Class Claim

All Implemented Interfaces:
ca.uhn.fhir.model.api.IElement, Serializable, org.hl7.fhir.instance.model.api.IAnyResource, org.hl7.fhir.instance.model.api.IBase, org.hl7.fhir.instance.model.api.IBaseHasExtensions, org.hl7.fhir.instance.model.api.IBaseHasModifierExtensions, org.hl7.fhir.instance.model.api.IBaseResource, org.hl7.fhir.instance.model.api.IDomainResource

public class Claim extends DomainResource
A provider issued list of services and products provided, or to be provided, to a patient which is provided to an insurer for payment recovery.
See Also:
Serialized Form
  • Field Details

    • identifier

      The business identifier for the instance: claim number, pre-determination or pre-authorization number.
    • status

      The status of the resource instance.
    • type

      protected CodeableConcept type
      The category of claim, eg, oral, pharmacy, vision, insitutional, professional.
    • subType

      A finer grained suite of claim subtype codes which may convey Inpatient vs Outpatient and/or a specialty service. In the US the BillType.
    • use

      Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination).
    • patient

      protected Reference patient
      Patient Resource.
    • patientTarget

      The actual object that is the target of the reference (Patient Resource.)
    • billablePeriod

      The billable period for which charges are being submitted.
    • created

      protected DateTimeType created
      The date when the enclosed suite of services were performed or completed.
    • enterer

      protected Reference enterer
      Person who created the invoice/claim/pre-determination or pre-authorization.
    • entererTarget

      The actual object that is the target of the reference (Person who created the invoice/claim/pre-determination or pre-authorization.)
    • insurer

      protected Reference insurer
      The Insurer who is target of the request.
    • insurerTarget

      The actual object that is the target of the reference (The Insurer who is target of the request.)
    • provider

      protected Reference provider
      The provider which is responsible for the bill, claim pre-determination, pre-authorization.
    • providerTarget

      The actual object that is the target of the reference (The provider which is responsible for the bill, claim pre-determination, pre-authorization.)
    • organization

      The organization which is responsible for the bill, claim pre-determination, pre-authorization.
    • organizationTarget

      The actual object that is the target of the reference (The organization which is responsible for the bill, claim pre-determination, pre-authorization.)
    • priority

      Immediate (STAT), best effort (NORMAL), deferred (DEFER).
    • fundsReserve

      In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.
    • prescription

      Prescription to support the dispensing of Pharmacy or Vision products.
    • prescriptionTarget

      The actual object that is the target of the reference (Prescription to support the dispensing of Pharmacy or Vision products.)
    • originalPrescription

      Original prescription which has been superceded by this prescription to support the dispensing of pharmacy services, medications or products. For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new precription for an alternate medication which has the same theraputic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.
    • originalPrescriptionTarget

      The actual object that is the target of the reference (Original prescription which has been superceded by this prescription to support the dispensing of pharmacy services, medications or products. For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new precription for an alternate medication which has the same theraputic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.)
    • payee

      The party to be reimbursed for the services.
    • referral

      protected Reference referral
      The referral resource which lists the date, practitioner, reason and other supporting information.
    • referralTarget

      The actual object that is the target of the reference (The referral resource which lists the date, practitioner, reason and other supporting information.)
    • facility

      protected Reference facility
      Facility where the services were provided.
    • facilityTarget

      The actual object that is the target of the reference (Facility where the services were provided.)
    • careTeam

      The members of the team who provided the overall service as well as their role and whether responsible and qualifications.
    • information

      Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues. Often there are mutiple jurisdiction specific valuesets which are required.
    • diagnosis

      List of patient diagnosis for which care is sought.
    • procedure

      Ordered list of patient procedures performed to support the adjudication.
    • insurance

      Financial instrument by which payment information for health care.
    • accident

      An accident which resulted in the need for healthcare services.
    • employmentImpacted

      The start and optional end dates of when the patient was precluded from working due to the treatable condition(s).
    • hospitalization

      The start and optional end dates of when the patient was confined to a treatment center.
    • item

      First tier of goods and services.
    • total

      protected Money total
      The total value of the claim.
    • SP_CARE_TEAM

      public static final String SP_CARE_TEAM
      Search parameter: care-team

      Description: Member of the CareTeam
      Type: reference
      Path: Claim.careTeam.provider

      See Also:
      Constant Field Values
    • CARE_TEAM

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam CARE_TEAM
      Fluent Client search parameter constant for care-team

      Description: Member of the CareTeam
      Type: reference
      Path: Claim.careTeam.provider

    • INCLUDE_CARE_TEAM

      public static final ca.uhn.fhir.model.api.Include INCLUDE_CARE_TEAM
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:care-team".
    • SP_IDENTIFIER

      public static final String SP_IDENTIFIER
      Search parameter: identifier

      Description: The primary identifier of the financial resource
      Type: token
      Path: Claim.identifier

      See Also:
      Constant Field Values
    • IDENTIFIER

      public static final ca.uhn.fhir.rest.gclient.TokenClientParam IDENTIFIER
      Fluent Client search parameter constant for identifier

      Description: The primary identifier of the financial resource
      Type: token
      Path: Claim.identifier

    • SP_USE

      public static final String SP_USE
      Search parameter: use

      Description: The kind of financial resource
      Type: token
      Path: Claim.use

      See Also:
      Constant Field Values
    • USE

      public static final ca.uhn.fhir.rest.gclient.TokenClientParam USE
      Fluent Client search parameter constant for use

      Description: The kind of financial resource
      Type: token
      Path: Claim.use

    • SP_CREATED

      public static final String SP_CREATED
      Search parameter: created

      Description: The creation date for the Claim
      Type: date
      Path: Claim.created

      See Also:
      Constant Field Values
    • CREATED

      public static final ca.uhn.fhir.rest.gclient.DateClientParam CREATED
      Fluent Client search parameter constant for created

      Description: The creation date for the Claim
      Type: date
      Path: Claim.created

    • SP_ENCOUNTER

      public static final String SP_ENCOUNTER
      Search parameter: encounter

      Description: Encounters associated with a billed line item
      Type: reference
      Path: Claim.item.encounter

      See Also:
      Constant Field Values
    • ENCOUNTER

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam ENCOUNTER
      Fluent Client search parameter constant for encounter

      Description: Encounters associated with a billed line item
      Type: reference
      Path: Claim.item.encounter

    • INCLUDE_ENCOUNTER

      public static final ca.uhn.fhir.model.api.Include INCLUDE_ENCOUNTER
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:encounter".
    • SP_PRIORITY

      public static final String SP_PRIORITY
      Search parameter: priority

      Description: Processing priority requested
      Type: token
      Path: Claim.priority

      See Also:
      Constant Field Values
    • PRIORITY

      public static final ca.uhn.fhir.rest.gclient.TokenClientParam PRIORITY
      Fluent Client search parameter constant for priority

      Description: Processing priority requested
      Type: token
      Path: Claim.priority

    • SP_PAYEE

      public static final String SP_PAYEE
      Search parameter: payee

      Description: The party receiving any payment for the Claim
      Type: reference
      Path: Claim.payee.party

      See Also:
      Constant Field Values
    • PAYEE

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam PAYEE
      Fluent Client search parameter constant for payee

      Description: The party receiving any payment for the Claim
      Type: reference
      Path: Claim.payee.party

    • INCLUDE_PAYEE

      public static final ca.uhn.fhir.model.api.Include INCLUDE_PAYEE
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:payee".
    • SP_PROVIDER

      public static final String SP_PROVIDER
      Search parameter: provider

      Description: Provider responsible for the Claim
      Type: reference
      Path: Claim.provider

      See Also:
      Constant Field Values
    • PROVIDER

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam PROVIDER
      Fluent Client search parameter constant for provider

      Description: Provider responsible for the Claim
      Type: reference
      Path: Claim.provider

    • INCLUDE_PROVIDER

      public static final ca.uhn.fhir.model.api.Include INCLUDE_PROVIDER
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:provider".
    • SP_PATIENT

      public static final String SP_PATIENT
      Search parameter: patient

      Description: Patient receiving the services
      Type: reference
      Path: Claim.patient

      See Also:
      Constant Field Values
    • PATIENT

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam PATIENT
      Fluent Client search parameter constant for patient

      Description: Patient receiving the services
      Type: reference
      Path: Claim.patient

    • INCLUDE_PATIENT

      public static final ca.uhn.fhir.model.api.Include INCLUDE_PATIENT
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:patient".
    • SP_INSURER

      public static final String SP_INSURER
      Search parameter: insurer

      Description: The target payor/insurer for the Claim
      Type: reference
      Path: Claim.insurer

      See Also:
      Constant Field Values
    • INSURER

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam INSURER
      Fluent Client search parameter constant for insurer

      Description: The target payor/insurer for the Claim
      Type: reference
      Path: Claim.insurer

    • INCLUDE_INSURER

      public static final ca.uhn.fhir.model.api.Include INCLUDE_INSURER
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:insurer".
    • SP_ORGANIZATION

      public static final String SP_ORGANIZATION
      Search parameter: organization

      Description: The reference to the providing organization
      Type: reference
      Path: Claim.organization

      See Also:
      Constant Field Values
    • ORGANIZATION

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam ORGANIZATION
      Fluent Client search parameter constant for organization

      Description: The reference to the providing organization
      Type: reference
      Path: Claim.organization

    • INCLUDE_ORGANIZATION

      public static final ca.uhn.fhir.model.api.Include INCLUDE_ORGANIZATION
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:organization".
    • SP_ENTERER

      public static final String SP_ENTERER
      Search parameter: enterer

      Description: The party responsible for the entry of the Claim
      Type: reference
      Path: Claim.enterer

      See Also:
      Constant Field Values
    • ENTERER

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam ENTERER
      Fluent Client search parameter constant for enterer

      Description: The party responsible for the entry of the Claim
      Type: reference
      Path: Claim.enterer

    • INCLUDE_ENTERER

      public static final ca.uhn.fhir.model.api.Include INCLUDE_ENTERER
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:enterer".
    • SP_FACILITY

      public static final String SP_FACILITY
      Search parameter: facility

      Description: Facility responsible for the goods and services
      Type: reference
      Path: Claim.facility

      See Also:
      Constant Field Values
    • FACILITY

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam FACILITY
      Fluent Client search parameter constant for facility

      Description: Facility responsible for the goods and services
      Type: reference
      Path: Claim.facility

    • INCLUDE_FACILITY

      public static final ca.uhn.fhir.model.api.Include INCLUDE_FACILITY
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Claim:facility".
  • Constructor Details

    • Claim

      public Claim()
      Constructor
  • Method Details