Package org.hl7.fhir.r5.model

Class Coverage

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.Coverage
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 Coverage extends DomainResource
Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment.
See Also:

  • Field Details

    • identifier

      protected List<Identifier> identifier
      The identifier of the coverage as issued by the insurer.

    • status

      protected Enumeration<Enumerations.FinancialResourceStatusCodes> status
      The status of the resource instance.

    • kind

      protected Enumeration<Coverage.Kind> kind
      The nature of the coverage be it insurance, or cash payment such as self-pay.

    • paymentBy

      protected List<Coverage.CoveragePaymentByComponent> paymentBy
      Link to the paying party and optionally what specifically they will be responsible to pay.

    • type

      protected CodeableConcept type
      The type of coverage: social program, medical plan, accident coverage (workers compensation, auto), group health or payment by an individual or organization.

    • policyHolder

      protected Reference policyHolder
      The party who 'owns' the insurance policy.

    • subscriber

      protected Reference subscriber
      The party who has signed-up for or 'owns' the contractual relationship to the policy or to whom the benefit of the policy for services rendered to them or their family is due.

    • subscriberId

      protected List<Identifier> subscriberId
      The insurer assigned ID for the Subscriber.

    • beneficiary

      protected Reference beneficiary
      The party who benefits from the insurance coverage; the patient when products and/or services are provided.

    • dependent

      protected StringType dependent
      A designator for a dependent under the coverage.

    • relationship

      protected CodeableConcept relationship
      The relationship of beneficiary (patient) to the subscriber.

    • period

      protected Period period
      Time period during which the coverage is in force. A missing start date indicates the start date isn't known, a missing end date means the coverage is continuing to be in force.

    • insurer

      protected Reference insurer
      The program or plan underwriter, payor, insurance company.

    • class_

      protected List<Coverage.ClassComponent> class_
      A suite of underwriter specific classifiers.

    • order

      protected PositiveIntType order
      The order of applicability of this coverage relative to other coverages which are currently in force. Note, there may be gaps in the numbering and this does not imply primary, secondary etc. as the specific positioning of coverages depends upon the episode of care. For example; a patient might have (0) auto insurance (1) their own health insurance and (2) spouse's health insurance. When claiming for treatments which were not the result of an auto accident then only coverages (1) and (2) above would be applicatble and would apply in the order specified in parenthesis.

    • network

      protected StringType network
      The insurer-specific identifier for the insurer-defined network of providers to which the beneficiary may seek treatment which will be covered at the 'in-network' rate, otherwise 'out of network' terms and conditions apply.

    • costToBeneficiary

      protected List<Coverage.CostToBeneficiaryComponent> costToBeneficiary
      A suite of codes indicating the cost category and associated amount which have been detailed in the policy and may have been included on the health card.

    • subrogation

      protected BooleanType subrogation
      When 'subrogation=true' this insurance instance has been included not for adjudication but to provide insurers with the details to recover costs.

    • contract

      protected List<Reference> contract
      The policy(s) which constitute this insurance coverage.

    • insurancePlan

      protected Reference insurancePlan
      The insurance plan details, benefits and costs, which constitute this insurance coverage.

    • SP_BENEFICIARY

      public static final String SP_BENEFICIARY
      Search parameter: beneficiary

      Description: Covered party
      Type: reference
      Path: Coverage.beneficiary

      See Also:

    • BENEFICIARY

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

      Description: Covered party
      Type: reference
      Path: Coverage.beneficiary

    • INCLUDE_BENEFICIARY

      public static final ca.uhn.fhir.model.api.Include INCLUDE_BENEFICIARY
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Coverage:beneficiary".

    • SP_CLASS_TYPE

      public static final String SP_CLASS_TYPE
      Search parameter: class-type

      Description: Coverage class (eg. plan, group)
      Type: token
      Path: Coverage.class.type

      See Also:

    • CLASS_TYPE

      public static final ca.uhn.fhir.rest.gclient.TokenClientParam CLASS_TYPE
      Fluent Client search parameter constant for class-type

      Description: Coverage class (eg. plan, group)
      Type: token
      Path: Coverage.class.type

    • SP_CLASS_VALUE

      public static final String SP_CLASS_VALUE
      Search parameter: class-value

      Description: Value of the class (eg. Plan number, group number)
      Type: token
      Path: Coverage.class.value

      See Also:

    • CLASS_VALUE

      public static final ca.uhn.fhir.rest.gclient.TokenClientParam CLASS_VALUE
      Fluent Client search parameter constant for class-value

      Description: Value of the class (eg. Plan number, group number)
      Type: token
      Path: Coverage.class.value

    • SP_DEPENDENT

      public static final String SP_DEPENDENT
      Search parameter: dependent

      Description: Dependent number
      Type: string
      Path: Coverage.dependent

      See Also:

    • DEPENDENT

      public static final ca.uhn.fhir.rest.gclient.StringClientParam DEPENDENT
      Fluent Client search parameter constant for dependent

      Description: Dependent number
      Type: string
      Path: Coverage.dependent

    • SP_IDENTIFIER

      public static final String SP_IDENTIFIER
      Search parameter: identifier

      Description: The primary identifier of the insured and the coverage
      Type: token
      Path: Coverage.identifier

      See Also:

    • IDENTIFIER

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

      Description: The primary identifier of the insured and the coverage
      Type: token
      Path: Coverage.identifier

    • SP_INSURER

      public static final String SP_INSURER
      Search parameter: insurer

      Description: The identity of the insurer
      Type: reference
      Path: Coverage.insurer

      See Also:

    • INSURER

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

      Description: The identity of the insurer
      Type: reference
      Path: Coverage.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 "Coverage:insurer".

    • SP_PATIENT

      public static final String SP_PATIENT
      Search parameter: patient

      Description: Retrieve coverages for a patient
      Type: reference
      Path: Coverage.beneficiary

      See Also:

    • PATIENT

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

      Description: Retrieve coverages for a patient
      Type: reference
      Path: Coverage.beneficiary

    • 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 "Coverage:patient".

    • SP_PAYMENTBY_PARTY

      public static final String SP_PAYMENTBY_PARTY
      Search parameter: paymentby-party

      Description: Parties who will pay for services
      Type: reference
      Path: Coverage.paymentBy.party

      See Also:

    • PAYMENTBY_PARTY

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam PAYMENTBY_PARTY
      Fluent Client search parameter constant for paymentby-party

      Description: Parties who will pay for services
      Type: reference
      Path: Coverage.paymentBy.party

    • INCLUDE_PAYMENTBY_PARTY

      public static final ca.uhn.fhir.model.api.Include INCLUDE_PAYMENTBY_PARTY
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Coverage:paymentby-party".

    • SP_POLICY_HOLDER

      public static final String SP_POLICY_HOLDER
      Search parameter: policy-holder

      Description: Reference to the policyholder
      Type: reference
      Path: Coverage.policyHolder

      See Also:

    • POLICY_HOLDER

      public static final ca.uhn.fhir.rest.gclient.ReferenceClientParam POLICY_HOLDER
      Fluent Client search parameter constant for policy-holder

      Description: Reference to the policyholder
      Type: reference
      Path: Coverage.policyHolder

    • INCLUDE_POLICY_HOLDER

      public static final ca.uhn.fhir.model.api.Include INCLUDE_POLICY_HOLDER
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Coverage:policy-holder".

    • SP_STATUS

      public static final String SP_STATUS
      Search parameter: status

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

      See Also:

    • STATUS

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

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

    • SP_SUBSCRIBER

      public static final String SP_SUBSCRIBER
      Search parameter: subscriber

      Description: Reference to the subscriber
      Type: reference
      Path: Coverage.subscriber

      See Also:

    • SUBSCRIBER

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

      Description: Reference to the subscriber
      Type: reference
      Path: Coverage.subscriber

    • INCLUDE_SUBSCRIBER

      public static final ca.uhn.fhir.model.api.Include INCLUDE_SUBSCRIBER
      Constant for fluent queries to be used to add include statements. Specifies the path value of "Coverage:subscriber".

    • SP_SUBSCRIBERID

      public static final String SP_SUBSCRIBERID
      Search parameter: subscriberid

      Description: Identifier of the subscriber
      Type: token
      Path: Coverage.subscriberId

      See Also:

    • SUBSCRIBERID

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

      Description: Identifier of the subscriber
      Type: token
      Path: Coverage.subscriberId

    • SP_TYPE

      public static final String SP_TYPE
      Search parameter: type

      Description: The kind of coverage (health plan, auto, Workers Compensation)
      Type: token
      Path: Coverage.type

      See Also:

    • TYPE

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

      Description: The kind of coverage (health plan, auto, Workers Compensation)
      Type: token
      Path: Coverage.type

  • Constructor Details

  • Method Details