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

    • type

      The category of claim this is.
    • identifier

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

      protected Coding ruleset
      The version of the specification on which this instance relies.
    • originalRuleset

      The version of the specification from which the original instance was created.
    • created

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

      protected Reference target
      Insurer Identifier, typical BIN number (6 digit).
    • targetTarget

      The actual object that is the target of the reference (Insurer Identifier, typical BIN number (6 digit).)
    • 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.)
    • use

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

      protected Coding priority
      Immediate (stat), best effort (normal), deferred (deferred).
    • fundsReserve

      protected Coding 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.
    • 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.)
    • 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.)
    • 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 to support the dispensing of pharmacy services, medications or products.
    • originalPrescriptionTarget

      The actual object that is the target of the reference (Original prescription to support the dispensing of pharmacy services, medications or products.)
    • 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.)
    • diagnosis

      Ordered list of patient diagnosis for which care is sought.
    • condition

      protected List<Coding> condition
      List of patient conditions for which care is sought.
    • patient

      protected Reference patient
      Patient Resource.
    • patientTarget

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

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

      protected List<Coding> exception
      Factors which may influence the applicability of coverage.
    • school

      protected StringType school
      Name of school for over-aged dependents.
    • accident

      protected DateType accident
      Date of an accident which these services are addressing.
    • accidentType

      protected Coding accidentType
      Type of accident: work, auto, etc.
    • interventionException

      A list of intervention and exception codes which may influence the adjudication of the claim.
    • item

      First tier of goods and services.
    • additionalMaterials

      Code to indicate that Xrays, images, emails, documents, models or attachments are being sent in support of this submission.
    • missingTeeth

      A list of teeth which would be expected but are not found due to having been previously extracted or for other reasons.
    • SP_IDENTIFIER

      public static final String SP_IDENTIFIER
      See Also:
      Constant Field Values
    • SP_PROVIDER

      public static final String SP_PROVIDER
      See Also:
      Constant Field Values
    • SP_USE

      public static final String SP_USE
      See Also:
      Constant Field Values
    • SP_PATIENT

      public static final String SP_PATIENT
      See Also:
      Constant Field Values
    • SP_PRIORITY

      public static final String SP_PRIORITY
      See Also:
      Constant Field Values
  • Constructor Details

  • Method Details

    • getTypeElement

      Returns:
      type (The category of claim this is.). This is the underlying object with id, value and extensions. The accessor "getType" gives direct access to the value
    • hasTypeElement

      public boolean hasTypeElement()
    • hasType

      public boolean hasType()
    • setTypeElement

      Parameters:
      value - type (The category of claim this is.). This is the underlying object with id, value and extensions. The accessor "getType" gives direct access to the value
    • getType

      Returns:
      The category of claim this is.
    • setType

      public Claim setType​(Claim.ClaimType value)
      Parameters:
      value - The category of claim this is.
    • getIdentifier

      Returns:
      identifier (The business identifier for the instance: invoice number, claim number, pre-determination or pre-authorization number.)
    • hasIdentifier

      public boolean hasIdentifier()
    • addIdentifier

      Returns:
      identifier (The business identifier for the instance: invoice number, claim number, pre-determination or pre-authorization number.)
    • addIdentifier

    • getRuleset

      public Coding getRuleset()
      Returns:
      ruleset (The version of the specification on which this instance relies.)
    • hasRuleset

      public boolean hasRuleset()
    • setRuleset

      public Claim setRuleset​(Coding value)
      Parameters:
      value - ruleset (The version of the specification on which this instance relies.)
    • getOriginalRuleset

      Returns:
      originalRuleset (The version of the specification from which the original instance was created.)
    • hasOriginalRuleset

      public boolean hasOriginalRuleset()
    • setOriginalRuleset

      public Claim setOriginalRuleset​(Coding value)
      Parameters:
      value - originalRuleset (The version of the specification from which the original instance was created.)
    • getCreatedElement

      Returns:
      created (The date when the enclosed suite of services were performed or completed.). 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

      Parameters:
      value - created (The date when the enclosed suite of services were performed or completed.). 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 when the enclosed suite of services were performed or completed.
    • setCreated

      public Claim setCreated​(Date value)
      Parameters:
      value - The date when the enclosed suite of services were performed or completed.
    • getTarget

      public Reference getTarget()
      Returns:
      target (Insurer Identifier, typical BIN number (6 digit).)
    • hasTarget

      public boolean hasTarget()
    • setTarget

      public Claim setTarget​(Reference value)
      Parameters:
      value - target (Insurer Identifier, typical BIN number (6 digit).)
    • getTargetTarget

      Returns:
      target The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (Insurer Identifier, typical BIN number (6 digit).)
    • setTargetTarget

      public Claim setTargetTarget​(Organization value)
      Parameters:
      value - target The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (Insurer Identifier, typical BIN number (6 digit).)
    • getProvider

      Returns:
      provider (The provider which is responsible for the bill, claim pre-determination, pre-authorization.)
    • hasProvider

      public boolean hasProvider()
    • setProvider

      public Claim setProvider​(Reference value)
      Parameters:
      value - provider (The provider which is responsible for the bill, claim pre-determination, pre-authorization.)
    • getProviderTarget

      Returns:
      provider The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (The provider which is responsible for the bill, claim pre-determination, pre-authorization.)
    • setProviderTarget

      Parameters:
      value - provider The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (The provider which is responsible for the bill, claim pre-determination, pre-authorization.)
    • getOrganization

      Returns:
      organization (The organization which is responsible for the bill, claim pre-determination, pre-authorization.)
    • hasOrganization

      public boolean hasOrganization()
    • setOrganization

      public Claim setOrganization​(Reference value)
      Parameters:
      value - organization (The organization which is responsible for the bill, claim pre-determination, pre-authorization.)
    • getOrganizationTarget

      Returns:
      organization The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (The organization which is responsible for the bill, claim pre-determination, pre-authorization.)
    • setOrganizationTarget

      Parameters:
      value - organization The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (The organization which is responsible for the bill, claim pre-determination, pre-authorization.)
    • getUseElement

      Returns:
      use (Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination).). 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

      Parameters:
      value - use (Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination).). This is the underlying object with id, value and extensions. The accessor "getUse" gives direct access to the value
    • getUse

      public Claim.Use getUse()
      Returns:
      Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination).
    • setUse

      public Claim setUse​(Claim.Use value)
      Parameters:
      value - Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination).
    • getPriority

      public Coding getPriority()
      Returns:
      priority (Immediate (stat), best effort (normal), deferred (deferred).)
    • hasPriority

      public boolean hasPriority()
    • setPriority

      public Claim setPriority​(Coding value)
      Parameters:
      value - priority (Immediate (stat), best effort (normal), deferred (deferred).)
    • getFundsReserve

      Returns:
      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.)
    • hasFundsReserve

      public boolean hasFundsReserve()
    • setFundsReserve

      public Claim setFundsReserve​(Coding value)
      Parameters:
      value - 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.)
    • getEnterer

      Returns:
      enterer (Person who created the invoice/claim/pre-determination or pre-authorization.)
    • hasEnterer

      public boolean hasEnterer()
    • setEnterer

      public Claim setEnterer​(Reference value)
      Parameters:
      value - enterer (Person who created the invoice/claim/pre-determination or pre-authorization.)
    • getEntererTarget

      Returns:
      enterer The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (Person who created the invoice/claim/pre-determination or pre-authorization.)
    • setEntererTarget

      public Claim setEntererTarget​(Practitioner value)
      Parameters:
      value - enterer The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (Person who created the invoice/claim/pre-determination or pre-authorization.)
    • getFacility

      Returns:
      facility (Facility where the services were provided.)
    • hasFacility

      public boolean hasFacility()
    • setFacility

      public Claim setFacility​(Reference value)
      Parameters:
      value - facility (Facility where the services were provided.)
    • getFacilityTarget

      Returns:
      facility The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (Facility where the services were provided.)
    • setFacilityTarget

      public Claim setFacilityTarget​(Location value)
      Parameters:
      value - facility The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (Facility where the services were provided.)
    • getPrescription

      Returns:
      prescription (Prescription to support the dispensing of Pharmacy or Vision products.)
    • hasPrescription

      public boolean hasPrescription()
    • setPrescription

      public Claim setPrescription​(Reference value)
      Parameters:
      value - prescription (Prescription to support the dispensing of Pharmacy or Vision products.)
    • getPrescriptionTarget

      Returns:
      prescription The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (Prescription to support the dispensing of Pharmacy or Vision products.)
    • setPrescriptionTarget

      Parameters:
      value - prescription The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (Prescription to support the dispensing of Pharmacy or Vision products.)
    • getOriginalPrescription

      Returns:
      originalPrescription (Original prescription to support the dispensing of pharmacy services, medications or products.)
    • hasOriginalPrescription

      public boolean hasOriginalPrescription()
    • setOriginalPrescription

      Parameters:
      value - originalPrescription (Original prescription to support the dispensing of pharmacy services, medications or products.)
    • getOriginalPrescriptionTarget

      Returns:
      originalPrescription The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (Original prescription to support the dispensing of pharmacy services, medications or products.)
    • setOriginalPrescriptionTarget

      Parameters:
      value - originalPrescription The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (Original prescription to support the dispensing of pharmacy services, medications or products.)
    • getPayee

      Returns:
      payee (The party to be reimbursed for the services.)
    • hasPayee

      public boolean hasPayee()
    • setPayee

      public Claim setPayee​(Claim.PayeeComponent value)
      Parameters:
      value - payee (The party to be reimbursed for the services.)
    • getReferral

      Returns:
      referral (The referral resource which lists the date, practitioner, reason and other supporting information.)
    • hasReferral

      public boolean hasReferral()
    • setReferral

      public Claim setReferral​(Reference value)
      Parameters:
      value - referral (The referral resource which lists the date, practitioner, reason and other supporting information.)
    • getReferralTarget

      Returns:
      referral The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (The referral resource which lists the date, practitioner, reason and other supporting information.)
    • setReferralTarget

      Parameters:
      value - referral The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (The referral resource which lists the date, practitioner, reason and other supporting information.)
    • getDiagnosis

      Returns:
      diagnosis (Ordered list of patient diagnosis for which care is sought.)
    • hasDiagnosis

      public boolean hasDiagnosis()
    • addDiagnosis

      Returns:
      diagnosis (Ordered list of patient diagnosis for which care is sought.)
    • addDiagnosis

    • getCondition

      Returns:
      condition (List of patient conditions for which care is sought.)
    • hasCondition

      public boolean hasCondition()
    • addCondition

      public Coding addCondition()
      Returns:
      condition (List of patient conditions for which care is sought.)
    • addCondition

      public Claim addCondition​(Coding t)
    • getPatient

      Returns:
      patient (Patient Resource.)
    • hasPatient

      public boolean hasPatient()
    • setPatient

      public Claim setPatient​(Reference value)
      Parameters:
      value - patient (Patient Resource.)
    • getPatientTarget

      Returns:
      patient The actual object that is the target of the reference. The reference library doesn't populate this, but you can use it to hold the resource if you resolve it. (Patient Resource.)
    • setPatientTarget

      public Claim setPatientTarget​(Patient value)
      Parameters:
      value - patient The actual object that is the target of the reference. The reference library doesn't use these, but you can use it to hold the resource if you resolve it. (Patient Resource.)
    • getCoverage

      Returns:
      coverage (Financial instrument by which payment information for health care.)
    • hasCoverage

      public boolean hasCoverage()
    • addCoverage

      Returns:
      coverage (Financial instrument by which payment information for health care.)
    • addCoverage

    • getException

      Returns:
      exception (Factors which may influence the applicability of coverage.)
    • hasException

      public boolean hasException()
    • addException

      public Coding addException()
      Returns:
      exception (Factors which may influence the applicability of coverage.)
    • addException

      public Claim addException​(Coding t)
    • getSchoolElement

      Returns:
      school (Name of school for over-aged dependents.). This is the underlying object with id, value and extensions. The accessor "getSchool" gives direct access to the value
    • hasSchoolElement

      public boolean hasSchoolElement()
    • hasSchool

      public boolean hasSchool()
    • setSchoolElement

      public Claim setSchoolElement​(StringType value)
      Parameters:
      value - school (Name of school for over-aged dependents.). This is the underlying object with id, value and extensions. The accessor "getSchool" gives direct access to the value
    • getSchool

      public String getSchool()
      Returns:
      Name of school for over-aged dependents.
    • setSchool

      public Claim setSchool​(String value)
      Parameters:
      value - Name of school for over-aged dependents.
    • getAccidentElement

      Returns:
      accident (Date of an accident which these services are addressing.). This is the underlying object with id, value and extensions. The accessor "getAccident" gives direct access to the value
    • hasAccidentElement

      public boolean hasAccidentElement()
    • hasAccident

      public boolean hasAccident()
    • setAccidentElement

      public Claim setAccidentElement​(DateType value)
      Parameters:
      value - accident (Date of an accident which these services are addressing.). This is the underlying object with id, value and extensions. The accessor "getAccident" gives direct access to the value
    • getAccident

      public Date getAccident()
      Returns:
      Date of an accident which these services are addressing.
    • setAccident

      public Claim setAccident​(Date value)
      Parameters:
      value - Date of an accident which these services are addressing.
    • getAccidentType

      Returns:
      accidentType (Type of accident: work, auto, etc.)
    • hasAccidentType

      public boolean hasAccidentType()
    • setAccidentType

      public Claim setAccidentType​(Coding value)
      Parameters:
      value - accidentType (Type of accident: work, auto, etc.)
    • getInterventionException

      Returns:
      interventionException (A list of intervention and exception codes which may influence the adjudication of the claim.)
    • hasInterventionException

      public boolean hasInterventionException()
    • addInterventionException

      Returns:
      interventionException (A list of intervention and exception codes which may influence the adjudication of the claim.)
    • addInterventionException

    • getItem

      Returns:
      item (First tier of goods and services.)
    • hasItem

      public boolean hasItem()
    • addItem

      Returns:
      item (First tier of goods and services.)
    • addItem

    • getAdditionalMaterials

      Returns:
      additionalMaterials (Code to indicate that Xrays, images, emails, documents, models or attachments are being sent in support of this submission.)
    • hasAdditionalMaterials

      public boolean hasAdditionalMaterials()
    • addAdditionalMaterials

      Returns:
      additionalMaterials (Code to indicate that Xrays, images, emails, documents, models or attachments are being sent in support of this submission.)
    • addAdditionalMaterials

    • getMissingTeeth

      Returns:
      missingTeeth (A list of teeth which would be expected but are not found due to having been previously extracted or for other reasons.)
    • hasMissingTeeth

      public boolean hasMissingTeeth()
    • addMissingTeeth

      Returns:
      missingTeeth (A list of teeth which would be expected but are not found due to having been previously extracted or for other reasons.)
    • addMissingTeeth

    • listChildren

      protected void listChildren​(List<Property> childrenList)
      Overrides:
      listChildren in class DomainResource
    • setProperty

      public void setProperty​(String name, Base value) throws org.hl7.fhir.exceptions.FHIRException
      Overrides:
      setProperty 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 Claim copy()
      Specified by:
      copy in class DomainResource
    • typedCopy

      protected Claim 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

      Specified by:
      getResourceType in class Resource