Package org.hl7.fhir.r5.model

Class ClaimResponse

java.lang.Object

org.hl7.fhir.r5.model.Base

org.hl7.fhir.r5.model.BaseResource

org.hl7.fhir.r5.model.Resource

org.hl7.fhir.r5.model.DomainResource

org.hl7.fhir.r5.model.ClaimResponse

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 ClaimResponse
extends DomainResource

This resource provides the adjudication details from the processing of a Claim resource.

See Also:

• Serialized Form

Nested Class Summary

Nested Classes

Modifier and Type	Class	Description
static class	ClaimResponse.AddedItemComponent
static class	ClaimResponse.AddedItemDetailComponent
static class	ClaimResponse.AddedItemSubDetailComponent
static class	ClaimResponse.AdjudicationComponent
static class	ClaimResponse.BodySiteComponent
static class	ClaimResponse.ErrorComponent
static class	ClaimResponse.InsuranceComponent
static class	ClaimResponse.ItemComponent
static class	ClaimResponse.ItemDetailComponent
static class	ClaimResponse.NoteComponent
static class	ClaimResponse.PaymentComponent
static class	ClaimResponse.SubDetailComponent
static class	ClaimResponse.TotalComponent

Nested classes/interfaces inherited from class org.hl7.fhir.r5.model.Base

Base.ProfileSource, Base.ValidationInfo, Base.ValidationMode, Base.ValidationReason

Field Summary

Fields

Modifier and Type	Field	Description
protected List<ClaimResponse.AddedItemComponent>	addItem	The first-tier service adjudications for payor added product or service lines.
protected List<ClaimResponse.AdjudicationComponent>	adjudication	The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
protected List<Reference>	communicationRequest	Request for additional supporting or authorizing information.
protected DateTimeType	created	The date this resource was created.
static final ca.uhn.fhir.rest.gclient.DateClientParam	CREATED	Fluent Client search parameter constant for created
protected CodeableConcept	decision	The result of the claim, predetermination, or preauthorization adjudication.
protected CodeableConcept	diagnosisRelatedGroup	A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.
protected StringType	disposition	A human readable description of the status of the adjudication.
static final ca.uhn.fhir.rest.gclient.StringClientParam	DISPOSITION	Fluent Client search parameter constant for disposition
protected List<Reference>	encounter	The Encounters during which this Claim was created or to which the creation of this record is tightly associated.
protected List<ClaimResponse.ErrorComponent>	error	Errors encountered during the processing of the adjudication.
protected Attachment	form	The actual form, by reference or inclusion, for printing the content or an EOB.
protected CodeableConcept	formCode	A code for the form to be used for printing the content.
protected CodeableConcept	fundsReserve	A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.
protected List<Identifier>	identifier	A unique identifier assigned to this claim response.
static final ca.uhn.fhir.rest.gclient.TokenClientParam	IDENTIFIER	Fluent Client search parameter constant for identifier
static final ca.uhn.fhir.model.api.Include	INCLUDE_INSURER	Constant for fluent queries to be used to add include statements.
static final ca.uhn.fhir.model.api.Include	INCLUDE_PATIENT	Constant for fluent queries to be used to add include statements.
static final ca.uhn.fhir.model.api.Include	INCLUDE_REQUEST	Constant for fluent queries to be used to add include statements.
static final ca.uhn.fhir.model.api.Include	INCLUDE_REQUESTOR	Constant for fluent queries to be used to add include statements.
protected List<ClaimResponse.InsuranceComponent>	insurance	Financial instruments for reimbursement for the health care products and services specified on the claim.
protected Reference	insurer	The party responsible for authorization, adjudication and reimbursement.
static final ca.uhn.fhir.rest.gclient.ReferenceClientParam	INSURER	Fluent Client search parameter constant for insurer
protected List<ClaimResponse.ItemComponent>	item	A claim line.
protected Enumeration<Enumerations.ClaimProcessingCodes>	outcome	The outcome of the claim, predetermination, or preauthorization processing.
static final ca.uhn.fhir.rest.gclient.TokenClientParam	OUTCOME	Fluent Client search parameter constant for outcome
protected Reference	patient	The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.
static final ca.uhn.fhir.rest.gclient.ReferenceClientParam	PATIENT	Fluent Client search parameter constant for patient
protected CodeableConcept	payeeType	Type of Party to be reimbursed: subscriber, provider, other.
protected ClaimResponse.PaymentComponent	payment	Payment details for the adjudication of the claim.
static final ca.uhn.fhir.rest.gclient.DateClientParam	PAYMENT_DATE	Fluent Client search parameter constant for payment-date
protected Period	preAuthPeriod	The time frame during which this authorization is effective.
protected StringType	preAuthRef	Reference from the Insurer which is used in later communications which refers to this adjudication.
protected List<ClaimResponse.NoteComponent>	processNote	A note that describes or explains adjudication results in a human readable form.
protected Reference	request	Original request resource reference.
static final ca.uhn.fhir.rest.gclient.ReferenceClientParam	REQUEST	Fluent Client search parameter constant for request
protected Reference	requestor	The provider which is responsible for the claim, predetermination or preauthorization.
static final ca.uhn.fhir.rest.gclient.ReferenceClientParam	REQUESTOR	Fluent Client search parameter constant for requestor
static final String	SP_CREATED	Search parameter: created
static final String	SP_DISPOSITION	Search parameter: disposition
static final String	SP_IDENTIFIER	Search parameter: identifier
static final String	SP_INSURER	Search parameter: insurer
static final String	SP_OUTCOME	Search parameter: outcome
static final String	SP_PATIENT	Search parameter: patient
static final String	SP_PAYMENT_DATE	Search parameter: payment-date
static final String	SP_REQUEST	Search parameter: request
static final String	SP_REQUESTOR	Search parameter: requestor
static final String	SP_STATUS	Search parameter: status
static final String	SP_USE	Search parameter: use
protected Enumeration<Enumerations.FinancialResourceStatusCodes>	status	The status of the resource instance.
static final ca.uhn.fhir.rest.gclient.TokenClientParam	STATUS	Fluent Client search parameter constant for status
protected CodeableConcept	subType	A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
protected List<ClaimResponse.TotalComponent>	total	Categorized monetary totals for the adjudication.
protected CodeableConcept	type	A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
protected Enumeration<Enumerations.Use>	use	A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.
static final ca.uhn.fhir.rest.gclient.TokenClientParam	USE	Fluent Client search parameter constant for use

Fields inherited from class org.hl7.fhir.r5.model.DomainResource

contained, extension, modifierExtension, SP_TEXT, text, TEXT

Fields inherited from class org.hl7.fhir.r5.model.Resource

id, implicitRules, language, meta

Fields inherited from interface org.hl7.fhir.instance.model.api.IAnyResource

RES_ID, SP_RES_ID

Fields inherited from interface org.hl7.fhir.instance.model.api.IBaseResource

INCLUDE_ALL, WILDCARD_ALL_SET

Constructor Summary

Constructors

Constructor	Description
ClaimResponse()	Constructor
ClaimResponse(Enumerations.FinancialResourceStatusCodes status, CodeableConcept type, Enumerations.Use use, Reference patient, Date created, Enumerations.ClaimProcessingCodes outcome)	Constructor

Method Summary

Modifier and Type	Method	Description
ClaimResponse.AddedItemComponent	addAddItem()
ClaimResponse	addAddItem(ClaimResponse.AddedItemComponent t)
ClaimResponse.AdjudicationComponent	addAdjudication()
ClaimResponse	addAdjudication(ClaimResponse.AdjudicationComponent t)
Base	addChild(String name)
Reference	addCommunicationRequest()
ClaimResponse	addCommunicationRequest(Reference t)
Reference	addEncounter()
ClaimResponse	addEncounter(Reference t)
ClaimResponse.ErrorComponent	addError()
ClaimResponse	addError(ClaimResponse.ErrorComponent t)
Identifier	addIdentifier()
ClaimResponse	addIdentifier(Identifier t)
ClaimResponse.InsuranceComponent	addInsurance()
ClaimResponse	addInsurance(ClaimResponse.InsuranceComponent t)
ClaimResponse.ItemComponent	addItem()
ClaimResponse	addItem(ClaimResponse.ItemComponent t)
ClaimResponse.NoteComponent	addProcessNote()
ClaimResponse	addProcessNote(ClaimResponse.NoteComponent t)
ClaimResponse.TotalComponent	addTotal()
ClaimResponse	addTotal(ClaimResponse.TotalComponent t)
ClaimResponse	copy()
void	copyValues(ClaimResponse dst)
boolean	equalsDeep(Base other_)
boolean	equalsShallow(Base other_)
String	fhirType()
List<ClaimResponse.AddedItemComponent>	getAddItem()
ClaimResponse.AddedItemComponent	getAddItemFirstRep()
List<ClaimResponse.AdjudicationComponent>	getAdjudication()
ClaimResponse.AdjudicationComponent	getAdjudicationFirstRep()
List<Reference>	getCommunicationRequest()
Reference	getCommunicationRequestFirstRep()
Date	getCreated()
DateTimeType	getCreatedElement()
CodeableConcept	getDecision()
CodeableConcept	getDiagnosisRelatedGroup()
String	getDisposition()
StringType	getDispositionElement()
List<Reference>	getEncounter()
Reference	getEncounterFirstRep()
List<ClaimResponse.ErrorComponent>	getError()
ClaimResponse.ErrorComponent	getErrorFirstRep()
Attachment	getForm()
CodeableConcept	getFormCode()
CodeableConcept	getFundsReserve()
List<Identifier>	getIdentifier()
Identifier	getIdentifierFirstRep()
List<ClaimResponse.InsuranceComponent>	getInsurance()
ClaimResponse.InsuranceComponent	getInsuranceFirstRep()
Reference	getInsurer()
List<ClaimResponse.ItemComponent>	getItem()
ClaimResponse.ItemComponent	getItemFirstRep()
Property	getNamedProperty(int _hash, String _name, boolean _checkValid)
Enumerations.ClaimProcessingCodes	getOutcome()
Enumeration<Enumerations.ClaimProcessingCodes>	getOutcomeElement()
Reference	getPatient()
CodeableConcept	getPayeeType()
ClaimResponse.PaymentComponent	getPayment()
Period	getPreAuthPeriod()
String	getPreAuthRef()
StringType	getPreAuthRefElement()
List<ClaimResponse.NoteComponent>	getProcessNote()
ClaimResponse.NoteComponent	getProcessNoteFirstRep()
Base[]	getProperty(int hash, String name, boolean checkValid)
Reference	getRequest()
Reference	getRequestor()
ResourceType	getResourceType()
Enumerations.FinancialResourceStatusCodes	getStatus()
Enumeration<Enumerations.FinancialResourceStatusCodes>	getStatusElement()
CodeableConcept	getSubType()
List<ClaimResponse.TotalComponent>	getTotal()
ClaimResponse.TotalComponent	getTotalFirstRep()
CodeableConcept	getType()
String[]	getTypesForProperty(int hash, String name)
Enumerations.Use	getUse()
Enumeration<Enumerations.Use>	getUseElement()
boolean	hasAddItem()
boolean	hasAdjudication()
boolean	hasCommunicationRequest()
boolean	hasCreated()
boolean	hasCreatedElement()
boolean	hasDecision()
boolean	hasDiagnosisRelatedGroup()
boolean	hasDisposition()
boolean	hasDispositionElement()
boolean	hasEncounter()
boolean	hasError()
boolean	hasForm()
boolean	hasFormCode()
boolean	hasFundsReserve()
boolean	hasIdentifier()
boolean	hasInsurance()
boolean	hasInsurer()
boolean	hasItem()
boolean	hasOutcome()
boolean	hasOutcomeElement()
boolean	hasPatient()
boolean	hasPayeeType()
boolean	hasPayment()
boolean	hasPreAuthPeriod()
boolean	hasPreAuthRef()
boolean	hasPreAuthRefElement()
boolean	hasProcessNote()
boolean	hasRequest()
boolean	hasRequestor()
boolean	hasStatus()
boolean	hasStatusElement()
boolean	hasSubType()
boolean	hasTotal()
boolean	hasType()
boolean	hasUse()
boolean	hasUseElement()
boolean	isEmpty()
protected void	listChildren(List<Property> children)
Base	makeProperty(int hash, String name)
ClaimResponse	setAddItem(List<ClaimResponse.AddedItemComponent> theAddItem)
ClaimResponse	setAdjudication(List<ClaimResponse.AdjudicationComponent> theAdjudication)
ClaimResponse	setCommunicationRequest(List<Reference> theCommunicationRequest)
ClaimResponse	setCreated(Date value)
ClaimResponse	setCreatedElement(DateTimeType value)
ClaimResponse	setDecision(CodeableConcept value)
ClaimResponse	setDiagnosisRelatedGroup(CodeableConcept value)
ClaimResponse	setDisposition(String value)
ClaimResponse	setDispositionElement(StringType value)
ClaimResponse	setEncounter(List<Reference> theEncounter)
ClaimResponse	setError(List<ClaimResponse.ErrorComponent> theError)
ClaimResponse	setForm(Attachment value)
ClaimResponse	setFormCode(CodeableConcept value)
ClaimResponse	setFundsReserve(CodeableConcept value)
ClaimResponse	setIdentifier(List<Identifier> theIdentifier)
ClaimResponse	setInsurance(List<ClaimResponse.InsuranceComponent> theInsurance)
ClaimResponse	setInsurer(Reference value)
ClaimResponse	setItem(List<ClaimResponse.ItemComponent> theItem)
ClaimResponse	setOutcome(Enumerations.ClaimProcessingCodes value)
ClaimResponse	setOutcomeElement(Enumeration<Enumerations.ClaimProcessingCodes> value)
ClaimResponse	setPatient(Reference value)
ClaimResponse	setPayeeType(CodeableConcept value)
ClaimResponse	setPayment(ClaimResponse.PaymentComponent value)
ClaimResponse	setPreAuthPeriod(Period value)
ClaimResponse	setPreAuthRef(String value)
ClaimResponse	setPreAuthRefElement(StringType value)
ClaimResponse	setProcessNote(List<ClaimResponse.NoteComponent> theProcessNote)
Base	setProperty(int hash, String name, Base value)
Base	setProperty(String name, Base value)
ClaimResponse	setRequest(Reference value)
ClaimResponse	setRequestor(Reference value)
ClaimResponse	setStatus(Enumerations.FinancialResourceStatusCodes value)
ClaimResponse	setStatusElement(Enumeration<Enumerations.FinancialResourceStatusCodes> value)
ClaimResponse	setSubType(CodeableConcept value)
ClaimResponse	setTotal(List<ClaimResponse.TotalComponent> theTotal)
ClaimResponse	setType(CodeableConcept value)
ClaimResponse	setUse(Enumerations.Use value)
ClaimResponse	setUseElement(Enumeration<Enumerations.Use> value)
protected ClaimResponse	typedCopy()

Methods inherited from class org.hl7.fhir.r5.model.DomainResource

addContained, addExtension, addExtension, addExtension, addModifierExtension, addModifierExtension, checkNoModifiers, copyValues, getContained, getContained, getExtension, getExtensionByUrl, getExtensionsByUrl, getModifierExtension, getModifierExtensionsByUrl, getText, hasContained, hasExtension, hasExtension, hasModifierExtension, hasText, setContained, setExtension, setModifierExtension, setText

Methods inherited from class org.hl7.fhir.r5.model.Resource

copyValues, getId, getIdBase, getIdElement, getIdPart, getImplicitRules, getImplicitRulesElement, getLanguage, getLanguage, getLanguageElement, getMeta, getSourcePackage, hasId, hasIdElement, hasImplicitRules, hasImplicitRulesElement, hasLanguage, hasLanguageElement, hasMeta, hasSourcePackage, setId, setIdBase, setIdElement, setImplicitRules, setImplicitRulesElement, setLanguage, setLanguageElement, setMeta, setSourcePackage

Methods inherited from class org.hl7.fhir.r5.model.BaseResource

getStructureFhirVersionEnum, isResource, setId

Methods inherited from class org.hl7.fhir.r5.model.Base

addDefinition, children, clearUserData, compareDeep, compareDeep, compareDeep, compareDeep, compareValues, compareValues, copyUserData, copyValues, dateTimeValue, equals, getChildByName, getFormatCommentsPost, getFormatCommentsPre, getNamedProperty, getUserData, getUserInt, getUserString, getValidationInfo, getXhtml, hasFormatComment, hasPrimitiveValue, hasType, hasUserData, hasValidationInfo, isBooleanPrimitive, isDateTime, isMetadataBased, isPrimitive, listChildrenByName, listChildrenByName, primitiveValue, removeChild, setUserData, setUserDataINN

Methods inherited from class java.lang.Object

clone, equals, finalize, getClass, hashCode, notify, notifyAll, toString, wait, wait, wait

Methods inherited from interface org.hl7.fhir.instance.model.api.IAnyResource

getId, getIdElement, getLanguageElement, getUserData, setId, setUserData

Methods inherited from interface org.hl7.fhir.instance.model.api.IBase

getFormatCommentsPost, getFormatCommentsPre, hasFormatComment

Methods inherited from interface org.hl7.fhir.instance.model.api.IBaseResource

getMeta, getStructureFhirVersionEnum, setId

Field Details

identifier

protected List<Identifier> identifier

A unique identifier assigned to this claim response.

status

protected Enumeration<Enumerations.FinancialResourceStatusCodes> status

The status of the resource instance.

type

protected CodeableConcept type

A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.

subType

protected CodeableConcept subType

A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.

use

protected Enumeration<Enumerations.Use> use

A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.

patient

protected Reference patient

The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.

created

protected DateTimeType created

The date this resource was created.

insurer

protected Reference insurer

The party responsible for authorization, adjudication and reimbursement.

requestor

protected Reference requestor

The provider which is responsible for the claim, predetermination or preauthorization.

request

protected Reference request

Original request resource reference.

outcome

protected Enumeration<Enumerations.ClaimProcessingCodes> outcome

The outcome of the claim, predetermination, or preauthorization processing.

decision

protected CodeableConcept decision

The result of the claim, predetermination, or preauthorization adjudication.

disposition

protected StringType disposition

A human readable description of the status of the adjudication.

preAuthRef

protected StringType preAuthRef

Reference from the Insurer which is used in later communications which refers to this adjudication.

preAuthPeriod

protected Period preAuthPeriod

The time frame during which this authorization is effective.

payeeType

protected CodeableConcept payeeType

Type of Party to be reimbursed: subscriber, provider, other.

encounter

protected List<Reference> encounter

The Encounters during which this Claim was created or to which the creation of this record is tightly associated.

diagnosisRelatedGroup

protected CodeableConcept diagnosisRelatedGroup

A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.

item

protected List<ClaimResponse.ItemComponent> item

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.

addItem

protected List<ClaimResponse.AddedItemComponent> addItem

The first-tier service adjudications for payor added product or service lines.

adjudication

protected List<ClaimResponse.AdjudicationComponent> adjudication

The adjudication results which are presented at the header level rather than at the line-item or add-item levels.

total

protected List<ClaimResponse.TotalComponent> total

Categorized monetary totals for the adjudication.

payment

protected ClaimResponse.PaymentComponent payment

Payment details for the adjudication of the claim.

fundsReserve

protected CodeableConcept fundsReserve

A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.

formCode

protected CodeableConcept formCode

A code for the form to be used for printing the content.

form

protected Attachment form

The actual form, by reference or inclusion, for printing the content or an EOB.

processNote

protected List<ClaimResponse.NoteComponent> processNote

A note that describes or explains adjudication results in a human readable form.

communicationRequest

protected List<Reference> communicationRequest

Request for additional supporting or authorizing information.

insurance

protected List<ClaimResponse.InsuranceComponent> insurance

Financial instruments for reimbursement for the health care products and services specified on the claim.

error

protected List<ClaimResponse.ErrorComponent> error

Errors encountered during the processing of the adjudication.

SP_CREATED

public static final String SP_CREATED

Search parameter: created

Description: The creation date
Type: date
Path: ClaimResponse.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
Type: date
Path: ClaimResponse.created

SP_DISPOSITION

public static final String SP_DISPOSITION

Search parameter: disposition

Description: The contents of the disposition message
Type: string
Path: ClaimResponse.disposition

See Also:

• Constant Field Values

DISPOSITION

public static final ca.uhn.fhir.rest.gclient.StringClientParam DISPOSITION

Fluent Client search parameter constant for disposition

Description: The contents of the disposition message
Type: string
Path: ClaimResponse.disposition

SP_IDENTIFIER

public static final String SP_IDENTIFIER

Search parameter: identifier

Description: The identity of the ClaimResponse
Type: token
Path: ClaimResponse.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 identity of the ClaimResponse
Type: token
Path: ClaimResponse.identifier

SP_INSURER

public static final String SP_INSURER

Search parameter: insurer

Description: The organization which generated this resource
Type: reference
Path: ClaimResponse.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 organization which generated this resource
Type: reference
Path: ClaimResponse.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 "ClaimResponse:insurer".

SP_OUTCOME

public static final String SP_OUTCOME

Search parameter: outcome

Description: The processing outcome
Type: token
Path: ClaimResponse.outcome

See Also:

• Constant Field Values

OUTCOME

public static final ca.uhn.fhir.rest.gclient.TokenClientParam OUTCOME

Fluent Client search parameter constant for outcome

Description: The processing outcome
Type: token
Path: ClaimResponse.outcome

SP_PATIENT

public static final String SP_PATIENT

Search parameter: patient

Description: The subject of care
Type: reference
Path: ClaimResponse.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: The subject of care
Type: reference
Path: ClaimResponse.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 "ClaimResponse:patient".

SP_PAYMENT_DATE

public static final String SP_PAYMENT_DATE

Search parameter: payment-date

Description: The expected payment date
Type: date
Path: ClaimResponse.payment.date

See Also:

• Constant Field Values

PAYMENT_DATE

public static final ca.uhn.fhir.rest.gclient.DateClientParam PAYMENT_DATE

Fluent Client search parameter constant for payment-date

Description: The expected payment date
Type: date
Path: ClaimResponse.payment.date

SP_REQUEST

public static final String SP_REQUEST

Search parameter: request

Description: The claim reference
Type: reference
Path: ClaimResponse.request

See Also:

• Constant Field Values

REQUEST

public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam REQUEST

Fluent Client search parameter constant for request

Description: The claim reference
Type: reference
Path: ClaimResponse.request

INCLUDE_REQUEST

public static final ca.uhn.fhir.model.api.Include INCLUDE_REQUEST

Constant for fluent queries to be used to add include statements. Specifies the path value of "ClaimResponse:request".

SP_REQUESTOR

public static final String SP_REQUESTOR

Search parameter: requestor

Description: The Provider of the claim
Type: reference
Path: ClaimResponse.requestor

See Also:

• Constant Field Values

REQUESTOR

public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam REQUESTOR

Fluent Client search parameter constant for requestor

Description: The Provider of the claim
Type: reference
Path: ClaimResponse.requestor

INCLUDE_REQUESTOR

public static final ca.uhn.fhir.model.api.Include INCLUDE_REQUESTOR

Constant for fluent queries to be used to add include statements. Specifies the path value of "ClaimResponse:requestor".

SP_STATUS

public static final String SP_STATUS

Search parameter: status

Description: The status of the ClaimResponse
Type: token
Path: ClaimResponse.status

See Also:

• Constant Field Values

STATUS

public static final ca.uhn.fhir.rest.gclient.TokenClientParam STATUS

Fluent Client search parameter constant for status

Description: The status of the ClaimResponse
Type: token
Path: ClaimResponse.status

SP_USE

public static final String SP_USE

Search parameter: use

Description: The type of claim
Type: token
Path: ClaimResponse.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 type of claim
Type: token
Path: ClaimResponse.use

Constructor Details

ClaimResponse

public ClaimResponse()

Constructor

ClaimResponse

public ClaimResponse(Enumerations.FinancialResourceStatusCodes status,
 CodeableConcept type,
 Enumerations.Use use,
 Reference patient,
 Date created,
 Enumerations.ClaimProcessingCodes outcome)

Constructor

Method Details

getIdentifier

public List<Identifier> getIdentifier()

Returns:

identifier (A unique identifier assigned to this claim response.)

setIdentifier

public ClaimResponse setIdentifier(List<Identifier> theIdentifier)

Returns:

Returns a reference to this for easy method chaining

hasIdentifier

public boolean hasIdentifier()

addIdentifier

public Identifier addIdentifier()

addIdentifier

public ClaimResponse addIdentifier(Identifier t)

getIdentifierFirstRep

public Identifier getIdentifierFirstRep()

Returns:

The first repetition of repeating field identifier, creating it if it does not already exist {3}

getStatusElement

public Enumeration<Enumerations.FinancialResourceStatusCodes> getStatusElement()

Returns:

status (The status of the resource instance.). This is the underlying object with id, value and extensions. The accessor "getStatus" gives direct access to the value

hasStatusElement

public boolean hasStatusElement()

hasStatus

public boolean hasStatus()

setStatusElement

public ClaimResponse setStatusElement(Enumeration<Enumerations.FinancialResourceStatusCodes> value)

Parameters:

value - status (The status of the resource instance.). This is the underlying object with id, value and extensions. The accessor "getStatus" gives direct access to the value

getStatus

public Enumerations.FinancialResourceStatusCodes getStatus()

Returns:

The status of the resource instance.

setStatus

public ClaimResponse setStatus(Enumerations.FinancialResourceStatusCodes value)

Parameters:

value - The status of the resource instance.

getType

public CodeableConcept getType()

Returns:

type (A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.)

hasType

public boolean hasType()

setType

public ClaimResponse setType(CodeableConcept value)

Parameters:

value - type (A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.)

getSubType

public CodeableConcept getSubType()

Returns:

subType (A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.)

hasSubType

public boolean hasSubType()

setSubType

public ClaimResponse setSubType(CodeableConcept value)

Parameters:

value - subType (A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.)

getUseElement

public Enumeration<Enumerations.Use> getUseElement()

Returns:

use (A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.). This is the underlying object with id, value and extensions. The accessor "getUse" gives direct access to the value

hasUseElement

public boolean hasUseElement()

hasUse

public boolean hasUse()

setUseElement

public ClaimResponse setUseElement(Enumeration<Enumerations.Use> value)

Parameters:

value - use (A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.). This is the underlying object with id, value and extensions. The accessor "getUse" gives direct access to the value

getUse

public Enumerations.Use getUse()

Returns:

A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.

setUse

public ClaimResponse setUse(Enumerations.Use value)

Parameters:

value - A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied 'what if' charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.

getPatient

public Reference getPatient()

Returns:

patient (The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.)

hasPatient

public boolean hasPatient()

setPatient

public ClaimResponse setPatient(Reference value)

Parameters:

value - patient (The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.)

getCreatedElement

public DateTimeType getCreatedElement()

Returns:

created (The date this resource was created.). This is the underlying object with id, value and extensions. The accessor "getCreated" gives direct access to the value

hasCreatedElement

public boolean hasCreatedElement()

hasCreated

public boolean hasCreated()

setCreatedElement

public ClaimResponse setCreatedElement(DateTimeType value)

Parameters:

value - created (The date this resource was created.). This is the underlying object with id, value and extensions. The accessor "getCreated" gives direct access to the value

getCreated

public Date getCreated()

Returns:

The date this resource was created.

setCreated

public ClaimResponse setCreated(Date value)

Parameters:

value - The date this resource was created.

getInsurer

public Reference getInsurer()

Returns:

insurer (The party responsible for authorization, adjudication and reimbursement.)

hasInsurer

public boolean hasInsurer()

setInsurer

public ClaimResponse setInsurer(Reference value)

Parameters:

value - insurer (The party responsible for authorization, adjudication and reimbursement.)

getRequestor

public Reference getRequestor()

Returns:

requestor (The provider which is responsible for the claim, predetermination or preauthorization.)

hasRequestor

public boolean hasRequestor()

setRequestor

public ClaimResponse setRequestor(Reference value)

Parameters:

value - requestor (The provider which is responsible for the claim, predetermination or preauthorization.)

getRequest

public Reference getRequest()

Returns:

request (Original request resource reference.)

hasRequest

public boolean hasRequest()

setRequest

public ClaimResponse setRequest(Reference value)

Parameters:

value - request (Original request resource reference.)

getOutcomeElement

public Enumeration<Enumerations.ClaimProcessingCodes> getOutcomeElement()

Returns:

outcome (The outcome of the claim, predetermination, or preauthorization processing.). This is the underlying object with id, value and extensions. The accessor "getOutcome" gives direct access to the value

hasOutcomeElement

public boolean hasOutcomeElement()

hasOutcome

public boolean hasOutcome()

setOutcomeElement

public ClaimResponse setOutcomeElement(Enumeration<Enumerations.ClaimProcessingCodes> value)

Parameters:

value - outcome (The outcome of the claim, predetermination, or preauthorization processing.). This is the underlying object with id, value and extensions. The accessor "getOutcome" gives direct access to the value

getOutcome

public Enumerations.ClaimProcessingCodes getOutcome()

Returns:

The outcome of the claim, predetermination, or preauthorization processing.

setOutcome

public ClaimResponse setOutcome(Enumerations.ClaimProcessingCodes value)

Parameters:

value - The outcome of the claim, predetermination, or preauthorization processing.

getDecision

public CodeableConcept getDecision()

Returns:

decision (The result of the claim, predetermination, or preauthorization adjudication.)

hasDecision

public boolean hasDecision()

setDecision

public ClaimResponse setDecision(CodeableConcept value)

Parameters:

value - decision (The result of the claim, predetermination, or preauthorization adjudication.)

getDispositionElement

public StringType getDispositionElement()

Returns:

disposition (A human readable description of the status of the adjudication.). This is the underlying object with id, value and extensions. The accessor "getDisposition" gives direct access to the value

hasDispositionElement

public boolean hasDispositionElement()

hasDisposition

public boolean hasDisposition()

setDispositionElement

public ClaimResponse setDispositionElement(StringType value)

Parameters:

value - disposition (A human readable description of the status of the adjudication.). This is the underlying object with id, value and extensions. The accessor "getDisposition" gives direct access to the value

getDisposition

public String getDisposition()

Returns:

A human readable description of the status of the adjudication.

setDisposition

public ClaimResponse setDisposition(String value)

Parameters:

value - A human readable description of the status of the adjudication.

getPreAuthRefElement

public StringType getPreAuthRefElement()

Returns:

preAuthRef (Reference from the Insurer which is used in later communications which refers to this adjudication.). This is the underlying object with id, value and extensions. The accessor "getPreAuthRef" gives direct access to the value

hasPreAuthRefElement

public boolean hasPreAuthRefElement()

hasPreAuthRef

public boolean hasPreAuthRef()

setPreAuthRefElement

public ClaimResponse setPreAuthRefElement(StringType value)

Parameters:

value - preAuthRef (Reference from the Insurer which is used in later communications which refers to this adjudication.). This is the underlying object with id, value and extensions. The accessor "getPreAuthRef" gives direct access to the value

getPreAuthRef

public String getPreAuthRef()

Returns:

Reference from the Insurer which is used in later communications which refers to this adjudication.

setPreAuthRef

public ClaimResponse setPreAuthRef(String value)

Parameters:

value - Reference from the Insurer which is used in later communications which refers to this adjudication.

getPreAuthPeriod

public Period getPreAuthPeriod()

Returns:

preAuthPeriod (The time frame during which this authorization is effective.)

hasPreAuthPeriod

public boolean hasPreAuthPeriod()

setPreAuthPeriod

public ClaimResponse setPreAuthPeriod(Period value)

Parameters:

value - preAuthPeriod (The time frame during which this authorization is effective.)

getPayeeType

public CodeableConcept getPayeeType()

Returns:

payeeType (Type of Party to be reimbursed: subscriber, provider, other.)

hasPayeeType

public boolean hasPayeeType()

setPayeeType

public ClaimResponse setPayeeType(CodeableConcept value)

Parameters:

value - payeeType (Type of Party to be reimbursed: subscriber, provider, other.)

getEncounter

public List<Reference> getEncounter()

Returns:

encounter (The Encounters during which this Claim was created or to which the creation of this record is tightly associated.)

setEncounter

public ClaimResponse setEncounter(List<Reference> theEncounter)

Returns:

Returns a reference to this for easy method chaining

hasEncounter

public boolean hasEncounter()

addEncounter

public Reference addEncounter()

addEncounter

public ClaimResponse addEncounter(Reference t)

getEncounterFirstRep

public Reference getEncounterFirstRep()

Returns:

The first repetition of repeating field encounter, creating it if it does not already exist {3}

getDiagnosisRelatedGroup

public CodeableConcept getDiagnosisRelatedGroup()

Returns:

diagnosisRelatedGroup (A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.)

hasDiagnosisRelatedGroup

public boolean hasDiagnosisRelatedGroup()

setDiagnosisRelatedGroup

public ClaimResponse setDiagnosisRelatedGroup(CodeableConcept value)

Parameters:

value - diagnosisRelatedGroup (A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.)

getItem

public List<ClaimResponse.ItemComponent> getItem()

Returns:

item (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.)

setItem

public ClaimResponse setItem(List<ClaimResponse.ItemComponent> theItem)

Returns:

Returns a reference to this for easy method chaining

hasItem

public boolean hasItem()

addItem

public ClaimResponse.ItemComponent addItem()

addItem

public ClaimResponse addItem(ClaimResponse.ItemComponent t)

getItemFirstRep

public ClaimResponse.ItemComponent getItemFirstRep()

Returns:

The first repetition of repeating field item, creating it if it does not already exist {3}

getAddItem

public List<ClaimResponse.AddedItemComponent> getAddItem()

Returns:

addItem (The first-tier service adjudications for payor added product or service lines.)

setAddItem

public ClaimResponse setAddItem(List<ClaimResponse.AddedItemComponent> theAddItem)

Returns:

Returns a reference to this for easy method chaining

hasAddItem

public boolean hasAddItem()

addAddItem

public ClaimResponse.AddedItemComponent addAddItem()

addAddItem

public ClaimResponse addAddItem(ClaimResponse.AddedItemComponent t)

getAddItemFirstRep

public ClaimResponse.AddedItemComponent getAddItemFirstRep()

Returns:

The first repetition of repeating field addItem, creating it if it does not already exist {3}

getAdjudication

public List<ClaimResponse.AdjudicationComponent> getAdjudication()

Returns:

adjudication (The adjudication results which are presented at the header level rather than at the line-item or add-item levels.)

setAdjudication

public ClaimResponse setAdjudication(List<ClaimResponse.AdjudicationComponent> theAdjudication)

Returns:

Returns a reference to this for easy method chaining

hasAdjudication

public boolean hasAdjudication()

addAdjudication

public ClaimResponse.AdjudicationComponent addAdjudication()

addAdjudication

public ClaimResponse addAdjudication(ClaimResponse.AdjudicationComponent t)

getAdjudicationFirstRep

public ClaimResponse.AdjudicationComponent getAdjudicationFirstRep()

Returns:

The first repetition of repeating field adjudication, creating it if it does not already exist {3}

getTotal

public List<ClaimResponse.TotalComponent> getTotal()

Returns:

total (Categorized monetary totals for the adjudication.)

setTotal

public ClaimResponse setTotal(List<ClaimResponse.TotalComponent> theTotal)

Returns:

Returns a reference to this for easy method chaining

hasTotal

public boolean hasTotal()

addTotal

public ClaimResponse.TotalComponent addTotal()

addTotal

public ClaimResponse addTotal(ClaimResponse.TotalComponent t)

getTotalFirstRep

public ClaimResponse.TotalComponent getTotalFirstRep()

Returns:

The first repetition of repeating field total, creating it if it does not already exist {3}

getPayment

public ClaimResponse.PaymentComponent getPayment()

Returns:

payment (Payment details for the adjudication of the claim.)

hasPayment

public boolean hasPayment()

setPayment

public ClaimResponse setPayment(ClaimResponse.PaymentComponent value)

Parameters:

value - payment (Payment details for the adjudication of the claim.)

getFundsReserve

public CodeableConcept getFundsReserve()

Returns:

fundsReserve (A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.)

hasFundsReserve

public boolean hasFundsReserve()

setFundsReserve

public ClaimResponse setFundsReserve(CodeableConcept value)

Parameters:

value - fundsReserve (A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.)

getFormCode

public CodeableConcept getFormCode()

Returns:

formCode (A code for the form to be used for printing the content.)

hasFormCode

public boolean hasFormCode()

setFormCode

public ClaimResponse setFormCode(CodeableConcept value)

Parameters:

value - formCode (A code for the form to be used for printing the content.)

getForm

public Attachment getForm()

Returns:

form (The actual form, by reference or inclusion, for printing the content or an EOB.)

hasForm

public boolean hasForm()

setForm

public ClaimResponse setForm(Attachment value)

Parameters:

value - form (The actual form, by reference or inclusion, for printing the content or an EOB.)

getProcessNote

public List<ClaimResponse.NoteComponent> getProcessNote()

Returns:

processNote (A note that describes or explains adjudication results in a human readable form.)

setProcessNote

public ClaimResponse setProcessNote(List<ClaimResponse.NoteComponent> theProcessNote)

Returns:

Returns a reference to this for easy method chaining

hasProcessNote

public boolean hasProcessNote()

addProcessNote

public ClaimResponse.NoteComponent addProcessNote()

addProcessNote

public ClaimResponse addProcessNote(ClaimResponse.NoteComponent t)

getProcessNoteFirstRep

public ClaimResponse.NoteComponent getProcessNoteFirstRep()

Returns:

The first repetition of repeating field processNote, creating it if it does not already exist {3}

getCommunicationRequest

public List<Reference> getCommunicationRequest()

Returns:

communicationRequest (Request for additional supporting or authorizing information.)

setCommunicationRequest

public ClaimResponse setCommunicationRequest(List<Reference> theCommunicationRequest)

Returns:

Returns a reference to this for easy method chaining

hasCommunicationRequest

public boolean hasCommunicationRequest()

addCommunicationRequest

public Reference addCommunicationRequest()

addCommunicationRequest

public ClaimResponse addCommunicationRequest(Reference t)

getCommunicationRequestFirstRep

public Reference getCommunicationRequestFirstRep()

Returns:

The first repetition of repeating field communicationRequest, creating it if it does not already exist {3}

getInsurance

public List<ClaimResponse.InsuranceComponent> getInsurance()

Returns:

insurance (Financial instruments for reimbursement for the health care products and services specified on the claim.)

setInsurance

public ClaimResponse setInsurance(List<ClaimResponse.InsuranceComponent> theInsurance)

Returns:

Returns a reference to this for easy method chaining

hasInsurance

public boolean hasInsurance()

addInsurance

public ClaimResponse.InsuranceComponent addInsurance()

addInsurance

public ClaimResponse addInsurance(ClaimResponse.InsuranceComponent t)

getInsuranceFirstRep

public ClaimResponse.InsuranceComponent getInsuranceFirstRep()

Returns:

The first repetition of repeating field insurance, creating it if it does not already exist {3}

getError

public List<ClaimResponse.ErrorComponent> getError()

Returns:

error (Errors encountered during the processing of the adjudication.)

setError

public ClaimResponse setError(List<ClaimResponse.ErrorComponent> theError)

Returns:

Returns a reference to this for easy method chaining

hasError

public boolean hasError()

addError

public ClaimResponse.ErrorComponent addError()

addError

public ClaimResponse addError(ClaimResponse.ErrorComponent t)

getErrorFirstRep

public ClaimResponse.ErrorComponent getErrorFirstRep()

Returns:

The first repetition of repeating field error, creating it if it does not already exist {3}

listChildren

protected void listChildren(List<Property> children)

Overrides:

listChildren in class DomainResource

getNamedProperty

public Property getNamedProperty(int _hash,
 String _name,
 boolean _checkValid)
                          throws org.hl7.fhir.exceptions.FHIRException

Overrides:

getNamedProperty in class DomainResource

Throws:

org.hl7.fhir.exceptions.FHIRException

getProperty

public Base[] getProperty(int hash,
 String name,
 boolean checkValid)
                   throws org.hl7.fhir.exceptions.FHIRException

Overrides:

getProperty in class DomainResource

Throws:

org.hl7.fhir.exceptions.FHIRException

setProperty

public Base setProperty(int hash,
 String name,
 Base value)
                 throws org.hl7.fhir.exceptions.FHIRException

Overrides:

setProperty in class DomainResource

Throws:

org.hl7.fhir.exceptions.FHIRException

setProperty

public Base setProperty(String name,
 Base value)
                 throws org.hl7.fhir.exceptions.FHIRException

Overrides:

setProperty in class DomainResource

Throws:

org.hl7.fhir.exceptions.FHIRException

makeProperty

public Base makeProperty(int hash,
 String name)
                  throws org.hl7.fhir.exceptions.FHIRException

Overrides:

makeProperty in class DomainResource

Throws:

org.hl7.fhir.exceptions.FHIRException

getTypesForProperty

public String[] getTypesForProperty(int hash,
 String name)
                             throws org.hl7.fhir.exceptions.FHIRException

Overrides:

getTypesForProperty in class DomainResource

Throws:

org.hl7.fhir.exceptions.FHIRException

addChild

public Base addChild(String name)
              throws org.hl7.fhir.exceptions.FHIRException

Overrides:

addChild in class DomainResource

Throws:

org.hl7.fhir.exceptions.FHIRException

fhirType

public String fhirType()

Specified by:

fhirType in interface org.hl7.fhir.instance.model.api.IBase

Overrides:

fhirType in class DomainResource

copy

public ClaimResponse copy()

Specified by:

copy in class DomainResource

copyValues

public void copyValues(ClaimResponse dst)

typedCopy

protected ClaimResponse typedCopy()

equalsDeep

public boolean equalsDeep(Base other_)

Overrides:

equalsDeep in class DomainResource

equalsShallow

public boolean equalsShallow(Base other_)

Overrides:

equalsShallow in class DomainResource

isEmpty

public boolean isEmpty()

Specified by:

isEmpty in interface org.hl7.fhir.instance.model.api.IBase

Overrides:

isEmpty in class DomainResource

getResourceType

public ResourceType getResourceType()

Specified by:

getResourceType in class Resource