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HS.FHIRModel.R4.ExplanationOfBenefit

class HS.FHIRModel.R4.ExplanationOfBenefit extends HS.FHIRModel.FHIRClassSuper

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** ExplanationOfBenefit generated class schema
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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

Method Inventory

Parameters

parameter XMLTYPE = R4_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 _created as HS.FHIRModel.R4.Element;
Extensions for created
Property methods: _createdGet(), _createdGetSwizzled(), _createdIsValid(), _createdNewObject(), _createdSet()
property _disposition as HS.FHIRModel.R4.Element;
Extensions for disposition
Property methods: _dispositionGet(), _dispositionGetSwizzled(), _dispositionIsValid(), _dispositionNewObject(), _dispositionSet()
property _implicitRules as HS.FHIRModel.R4.Element;
Extensions for implicitRules
Property methods: _implicitRulesGet(), _implicitRulesGetSwizzled(), _implicitRulesIsValid(), _implicitRulesNewObject(), _implicitRulesSet()
property _language as HS.FHIRModel.R4.Element;
Extensions for language
Property methods: _languageGet(), _languageGetSwizzled(), _languageIsValid(), _languageNewObject(), _languageSet()
property _outcome as HS.FHIRModel.R4.Element;
Extensions for outcome
Property methods: _outcomeGet(), _outcomeGetSwizzled(), _outcomeIsValid(), _outcomeNewObject(), _outcomeSet()
property _preAuthRef as HS.FHIRModel.R4.SeqOfElement;
Extensions for preAuthRef
Property methods: _preAuthRefGet(), _preAuthRefGetSwizzled(), _preAuthRefIsValid(), _preAuthRefNewObject(), _preAuthRefSet()
property _precedence as HS.FHIRModel.R4.Element;
Extensions for precedence
Property methods: _precedenceGet(), _precedenceGetSwizzled(), _precedenceIsValid(), _precedenceNewObject(), _precedenceSet()
property _status as HS.FHIRModel.R4.Element;
Extensions for status
Property methods: _statusGet(), _statusGetSwizzled(), _statusIsValid(), _statusNewObject(), _statusSet()
property _use as HS.FHIRModel.R4.Element;
Extensions for use
Property methods: _useGet(), _useGetSwizzled(), _useIsValid(), _useNewObject(), _useSet()
Details of a accident which resulted in injuries which required the products and services listed in the claim.
Property methods: accidentGet(), accidentGetSwizzled(), accidentIsValid(), accidentNewObject(), accidentSet()
The first-tier service adjudications for payor added product or service lines.
Property methods: addItemGet(), addItemGetSwizzled(), addItemIsValid(), addItemNewObject(), addItemSet()
The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
Property methods: adjudicationGet(), adjudicationGetSwizzled(), adjudicationIsValid(), adjudicationNewObject(), adjudicationSet()
Balance by Benefit Category.
Property methods: benefitBalanceGet(), benefitBalanceGetSwizzled(), benefitBalanceIsValid(), benefitBalanceNewObject(), benefitBalanceSet()
property benefitPeriod as HS.FHIRModel.R4.Period;
The term of the benefits documented in this response.
Property methods: benefitPeriodGet(), benefitPeriodGetSwizzled(), benefitPeriodIsValid(), benefitPeriodNewObject(), benefitPeriodSet()
property billablePeriod as HS.FHIRModel.R4.Period;
The period for which charges are being submitted.
Property methods: billablePeriodGet(), billablePeriodGetSwizzled(), billablePeriodIsValid(), billablePeriodNewObject(), billablePeriodSet()
The members of the team who provided the products and services.
Property methods: careTeamGet(), careTeamGetSwizzled(), careTeamIsValid(), careTeamNewObject(), careTeamSet()
property claim as HS.FHIRModel.R4.Reference;
The business identifier for the instance of the adjudication request: claim predetermination or preauthorization.
Property methods: claimGet(), claimGetSwizzled(), claimIsValid(), claimNewObject(), claimSet()
property claimResponse as HS.FHIRModel.R4.Reference;
The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response.
Property methods: claimResponseGet(), claimResponseGetSwizzled(), claimResponseIsValid(), claimResponseNewObject(), claimResponseSet()
property contained as HS.FHIRModel.R4.SeqOfResourceList;
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Property methods: containedGet(), containedGetSwizzled(), containedIsValid(), containedNewObject(), containedSet()
property created as %String;
The date this resource was created.
Property methods: createdDisplayToLogical(), createdGet(), createdIsValid(), createdLogicalToDisplay(), createdLogicalToOdbc(), createdNormalize(), createdSet()
Information about diagnoses relevant to the claim items.
Property methods: diagnosisGet(), diagnosisGetSwizzled(), diagnosisIsValid(), diagnosisNewObject(), diagnosisSet()
property disposition as %String;
A human readable description of the status of the adjudication.
Property methods: dispositionDisplayToLogical(), dispositionGet(), dispositionIsValid(), dispositionLogicalToDisplay(), dispositionLogicalToOdbc(), dispositionNormalize(), dispositionSet()
property enterer as HS.FHIRModel.R4.Reference;
Individual who created the claim, predetermination or preauthorization.
Property methods: entererGet(), entererGetSwizzled(), entererIsValid(), entererNewObject(), entererSet()
property extension as HS.FHIRModel.R4.SeqOfExtension;
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Property methods: extensionGet(), extensionGetSwizzled(), extensionIsValid(), extensionNewObject(), extensionSet()
property facility as HS.FHIRModel.R4.Reference;
Facility where the services were provided.
Property methods: facilityGet(), facilityGetSwizzled(), facilityIsValid(), facilityNewObject(), facilitySet()
property fhirID as %String;
The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Property methods: fhirIDDisplayToLogical(), fhirIDGet(), fhirIDIsValid(), fhirIDLogicalToDisplay(), fhirIDLogicalToOdbc(), fhirIDNormalize(), fhirIDSet()
property form as HS.FHIRModel.R4.Attachment;
The actual form, by reference or inclusion, for printing the content or an EOB.
Property methods: formGet(), formGetSwizzled(), formIsValid(), formNewObject(), formSet()
property formCode as HS.FHIRModel.R4.CodeableConcept;
A code for the form to be used for printing the content.
Property methods: formCodeGet(), formCodeGetSwizzled(), formCodeIsValid(), formCodeNewObject(), formCodeSet()
property fundsReserve as HS.FHIRModel.R4.CodeableConcept;
A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.
Property methods: fundsReserveGet(), fundsReserveGetSwizzled(), fundsReserveIsValid(), fundsReserveNewObject(), fundsReserveSet()
property fundsReserveRequested as HS.FHIRModel.R4.CodeableConcept;
A code to indicate whether and for whom funds are to be reserved for future claims.
Property methods: fundsReserveRequestedGet(), fundsReserveRequestedGetSwizzled(), fundsReserveRequestedIsValid(), fundsReserveRequestedNewObject(), fundsReserveRequestedSet()
property identifier as HS.FHIRModel.R4.SeqOfIdentifier;
A unique identifier assigned to this explanation of benefit.
Property methods: identifierGet(), identifierGetSwizzled(), identifierIsValid(), identifierNewObject(), identifierSet()
property implicitRules as %String;
A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
Property methods: implicitRulesDisplayToLogical(), implicitRulesGet(), implicitRulesIsValid(), implicitRulesLogicalToDisplay(), implicitRulesLogicalToOdbc(), implicitRulesNormalize(), implicitRulesSet()
Financial instruments for reimbursement for the health care products and services specified on the claim.
Property methods: insuranceGet(), insuranceGetSwizzled(), insuranceIsValid(), insuranceNewObject(), insuranceSet()
property insurer as HS.FHIRModel.R4.Reference [ Required ];
The party responsible for authorization, adjudication and reimbursement.
Property methods: insurerGet(), insurerGetSwizzled(), insurerIsValid(), insurerNewObject(), insurerSet()
A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
Property methods: itemGet(), itemGetSwizzled(), itemIsValid(), itemNewObject(), itemSet()
property language as %String;
The base language in which the resource is written.
Property methods: languageDisplayToLogical(), languageGet(), languageIsValid(), languageLogicalToDisplay(), languageLogicalToOdbc(), languageNormalize(), languageSet()
property meta as HS.FHIRModel.R4.Meta;
The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
Property methods: metaGet(), metaGetSwizzled(), metaIsValid(), metaNewObject(), metaSet()
property modifierExtension as HS.FHIRModel.R4.SeqOfExtension;
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Property methods: modifierExtensionGet(), modifierExtensionGetSwizzled(), modifierExtensionIsValid(), modifierExtensionNewObject(), modifierExtensionSet()
property originalPrescription as HS.FHIRModel.R4.Reference;
Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.
Property methods: originalPrescriptionGet(), originalPrescriptionGetSwizzled(), originalPrescriptionIsValid(), originalPrescriptionNewObject(), originalPrescriptionSet()
property outcome as %String;
The outcome of the claim, predetermination, or preauthorization processing.
Property methods: outcomeDisplayToLogical(), outcomeGet(), outcomeIsValid(), outcomeLogicalToDisplay(), outcomeLogicalToOdbc(), outcomeNormalize(), outcomeSet()
property patient as HS.FHIRModel.R4.Reference [ Required ];
The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought.
Property methods: patientGet(), patientGetSwizzled(), patientIsValid(), patientNewObject(), patientSet()
The party to be reimbursed for cost of the products and services according to the terms of the policy.
Property methods: payeeGet(), payeeGetSwizzled(), payeeIsValid(), payeeNewObject(), payeeSet()
Payment details for the adjudication of the claim.
Property methods: paymentGet(), paymentGetSwizzled(), paymentIsValid(), paymentNewObject(), paymentSet()
property preAuthRef as HS.FHIRModel.R4.SeqOfString;
Reference from the Insurer which is used in later communications which refers to this adjudication.
Property methods: preAuthRefGet(), preAuthRefGetSwizzled(), preAuthRefIsValid(), preAuthRefNewObject(), preAuthRefSet()
property preAuthRefPeriod as HS.FHIRModel.R4.SeqOfPeriod;
The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.
Property methods: preAuthRefPeriodGet(), preAuthRefPeriodGetSwizzled(), preAuthRefPeriodIsValid(), preAuthRefPeriodNewObject(), preAuthRefPeriodSet()
property precedence as %Integer;
This indicates the relative order of a series of EOBs related to different coverages for the same suite of services.
Property methods: precedenceDisplayToLogical(), precedenceGet(), precedenceIsValid(), precedenceLogicalToDisplay(), precedenceNormalize(), precedenceSet(), precedenceXSDToLogical()
property prescription as HS.FHIRModel.R4.Reference;
Prescription to support the dispensing of pharmacy, device or vision products.
Property methods: prescriptionGet(), prescriptionGetSwizzled(), prescriptionIsValid(), prescriptionNewObject(), prescriptionSet()
property priority as HS.FHIRModel.R4.CodeableConcept;
The provider-required urgency of processing the request. Typical values include: stat, routine deferred.
Property methods: priorityGet(), priorityGetSwizzled(), priorityIsValid(), priorityNewObject(), prioritySet()
Procedures performed on the patient relevant to the billing items with the claim.
Property methods: procedureGet(), procedureGetSwizzled(), procedureIsValid(), procedureNewObject(), procedureSet()
A note that describes or explains adjudication results in a human readable form.
Property methods: processNoteGet(), processNoteGetSwizzled(), processNoteIsValid(), processNoteNewObject(), processNoteSet()
property provider as HS.FHIRModel.R4.Reference [ Required ];
The provider which is responsible for the claim, predetermination or preauthorization.
Property methods: providerGet(), providerGetSwizzled(), providerIsValid(), providerNewObject(), providerSet()
property referral as HS.FHIRModel.R4.Reference;
A reference to a referral resource.
Property methods: referralGet(), referralGetSwizzled(), referralIsValid(), referralNewObject(), referralSet()
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
Property methods: relatedGet(), relatedGetSwizzled(), relatedIsValid(), relatedNewObject(), relatedSet()
property resourceType as %String [ InitialExpression = "ExplanationOfBenefit" , Required ];
This is a ExplanationOfBenefit resource
Property methods: resourceTypeDisplayToLogical(), resourceTypeGet(), resourceTypeIsValid(), resourceTypeLogicalToDisplay(), resourceTypeLogicalToOdbc(), resourceTypeNormalize(), resourceTypeSet()
property status as %String (VALUELIST = ",active,cancelled,draft,entered-in-error");
The status of the resource instance.
Property methods: statusDisplayToLogical(), statusGet(), statusIsValid(), statusLogicalToDisplay(), statusLogicalToOdbc(), statusNormalize(), statusSet()
property subType as HS.FHIRModel.R4.CodeableConcept;
A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
Property methods: subTypeGet(), subTypeGetSwizzled(), subTypeIsValid(), subTypeNewObject(), subTypeSet()
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Property methods: supportingInfoGet(), supportingInfoGetSwizzled(), supportingInfoIsValid(), supportingInfoNewObject(), supportingInfoSet()
property text as HS.FHIRModel.R4.Narrative;
A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Property methods: textGet(), textGetSwizzled(), textIsValid(), textNewObject(), textSet()
Categorized monetary totals for the adjudication.
Property methods: totalGet(), totalGetSwizzled(), totalIsValid(), totalNewObject(), totalSet()
property type as HS.FHIRModel.R4.CodeableConcept [ Required ];
The category of claim, e.g. oral, pharmacy, vision, institutional, professional.
Property methods: typeGet(), typeGetSwizzled(), typeIsValid(), typeNewObject(), typeSet()
property use as %String;
A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
Property methods: useDisplayToLogical(), useGet(), useIsValid(), useLogicalToDisplay(), useLogicalToOdbc(), useNormalize(), useSet()

Methods

method IncludeAccident()
method IncludeAddItem()
method IncludeAdjudication()
method IncludeBenefitBalance()
method IncludeBenefitPeriod()
method IncludeBillablePeriod()
method IncludeCareTeam()
method IncludeClaim()
method IncludeClaimResponse()
method IncludeContained()
method IncludeDiagnosis()
method IncludeEnterer()
method IncludeExtension()
method IncludeFacility()
method IncludeForm()
method IncludeFormCode()
method IncludeFundsReserve()
method IncludeFundsReserveRequested()
method IncludeIdentifier()
method IncludeInsurance()
method IncludeInsurer()
method IncludeItem()
method IncludeMeta()
method IncludeModifierExtension()
method IncludeOriginalPrescription()
method IncludePatient()
method IncludePayee()
method IncludePayment()
method IncludePreAuthRef()
method IncludePreAuthRefPeriod()
method IncludePrescription()
method IncludePriority()
method IncludeProcedure()
method IncludeProcessNote()
method IncludeProvider()
method IncludeReferral()
method IncludeRelated()
method IncludeSubType()
method IncludeSupportingInfo()
method IncludeText()
method IncludeTotal()
method IncludeType()
method _getProperties() as %DynamicArray
Inherited description: Return an array of the defined properties of this class in the definition order that they were discovered in the the HL7FHIR JSchema document
method toDao() as %DynamicAbstractObject
Inherited description: >

The toDao() method casts the set to a DAO.

Inherited Members

Inherited Methods

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