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 Detail

      • identifier

        protected List<Identifier> identifier
        The business identifier for the instance: claim number, pre-determination or pre-authorization number.
      • type

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

        protected List<CodeableConcept> 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

        protected Enumeration<Claim.Use> use
        Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination).
      • patientTarget

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

        protected Period 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

        protected Practitioner 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

        protected Organization 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

        protected Practitioner 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

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

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

        protected CodeableConcept 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

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

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

        protected Reference 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

        protected MedicationRequest 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'.)
      • referral

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

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

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

        protected List<Claim.CareTeamComponent> careTeam
        The members of the team who provided the overall service as well as their role and whether responsible and qualifications.
      • information

        protected List<Claim.SpecialConditionComponent> 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.
      • employmentImpacted

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

        protected Period hospitalization
        The start and optional end dates of when the patient was confined to a treatment center.
      • 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".
      • 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 Detail

      • Claim

        public Claim()
        Constructor