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HS.FHIR.DTL.vSTU3.Model.Resource.ExplanationOfBenefit

class HS.FHIR.DTL.vSTU3.Model.Resource.ExplanationOfBenefit extends HS.FHIR.DTL.vSTU3.Model.Base.DomainResource

This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.

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.vSTU3.Model.Element.ExplanationOfBenefit.accident (XMLNAME = "accident", XMLPROJECTION = "ELEMENT");
BackboneElement

Details of an accident.

Property methods: accidentGet(), accidentGetSwizzled(), accidentIsValid(), accidentNewObject(), accidentSet()
property addItem as list of HS.FHIR.DTL.vSTU3.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 benefitBalance as list of HS.FHIR.DTL.vSTU3.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 billablePeriod as HS.FHIR.DTL.vSTU3.Model.Datatype.Period (XMLNAME = "billablePeriod", XMLPROJECTION = "ELEMENT");
Period

Period for charge submission.

Property methods: billablePeriodGet(), billablePeriodGetSwizzled(), billablePeriodIsValid(), billablePeriodNewObject(), billablePeriodSet()
property careTeam as list of HS.FHIR.DTL.vSTU3.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.vSTU3.Model.Base.Reference (XMLNAME = "claim", XMLPROJECTION = "ELEMENT");
Reference

Claim reference.

Claim

Property methods: claimGet(), claimGetSwizzled(), claimIsValid(), claimNewObject(), claimResponseGet(), claimResponseGetSwizzled(), claimResponseIsValid(), claimResponseNewObject(), claimResponseSet(), claimSet()
property claimResponse as HS.FHIR.DTL.vSTU3.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");
dateTime

Creation date.

Property methods: createdDisplayToLogical(), createdGet(), createdIsValid(), createdLogicalToDisplay(), createdLogicalToOdbc(), createdNormalize(), createdSet()
property diagnosis as list of HS.FHIR.DTL.vSTU3.Model.Element.ExplanationOfBenefit.diagnosis (XMLNAME = "diagnosis", XMLPROJECTION = "ELEMENT");
BackboneElement

List of Diagnosis.

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 employmentImpacted as HS.FHIR.DTL.vSTU3.Model.Datatype.Period (XMLNAME = "employmentImpacted", XMLPROJECTION = "ELEMENT");
Period

Period unable to work.

Property methods: employmentImpactedGet(), employmentImpactedGetSwizzled(), employmentImpactedIsValid(), employmentImpactedNewObject(), employmentImpactedSet()
property enterer as HS.FHIR.DTL.vSTU3.Model.Base.Reference (XMLNAME = "enterer", XMLPROJECTION = "ELEMENT");
Reference

Author.

Practitioner

Property methods: entererGet(), entererGetSwizzled(), entererIsValid(), entererNewObject(), entererSet()
property facility as HS.FHIR.DTL.vSTU3.Model.Base.Reference (XMLNAME = "facility", XMLPROJECTION = "ELEMENT");
Reference

Servicing Facility.

Location

Property methods: facilityGet(), facilityGetSwizzled(), facilityIsValid(), facilityNewObject(), facilitySet()
property form as HS.FHIR.DTL.vSTU3.Model.Datatype.CodeableConcept (XMLNAME = "form", XMLPROJECTION = "ELEMENT");
CodeableConcept

Printed Form Identifier.

any FHIR3 code may be used; forms shows EXAMPLE codes, but you may use codes from any ValueSet.

Property methods: formGet(), formGetSwizzled(), formIsValid(), formNewObject(), formSet()
property hospitalization as HS.FHIR.DTL.vSTU3.Model.Datatype.Period (XMLNAME = "hospitalization", XMLPROJECTION = "ELEMENT");
Period

Period in hospital.

Property methods: hospitalizationGet(), hospitalizationGetSwizzled(), hospitalizationIsValid(), hospitalizationNewObject(), hospitalizationSet()
property identifier as list of HS.FHIR.DTL.vSTU3.Model.Datatype.Identifier (XMLNAME = "identifier", XMLPROJECTION = "ELEMENT");
Identifier

Business Identifier.

Property methods: identifierBuildValueArray(), identifierCollectionToDisplay(), identifierCollectionToOdbc(), identifierDisplayToCollection(), identifierGet(), identifierGetObject(), identifierGetObjectId(), identifierGetSwizzled(), identifierIsValid(), identifierOdbcToCollection(), identifierSet(), identifierSetObject(), identifierSetObjectId()
property information as list of HS.FHIR.DTL.vSTU3.Model.Element.ExplanationOfBenefit.information (XMLNAME = "information", XMLPROJECTION = "ELEMENT");
BackboneElement

Exceptions, special considerations, the condition, situation, prior or concurrent issues.

Property methods: informationBuildValueArray(), informationCollectionToDisplay(), informationCollectionToOdbc(), informationDisplayToCollection(), informationGet(), informationGetObject(), informationGetObjectId(), informationGetSwizzled(), informationIsValid(), informationOdbcToCollection(), informationSet(), informationSetObject(), informationSetObjectId()
property insurance as HS.FHIR.DTL.vSTU3.Model.Element.ExplanationOfBenefit.insurance (XMLNAME = "insurance", XMLPROJECTION = "ELEMENT");
BackboneElement

Insurance or medical plan.

Property methods: insuranceGet(), insuranceGetSwizzled(), insuranceIsValid(), insuranceNewObject(), insuranceSet()
property insurer as HS.FHIR.DTL.vSTU3.Model.Base.Reference (XMLNAME = "insurer", XMLPROJECTION = "ELEMENT");
Reference

Insurer responsible for the EOB.

Organization

Property methods: insurerGet(), insurerGetSwizzled(), insurerIsValid(), insurerNewObject(), insurerSet()
property item as list of HS.FHIR.DTL.vSTU3.Model.Element.ExplanationOfBenefit.item (XMLNAME = "item", XMLPROJECTION = "ELEMENT");
BackboneElement

Goods and Services.

Property methods: itemBuildValueArray(), itemCollectionToDisplay(), itemCollectionToOdbc(), itemDisplayToCollection(), itemGet(), itemGetObject(), itemGetObjectId(), itemGetSwizzled(), itemIsValid(), itemOdbcToCollection(), itemSet(), itemSetObject(), itemSetObjectId()
property organization as HS.FHIR.DTL.vSTU3.Model.Base.Reference (XMLNAME = "organization", XMLPROJECTION = "ELEMENT");
Reference

Responsible organization for the claim.

Organization

Property methods: organizationGet(), organizationGetSwizzled(), organizationIsValid(), organizationNewObject(), organizationSet()
property originalPrescription as HS.FHIR.DTL.vSTU3.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 HS.FHIR.DTL.vSTU3.Model.Datatype.CodeableConcept (XMLNAME = "outcome", XMLPROJECTION = "ELEMENT");
CodeableConcept

complete | error | partial

any FHIR3 code may be used; remittance-outcome shows EXAMPLE codes, but you may use codes from any ValueSet.

Property methods: outcomeGet(), outcomeGetSwizzled(), outcomeIsValid(), outcomeNewObject(), outcomeSet()
property patient as HS.FHIR.DTL.vSTU3.Model.Base.Reference (XMLNAME = "patient", XMLPROJECTION = "ELEMENT");
Reference

The subject of the Products and Services.

Patient

Property methods: patientGet(), patientGetSwizzled(), patientIsValid(), patientNewObject(), patientSet()
property payee as HS.FHIR.DTL.vSTU3.Model.Element.ExplanationOfBenefit.payee (XMLNAME = "payee", XMLPROJECTION = "ELEMENT");
BackboneElement

Party to be paid any benefits payable.

Property methods: payeeGet(), payeeGetSwizzled(), payeeIsValid(), payeeNewObject(), payeeSet()
property payment as HS.FHIR.DTL.vSTU3.Model.Element.ExplanationOfBenefit.payment (XMLNAME = "payment", XMLPROJECTION = "ELEMENT");
BackboneElement

Payment (if paid)

Property methods: paymentGet(), paymentGetSwizzled(), paymentIsValid(), paymentNewObject(), paymentSet()
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.vSTU3.Model.Base.Reference (XMLNAME = "prescription", XMLPROJECTION = "ELEMENT");
Reference

Prescription authorizing services or products.

MedicationRequest | VisionPrescription

Property methods: prescriptionGet(), prescriptionGetSwizzled(), prescriptionIsValid(), prescriptionNewObject(), prescriptionSet()
property procedure as list of HS.FHIR.DTL.vSTU3.Model.Element.ExplanationOfBenefit.procedure (XMLNAME = "procedure", XMLPROJECTION = "ELEMENT");
BackboneElement

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.vSTU3.Model.Element.ExplanationOfBenefit.processNote (XMLNAME = "processNote", XMLPROJECTION = "ELEMENT");
BackboneElement

Processing notes.

Property methods: processNoteBuildValueArray(), processNoteCollectionToDisplay(), processNoteCollectionToOdbc(), processNoteDisplayToCollection(), processNoteGet(), processNoteGetObject(), processNoteGetObjectId(), processNoteGetSwizzled(), processNoteIsValid(), processNoteOdbcToCollection(), processNoteSet(), processNoteSetObject(), processNoteSetObjectId()
property provider as HS.FHIR.DTL.vSTU3.Model.Base.Reference (XMLNAME = "provider", XMLPROJECTION = "ELEMENT");
Reference

Responsible provider for the claim.

Practitioner

Property methods: providerGet(), providerGetSwizzled(), providerIsValid(), providerNewObject(), providerSet()
property referral as HS.FHIR.DTL.vSTU3.Model.Base.Reference (XMLNAME = "referral", XMLPROJECTION = "ELEMENT");
Reference

Treatment Referral.

ReferralRequest

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

Related Claims which may be revelant to processing this claim.

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");
code

active | cancelled | draft | entered-in-error

explanationofbenefit-status is the REQUIRED FHIR3 ValueSet for codes; you may NOT extend explanationofbenefit-status and you may NOT use codes from other ValueSets.

Property methods: statusDisplayToLogical(), statusGet(), statusIsValid(), statusLogicalToDisplay(), statusLogicalToOdbc(), statusNormalize(), statusSet()
property subType as list of HS.FHIR.DTL.vSTU3.Model.Datatype.CodeableConcept (XMLNAME = "subType", XMLPROJECTION = "ELEMENT");
CodeableConcept

Finer grained claim type information.

any FHIR3 code may be used; claim-subtype shows EXAMPLE codes, but you may use codes from any ValueSet.

Property methods: subTypeBuildValueArray(), subTypeCollectionToDisplay(), subTypeCollectionToOdbc(), subTypeDisplayToCollection(), subTypeGet(), subTypeGetObject(), subTypeGetObjectId(), subTypeGetSwizzled(), subTypeIsValid(), subTypeOdbcToCollection(), subTypeSet(), subTypeSetObject(), subTypeSetObjectId()
property totalBenefit as HS.FHIR.DTL.vSTU3.Model.Datatype.Money (XMLNAME = "totalBenefit", XMLPROJECTION = "ELEMENT");
Money

Total benefit payable for the Claim.

Property methods: totalBenefitGet(), totalBenefitGetSwizzled(), totalBenefitIsValid(), totalBenefitNewObject(), totalBenefitSet()
property totalCost as HS.FHIR.DTL.vSTU3.Model.Datatype.Money (XMLNAME = "totalCost", XMLPROJECTION = "ELEMENT");
Money

Total Cost of service from the Claim.

Property methods: totalCostGet(), totalCostGetSwizzled(), totalCostIsValid(), totalCostNewObject(), totalCostSet()
property type as HS.FHIR.DTL.vSTU3.Model.Datatype.CodeableConcept (XMLNAME = "type", XMLPROJECTION = "ELEMENT");
CodeableConcept

Type or discipline.

claim-type is the REQUIRED FHIR3 ValueSet for codes; you may NOT extend claim-type and you may NOT use codes from other ValueSets.

Property methods: typeGet(), typeGetSwizzled(), typeIsValid(), typeNewObject(), typeSet()
property unallocDeductable as HS.FHIR.DTL.vSTU3.Model.Datatype.Money (XMLNAME = "unallocDeductable", XMLPROJECTION = "ELEMENT");
Money

Unallocated deductable.

Property methods: unallocDeductableGet(), unallocDeductableGetSwizzled(), unallocDeductableIsValid(), unallocDeductableNewObject(), unallocDeductableSet()

Inherited Members

Inherited Properties

Inherited Methods

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