Package com.ibm.fhir.model.resource

Class Claim

  • All Implemented Interfaces:
    Visitable
    @Generated("com.ibm.fhir.tools.CodeGenerator")
public class Claim
extends DomainResource
    A provider issued list of professional services and products which have been provided, or are to be provided, to a patient which is sent to an insurer for reimbursement.

    Maturity level: FMM2 (Trial Use)

    • Method Detail

      • getIdentifier

        public java.util.List<Identifier> getIdentifier()
        A unique identifier assigned to this claim.
        Returns:
        An unmodifiable list containing immutable objects of type Identifier that may be empty.

      • getStatus

        public ClaimStatus getStatus()
        The status of the resource instance.
        Returns:
        An immutable object of type ClaimStatus that is non-null.

      • getType

        public CodeableConcept getType()
        The category of claim, e.g. oral, pharmacy, vision, institutional, professional.
        Returns:
        An immutable object of type CodeableConcept that is non-null.

      • getSubType

        public CodeableConcept getSubType()
        A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
        Returns:
        An immutable object of type CodeableConcept that may be null.

      • getUse

        public Use getUse()
        A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.
        Returns:
        An immutable object of type Use that is non-null.

      • getPatient

        public Reference getPatient()
        The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.
        Returns:
        An immutable object of type Reference that is non-null.

      • getBillablePeriod

        public Period getBillablePeriod()
        The period for which charges are being submitted.
        Returns:
        An immutable object of type Period that may be null.

      • getCreated

        public DateTime getCreated()
        The date this resource was created.
        Returns:
        An immutable object of type DateTime that is non-null.

      • getEnterer

        public Reference getEnterer()
        Individual who created the claim, predetermination or preauthorization.
        Returns:
        An immutable object of type Reference that may be null.

      • getInsurer

        public Reference getInsurer()
        The Insurer who is target of the request.
        Returns:
        An immutable object of type Reference that may be null.

      • getProvider

        public Reference getProvider()
        The provider which is responsible for the claim, predetermination or preauthorization.
        Returns:
        An immutable object of type Reference that is non-null.

      • getPriority

        public CodeableConcept getPriority()
        The provider-required urgency of processing the request. Typical values include: stat, routine deferred.
        Returns:
        An immutable object of type CodeableConcept that is non-null.

      • getFundsReserve

        public CodeableConcept getFundsReserve()
        A code to indicate whether and for whom funds are to be reserved for future claims.
        Returns:
        An immutable object of type CodeableConcept that may be null.

      • getRelated

        public java.util.List<Claim.Related> getRelated()
        Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
        Returns:
        An unmodifiable list containing immutable objects of type Claim.Related that may be empty.

      • getPrescription

        public Reference getPrescription()
        Prescription to support the dispensing of pharmacy, device or vision products.
        Returns:
        An immutable object of type Reference that may be null.

      • getOriginalPrescription

        public Reference getOriginalPrescription()
        Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.
        Returns:
        An immutable object of type Reference that may be null.

      • getPayee

        public Claim.Payee getPayee()
        The party to be reimbursed for cost of the products and services according to the terms of the policy.
        Returns:
        An immutable object of type Claim.Payee that may be null.

      • getReferral

        public Reference getReferral()
        A reference to a referral resource.
        Returns:
        An immutable object of type Reference that may be null.

      • getFacility

        public Reference getFacility()
        Facility where the services were provided.
        Returns:
        An immutable object of type Reference that may be null.

      • getCareTeam

        public java.util.List<Claim.CareTeam> getCareTeam()
        The members of the team who provided the products and services.
        Returns:
        An unmodifiable list containing immutable objects of type Claim.CareTeam that may be empty.

      • getSupportingInfo

        public java.util.List<Claim.SupportingInfo> getSupportingInfo()
        Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
        Returns:
        An unmodifiable list containing immutable objects of type Claim.SupportingInfo that may be empty.

      • getDiagnosis

        public java.util.List<Claim.Diagnosis> getDiagnosis()
        Information about diagnoses relevant to the claim items.
        Returns:
        An unmodifiable list containing immutable objects of type Claim.Diagnosis that may be empty.

      • getProcedure

        public java.util.List<Claim.Procedure> getProcedure()
        Procedures performed on the patient relevant to the billing items with the claim.
        Returns:
        An unmodifiable list containing immutable objects of type Claim.Procedure that may be empty.

      • getInsurance

        public java.util.List<Claim.Insurance> getInsurance()
        Financial instruments for reimbursement for the health care products and services specified on the claim.
        Returns:
        An unmodifiable list containing immutable objects of type Claim.Insurance that is non-empty.

      • getAccident

        public Claim.Accident getAccident()
        Details of an accident which resulted in injuries which required the products and services listed in the claim.
        Returns:
        An immutable object of type Claim.Accident that may be null.

      • getItem

        public java.util.List<Claim.Item> getItem()
        A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.
        Returns:
        An unmodifiable list containing immutable objects of type Claim.Item that may be empty.

      • getTotal

        public Money getTotal()
        The total value of the all the items in the claim.
        Returns:
        An immutable object of type Money that may be null.

      • accept

        public void accept​(java.lang.String elementName,
                   int elementIndex,
                   Visitor visitor)
        Description copied from interface: Visitable
        Accept a Visitor and invoke the appropriate visit methods. A typical implementation would look like this: 
         if (visitor.preVisit(this)) {
     visitor.visitStart(elementName, elementIndex, this);
     if (visitor.visit(elementName, elementIndex, this)) {
         // visit children
     }
     visitor.visitEnd(elementName, elementIndex, this);
     visitor.postVisit(this);
 }
        Specified by:
        accept in interface Visitable
        Specified by:
        accept in class AbstractVisitable
        Parameters:
        elementName - the name of the element in the context of this visit
        elementIndex - the index of the element in a list or -1 if it is not contained within a List
        visitor - the visitor to use

      • equals

        public boolean equals​(java.lang.Object obj)
        Overrides:
        equals in class java.lang.Object

      • hashCode

        public int hashCode()
        Overrides:
        hashCode in class java.lang.Object