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HS.FHIR.DTL.vR4.Model.Resource.ExplanationOfBenefit

class HS.FHIR.DTL.vR4.Model.Resource.ExplanationOfBenefit extends HS.FHIR.DTL.vR4.Model.Base.DomainResource

Explanation of Benefit resource.

Property Inventory

Parameters

parameter ELEMENTQUALIFIED = 1;
Inherited description: ELEMENTQUALIFIED controls the format of exported XML. The ELEMENTQUALIFIED specification should be based on the elementFormDefault attribute of the schema that defines the type. To maintain compatibility, ELEMENTQUALIFIED will default to 1 (true) for literal format export and will default to 0 (false) for encoded or encoded12 format export. These were the values always previously assumed for the elementFormDefault attribute.

NOTE: Direct use of XMLExport method does not support the ELEMENTQUALIFIED. The export must be done using %XML.Writer or SOAP support.

parameter XMLNAME = ExplanationOfBenefit;
Inherited description: This parameter provides the default XMLNAME for the class. If it is empty then the class name will be used to construct a default XML name. The default XMLNAME is used as the top level tag when exporting objects and the export context did not provide an XML container name.
parameter XMLPROJECTION = ELEMENT;
parameter XMLSEQUENCE = 1;
Inherited description: If the XMLSEQUENCE = 1, then the order of the XML elements must match the order of the class properties. This allows us to deal with XML where the same field appears multiple times and is distinguished by the order.
parameter XMLTYPE = ExplanationOfBenefit;
Inherited description: This parameter provides the default XMLTYPE for the class. If it is empty then the class name will be used to construct a default XML type.

The default XMLTYPE is used when naming and referencing this type in a schema and the schema context did not provide an XML type name.

Properties

property accident as HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.accident (XMLNAME = "accident", XMLPROJECTION = "ELEMENT");
BackboneElement

Details of the event.

Property methods: accidentGet(), accidentGetSwizzled(), accidentIsValid(), accidentNewObject(), accidentSet()
property addItem as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.addItem (XMLNAME = "addItem", XMLPROJECTION = "ELEMENT");
BackboneElement

Insurer added line items.

Property methods: addItemBuildValueArray(), addItemCollectionToDisplay(), addItemCollectionToOdbc(), addItemDisplayToCollection(), addItemGet(), addItemGetObject(), addItemGetObjectId(), addItemGetSwizzled(), addItemIsValid(), addItemOdbcToCollection(), addItemSet(), addItemSetObject(), addItemSetObjectId()
property adjudication as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.item.adjudication (XMLNAME = "adjudication", XMLPROJECTION = "ELEMENT");
ExplanationOfBenefit:item[n].adjudication

Header-level adjudication.

Property methods: adjudicationBuildValueArray(), adjudicationCollectionToDisplay(), adjudicationCollectionToOdbc(), adjudicationDisplayToCollection(), adjudicationGet(), adjudicationGetObject(), adjudicationGetObjectId(), adjudicationGetSwizzled(), adjudicationIsValid(), adjudicationOdbcToCollection(), adjudicationSet(), adjudicationSetObject(), adjudicationSetObjectId()
property benefitBalance as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.benefitBalance (XMLNAME = "benefitBalance", XMLPROJECTION = "ELEMENT");
BackboneElement

Balance by Benefit Category.

Property methods: benefitBalanceBuildValueArray(), benefitBalanceCollectionToDisplay(), benefitBalanceCollectionToOdbc(), benefitBalanceDisplayToCollection(), benefitBalanceGet(), benefitBalanceGetObject(), benefitBalanceGetObjectId(), benefitBalanceGetSwizzled(), benefitBalanceIsValid(), benefitBalanceOdbcToCollection(), benefitBalanceSet(), benefitBalanceSetObject(), benefitBalanceSetObjectId()
property benefitPeriod as HS.FHIR.DTL.vR4.Model.Datatype.Period (XMLNAME = "benefitPeriod", XMLPROJECTION = "ELEMENT");
Period

When the benefits are applicable.

Property methods: benefitPeriodGet(), benefitPeriodGetSwizzled(), benefitPeriodIsValid(), benefitPeriodNewObject(), benefitPeriodSet()
property billablePeriod as HS.FHIR.DTL.vR4.Model.Datatype.Period (XMLNAME = "billablePeriod", XMLPROJECTION = "ELEMENT");
Period

Relevant time frame for the claim.

Property methods: billablePeriodGet(), billablePeriodGetSwizzled(), billablePeriodIsValid(), billablePeriodNewObject(), billablePeriodSet()
property careTeam as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.careTeam (XMLNAME = "careTeam", XMLPROJECTION = "ELEMENT");
BackboneElement

Care Team members.

Property methods: careTeamBuildValueArray(), careTeamCollectionToDisplay(), careTeamCollectionToOdbc(), careTeamDisplayToCollection(), careTeamGet(), careTeamGetObject(), careTeamGetObjectId(), careTeamGetSwizzled(), careTeamIsValid(), careTeamOdbcToCollection(), careTeamSet(), careTeamSetObject(), careTeamSetObjectId()
property claim as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "claim", XMLPROJECTION = "ELEMENT");
Reference

Claim reference.

Claim

Property methods: claimGet(), claimGetSwizzled(), claimIsValid(), claimNewObject(), claimSet()
property claimResponse as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "claimResponse", XMLPROJECTION = "ELEMENT");
Reference

Claim response reference.

ClaimResponse

Property methods: claimResponseGet(), claimResponseGetSwizzled(), claimResponseIsValid(), claimResponseNewObject(), claimResponseSet()
property created as %String (MAXLEN = 1000000, XMLNAME = "created", XMLPROJECTION = "ATTRIBUTE") [ Required ];
dateTime

Response creation date.

Property methods: createdDisplayToLogical(), createdGet(), createdIsValid(), createdLogicalToDisplay(), createdLogicalToOdbc(), createdNormalize(), createdSet()
property diagnosis as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.diagnosis (XMLNAME = "diagnosis", XMLPROJECTION = "ELEMENT");
BackboneElement

Pertinent diagnosis information.

Property methods: diagnosisBuildValueArray(), diagnosisCollectionToDisplay(), diagnosisCollectionToOdbc(), diagnosisDisplayToCollection(), diagnosisGet(), diagnosisGetObject(), diagnosisGetObjectId(), diagnosisGetSwizzled(), diagnosisIsValid(), diagnosisOdbcToCollection(), diagnosisSet(), diagnosisSetObject(), diagnosisSetObjectId()
property disposition as %String (MAXLEN = 1000000, XMLNAME = "disposition", XMLPROJECTION = "ATTRIBUTE");
string

Disposition Message.

Property methods: dispositionDisplayToLogical(), dispositionGet(), dispositionIsValid(), dispositionLogicalToDisplay(), dispositionLogicalToOdbc(), dispositionNormalize(), dispositionSet()
property enterer as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "enterer", XMLPROJECTION = "ELEMENT");
Reference

Author of the claim.

Practitioner | PractitionerRole

Property methods: entererGet(), entererGetSwizzled(), entererIsValid(), entererNewObject(), entererSet()
property facility as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "facility", XMLPROJECTION = "ELEMENT");
Reference

Servicing Facility.

Location

Property methods: facilityGet(), facilityGetSwizzled(), facilityIsValid(), facilityNewObject(), facilitySet()
property form as HS.FHIR.DTL.vR4.Model.Datatype.Attachment (XMLNAME = "form", XMLPROJECTION = "ELEMENT");
Attachment

Printed reference or actual form.

Property methods: formGet(), formGetSwizzled(), formIsValid(), formNewObject(), formSet()
property formCode as HS.FHIR.DTL.vR4.Model.Datatype.CodeableConcept (XMLNAME = "formCode", XMLPROJECTION = "ELEMENT");
CodeableConcept

Printed form identifier.

any FHIR4 code may be used; forms shows EXAMPLE codes, but you may use codes from any ValueSet.

Property methods: formCodeGet(), formCodeGetSwizzled(), formCodeIsValid(), formCodeNewObject(), formCodeSet()
property fundsReserve as HS.FHIR.DTL.vR4.Model.Datatype.CodeableConcept (XMLNAME = "fundsReserve", XMLPROJECTION = "ELEMENT");
CodeableConcept

Funds reserved status.

any FHIR4 code may be used; fundsreserve shows EXAMPLE codes, but you may use codes from any ValueSet.

Property methods: fundsReserveGet(), fundsReserveGetSwizzled(), fundsReserveIsValid(), fundsReserveNewObject(), fundsReserveSet()
property fundsReserveRequested as HS.FHIR.DTL.vR4.Model.Datatype.CodeableConcept (XMLNAME = "fundsReserveRequested", XMLPROJECTION = "ELEMENT");
CodeableConcept

For whom to reserve funds.

any FHIR4 code may be used; fundsreserve shows EXAMPLE codes, but you may use codes from any ValueSet.

Property methods: fundsReserveRequestedGet(), fundsReserveRequestedGetSwizzled(), fundsReserveRequestedIsValid(), fundsReserveRequestedNewObject(), fundsReserveRequestedSet()
property identifier as list of HS.FHIR.DTL.vR4.Model.Datatype.Identifier (XMLNAME = "identifier", XMLPROJECTION = "ELEMENT");
Identifier

Business Identifier for the resource.

Property methods: identifierBuildValueArray(), identifierCollectionToDisplay(), identifierCollectionToOdbc(), identifierDisplayToCollection(), identifierGet(), identifierGetObject(), identifierGetObjectId(), identifierGetSwizzled(), identifierIsValid(), identifierOdbcToCollection(), identifierSet(), identifierSetObject(), identifierSetObjectId()
property insurance as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.insurance (XMLNAME = "insurance", XMLPROJECTION = "ELEMENT") [ Required ];
BackboneElement

Patient insurance information.

Property methods: insuranceBuildValueArray(), insuranceCollectionToDisplay(), insuranceCollectionToOdbc(), insuranceDisplayToCollection(), insuranceGet(), insuranceGetObject(), insuranceGetObjectId(), insuranceGetSwizzled(), insuranceIsValid(), insuranceOdbcToCollection(), insuranceSet(), insuranceSetObject(), insuranceSetObjectId()
property insurer as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "insurer", XMLPROJECTION = "ELEMENT") [ Required ];
Reference

Party responsible for reimbursement.

Organization

Property methods: insurerGet(), insurerGetSwizzled(), insurerIsValid(), insurerNewObject(), insurerSet()
property item as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.item (XMLNAME = "item", XMLPROJECTION = "ELEMENT");
BackboneElement

Product or service provided.

Property methods: itemBuildValueArray(), itemCollectionToDisplay(), itemCollectionToOdbc(), itemDisplayToCollection(), itemGet(), itemGetObject(), itemGetObjectId(), itemGetSwizzled(), itemIsValid(), itemOdbcToCollection(), itemSet(), itemSetObject(), itemSetObjectId()
property originalPrescription as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "originalPrescription", XMLPROJECTION = "ELEMENT");
Reference

Original prescription if superceded by fulfiller.

MedicationRequest

Property methods: originalPrescriptionGet(), originalPrescriptionGetSwizzled(), originalPrescriptionIsValid(), originalPrescriptionNewObject(), originalPrescriptionSet()
property outcome as %String (MAXLEN = 1000000, XMLNAME = "outcome", XMLPROJECTION = "ATTRIBUTE") [ Required ];
code

queued | complete | error | partial

remittance-outcome|4.0.1 is the REQUIRED FHIR4 ValueSet for codes; you may NOT extend remittance-outcome|4.0.1 and you may NOT use codes from other ValueSets.

Property methods: outcomeDisplayToLogical(), outcomeGet(), outcomeIsValid(), outcomeLogicalToDisplay(), outcomeLogicalToOdbc(), outcomeNormalize(), outcomeSet()
property patient as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "patient", XMLPROJECTION = "ELEMENT") [ Required ];
Reference

The recipient of the products and services.

Patient

Property methods: patientGet(), patientGetSwizzled(), patientIsValid(), patientNewObject(), patientSet()
property payee as HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.payee (XMLNAME = "payee", XMLPROJECTION = "ELEMENT");
BackboneElement

Recipient of benefits payable.

Property methods: payeeGet(), payeeGetSwizzled(), payeeIsValid(), payeeNewObject(), payeeSet()
property payment as HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.payment (XMLNAME = "payment", XMLPROJECTION = "ELEMENT");
BackboneElement

Payment Details.

Property methods: paymentGet(), paymentGetSwizzled(), paymentIsValid(), paymentNewObject(), paymentSet()
property preAuthRef as list of %String (MAXLEN = 1000000, XMLNAME = "preAuthRef", XMLPROJECTION = "ELEMENT");
string

Preauthorization reference.

Property methods: preAuthRefBuildValueArray(), preAuthRefCollectionToDisplay(), preAuthRefCollectionToOdbc(), preAuthRefDisplayToCollection(), preAuthRefDisplayToLogical(), preAuthRefGet(), preAuthRefGetObject(), preAuthRefGetObjectId(), preAuthRefGetSwizzled(), preAuthRefIsValid(), preAuthRefLogicalToDisplay(), preAuthRefLogicalToOdbc(), preAuthRefNormalize(), preAuthRefOdbcToCollection(), preAuthRefSet(), preAuthRefSetObject(), preAuthRefSetObjectId()
property preAuthRefPeriod as list of HS.FHIR.DTL.vR4.Model.Datatype.Period (XMLNAME = "preAuthRefPeriod", XMLPROJECTION = "ELEMENT");
Period

Preauthorization in-effect period.

Property methods: preAuthRefPeriodBuildValueArray(), preAuthRefPeriodCollectionToDisplay(), preAuthRefPeriodCollectionToOdbc(), preAuthRefPeriodDisplayToCollection(), preAuthRefPeriodGet(), preAuthRefPeriodGetObject(), preAuthRefPeriodGetObjectId(), preAuthRefPeriodGetSwizzled(), preAuthRefPeriodIsValid(), preAuthRefPeriodOdbcToCollection(), preAuthRefPeriodSet(), preAuthRefPeriodSetObject(), preAuthRefPeriodSetObjectId()
property precedence as %Integer (XMLNAME = "precedence", XMLPROJECTION = "ATTRIBUTE");
positiveInt

Precedence (primary, secondary, etc.)

Property methods: precedenceDisplayToLogical(), precedenceGet(), precedenceIsValid(), precedenceLogicalToDisplay(), precedenceNormalize(), precedenceSet(), precedenceXSDToLogical()
property prescription as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "prescription", XMLPROJECTION = "ELEMENT");
Reference

Prescription authorizing services or products.

MedicationRequest | VisionPrescription

Property methods: prescriptionGet(), prescriptionGetSwizzled(), prescriptionIsValid(), prescriptionNewObject(), prescriptionSet()
property priority as HS.FHIR.DTL.vR4.Model.Datatype.CodeableConcept (XMLNAME = "priority", XMLPROJECTION = "ELEMENT");
CodeableConcept

Desired processing urgency.

any FHIR4 code may be used; processpriority shows EXAMPLE codes, but you may use codes from any ValueSet.

Property methods: priorityGet(), priorityGetSwizzled(), priorityIsValid(), priorityNewObject(), prioritySet()
property procedure as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.procedure (XMLNAME = "procedure", XMLPROJECTION = "ELEMENT");
BackboneElement

Clinical procedures performed.

Property methods: procedureBuildValueArray(), procedureCollectionToDisplay(), procedureCollectionToOdbc(), procedureDisplayToCollection(), procedureGet(), procedureGetObject(), procedureGetObjectId(), procedureGetSwizzled(), procedureIsValid(), procedureOdbcToCollection(), procedureSet(), procedureSetObject(), procedureSetObjectId()
property processNote as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.processNote (XMLNAME = "processNote", XMLPROJECTION = "ELEMENT");
BackboneElement

Note concerning adjudication.

Property methods: processNoteBuildValueArray(), processNoteCollectionToDisplay(), processNoteCollectionToOdbc(), processNoteDisplayToCollection(), processNoteGet(), processNoteGetObject(), processNoteGetObjectId(), processNoteGetSwizzled(), processNoteIsValid(), processNoteOdbcToCollection(), processNoteSet(), processNoteSetObject(), processNoteSetObjectId()
property provider as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "provider", XMLPROJECTION = "ELEMENT") [ Required ];
Reference

Party responsible for the claim.

Practitioner | PractitionerRole | Organization

Property methods: providerGet(), providerGetSwizzled(), providerIsValid(), providerNewObject(), providerSet()
property referral as HS.FHIR.DTL.vR4.Model.Base.Reference (XMLNAME = "referral", XMLPROJECTION = "ELEMENT");
Reference

Treatment Referral.

ServiceRequest

Property methods: referralGet(), referralGetSwizzled(), referralIsValid(), referralNewObject(), referralSet()
BackboneElement

Prior or corollary claims.

Property methods: relatedBuildValueArray(), relatedCollectionToDisplay(), relatedCollectionToOdbc(), relatedDisplayToCollection(), relatedGet(), relatedGetObject(), relatedGetObjectId(), relatedGetSwizzled(), relatedIsValid(), relatedOdbcToCollection(), relatedSet(), relatedSetObject(), relatedSetObjectId()
property status as %String (MAXLEN = 1000000, XMLNAME = "status", XMLPROJECTION = "ATTRIBUTE") [ Required ];
code

active | cancelled | draft | entered-in-error

explanationofbenefit-status|4.0.1 is the REQUIRED FHIR4 ValueSet for codes; you may NOT extend explanationofbenefit-status|4.0.1 and you may NOT use codes from other ValueSets.

Property methods: statusDisplayToLogical(), statusGet(), statusIsValid(), statusLogicalToDisplay(), statusLogicalToOdbc(), statusNormalize(), statusSet()
property subType as HS.FHIR.DTL.vR4.Model.Datatype.CodeableConcept (XMLNAME = "subType", XMLPROJECTION = "ELEMENT");
CodeableConcept

More granular claim type.

any FHIR4 code may be used; claim-subtype shows EXAMPLE codes, but you may use codes from any ValueSet.

Property methods: subTypeGet(), subTypeGetSwizzled(), subTypeIsValid(), subTypeNewObject(), subTypeSet()
property supportingInfo as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.supportingInfo (XMLNAME = "supportingInfo", XMLPROJECTION = "ELEMENT");
BackboneElement

Supporting information.

Property methods: supportingInfoBuildValueArray(), supportingInfoCollectionToDisplay(), supportingInfoCollectionToOdbc(), supportingInfoDisplayToCollection(), supportingInfoGet(), supportingInfoGetObject(), supportingInfoGetObjectId(), supportingInfoGetSwizzled(), supportingInfoIsValid(), supportingInfoOdbcToCollection(), supportingInfoSet(), supportingInfoSetObject(), supportingInfoSetObjectId()
property total as list of HS.FHIR.DTL.vR4.Model.Element.ExplanationOfBenefit.total (XMLNAME = "total", XMLPROJECTION = "ELEMENT");
BackboneElement

Adjudication totals.

Property methods: totalBuildValueArray(), totalCollectionToDisplay(), totalCollectionToOdbc(), totalDisplayToCollection(), totalGet(), totalGetObject(), totalGetObjectId(), totalGetSwizzled(), totalIsValid(), totalOdbcToCollection(), totalSet(), totalSetObject(), totalSetObjectId()
property type as HS.FHIR.DTL.vR4.Model.Datatype.CodeableConcept (XMLNAME = "type", XMLPROJECTION = "ELEMENT") [ Required ];
CodeableConcept

Category or discipline.

claim-type is the REQUIRED FHIR4 ValueSet for codes, but if you need to express meanings not found in claim-type, you may formally EXTEND claim-type to add codes to it.

Property methods: typeGet(), typeGetSwizzled(), typeIsValid(), typeNewObject(), typeSet()
property use as %String (MAXLEN = 1000000, XMLNAME = "use", XMLPROJECTION = "ATTRIBUTE") [ Required ];
code

claim | preauthorization | predetermination

claim-use|4.0.1 is the REQUIRED FHIR4 ValueSet for codes; you may NOT extend claim-use|4.0.1 and you may NOT use codes from other ValueSets.

Property methods: useDisplayToLogical(), useGet(), useIsValid(), useLogicalToDisplay(), useLogicalToOdbc(), useNormalize(), useSet()

Inherited Members

Inherited Properties

Inherited Methods

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