ID reported here. This ID is linked to other elements in the file for quality control 837apP: loop1000A.NM1:IdentificationCode
Property methods: SubmitterDisplayToLogical(), SubmitterGet(), SubmitterIsValid(), SubmitterLogicalToDisplay(), SubmitterLogicalToOdbc(), SubmitterNormalize(), SubmitterSet()
property Subscriber as HS.SDA3.Guarantor;
Subscriber 837apP: loop2000A().loop2000B()
Property methods: SubscriberGet(), SubscriberGetObject(), SubscriberGetObjectId(), SubscriberGetSwizzled(), SubscriberIsEmpty(), SubscriberIsValid(), SubscriberNewObject(), SubscriberSet(), SubscriberSetObject(), SubscriberSetObjectId(), SubscriberUnSwizzle()
deprecated property TypeOfBillInstitutional as %String (MAXLEN = 50);
Deprecated
For Institutional Claims: a standardized code that reports the type of facility where the claim line service occurred.
This property is deprecated and has been replaced by the TypeOfBillInstitutionalCoded property that is a coded representation of the data.
Property methods: TypeOfBillInstitutionalCodedGet(), TypeOfBillInstitutionalCodedGetObject(), TypeOfBillInstitutionalCodedGetObjectId(), TypeOfBillInstitutionalCodedGetSwizzled(), TypeOfBillInstitutionalCodedIsEmpty(), TypeOfBillInstitutionalCodedIsValid(), TypeOfBillInstitutionalCodedNewObject(), TypeOfBillInstitutionalCodedSet(), TypeOfBillInstitutionalCodedSetObject(), TypeOfBillInstitutionalCodedSetObjectId(), TypeOfBillInstitutionalCodedUnSwizzle(), TypeOfBillInstitutionalDisplayToLogical(), TypeOfBillInstitutionalGet(), TypeOfBillInstitutionalIsValid(), TypeOfBillInstitutionalLogicalToDisplay(), TypeOfBillInstitutionalLogicalToOdbc(), TypeOfBillInstitutionalNormalize(), TypeOfBillInstitutionalSet()
property TypeOfBillInstitutionalCoded as HS.SDA3.CodeTableDetail.TypeOfBill;
Type of bill code provides specific information for payer purposes. The first digit of the three-digit number denotes the type of institution, the second digit classifies the type of care being billed, and the third digit identifies the frequency of the bill for a specific course of treatment or inpatient confinement.This is a coded representation of the data and should be used in place of TypeOfBillInstitutional which is retained for compatibility with previous versions of HealthShare.
Property methods: TypeOfBillInstitutionalCodedGet(), TypeOfBillInstitutionalCodedGetObject(), TypeOfBillInstitutionalCodedGetObjectId(), TypeOfBillInstitutionalCodedGetSwizzled(), TypeOfBillInstitutionalCodedIsEmpty(), TypeOfBillInstitutionalCodedIsValid(), TypeOfBillInstitutionalCodedNewObject(), TypeOfBillInstitutionalCodedSet(), TypeOfBillInstitutionalCodedSetObject(), TypeOfBillInstitutionalCodedSetObjectId(), TypeOfBillInstitutionalCodedUnSwizzle()
property Version as HS.SDA3.Numeric;
Incrementing counter for a claim line that is reprocessed for any reason over the course of time.
Highest value should indicate latest reprocessing of line by the carrier/submitter.
Property methods: VersionDisplayToLogical(), VersionGet(), VersionIsValid(), VersionLogicalToDisplay(), VersionNormalize(), VersionSet(), VersionXSDToLogical()

Inherited Members

Inherited Properties

Inherited Methods

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