Package com.ibm.fhir.model.resource

Class ClaimResponse

  • All Implemented Interfaces:
    Visitable
    @Generated("com.ibm.fhir.tools.CodeGenerator")
public class ClaimResponse
extends DomainResource
    This resource provides the adjudication details from the processing of a Claim resource.

    • Method Detail

      • getIdentifier

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

      • getType

        public CodeableConcept getType()
        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 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 for facast reimbursement is sought.
        Returns:
        An immutable object of type Reference that is non-null.

      • getCreated

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

      • getInsurer

        public Reference getInsurer()
        The party responsible for authorization, adjudication and reimbursement.
        Returns:
        An immutable object of type Reference that is non-null.

      • getRequestor

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

      • getRequest

        public Reference getRequest()
        Original request resource reference.
        Returns:
        An immutable object of type Reference that may be null.

      • getOutcome

        public RemittanceOutcome getOutcome()
        The outcome of the claim, predetermination, or preauthorization processing.
        Returns:
        An immutable object of type RemittanceOutcome that is non-null.

      • getDisposition

        public String getDisposition()
        A human readable description of the status of the adjudication.
        Returns:
        An immutable object of type String that may be null.

      • getPreAuthRef

        public String getPreAuthRef()
        Reference from the Insurer which is used in later communications which refers to this adjudication.
        Returns:
        An immutable object of type String that may be null.

      • getPreAuthPeriod

        public Period getPreAuthPeriod()
        The time frame during which this authorization is effective.
        Returns:
        An immutable object of type Period that may be null.

      • getPayeeType

        public CodeableConcept getPayeeType()
        Type of Party to be reimbursed: subscriber, provider, other.
        Returns:
        An immutable object of type CodeableConcept that may be null.

      • getItem

        public List<ClaimResponse.Item> getItem()
        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.
        Returns:
        An unmodifiable list containing immutable objects of type ClaimResponse.Item that may be empty.

      • getAddItem

        public List<ClaimResponse.AddItem> getAddItem()
        The first-tier service adjudications for payor added product or service lines.
        Returns:
        An unmodifiable list containing immutable objects of type ClaimResponse.AddItem that may be empty.

      • getAdjudication

        public List<ClaimResponse.Item.Adjudication> getAdjudication()
        The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
        Returns:
        An unmodifiable list containing immutable objects of type Adjudication that may be empty.

      • getTotal

        public List<ClaimResponse.Total> getTotal()
        Categorized monetary totals for the adjudication.
        Returns:
        An unmodifiable list containing immutable objects of type ClaimResponse.Total that may be empty.

      • getFundsReserve

        public CodeableConcept getFundsReserve()
        A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.
        Returns:
        An immutable object of type CodeableConcept that may be null.

      • getFormCode

        public CodeableConcept getFormCode()
        A code for the form to be used for printing the content.
        Returns:
        An immutable object of type CodeableConcept that may be null.

      • getForm

        public Attachment getForm()
        The actual form, by reference or inclusion, for printing the content or an EOB.
        Returns:
        An immutable object of type Attachment that may be null.

      • getCommunicationRequest

        public List<Reference> getCommunicationRequest()
        Request for additional supporting or authorizing information.
        Returns:
        An unmodifiable list containing immutable objects of type Reference that may be empty.

      • getInsurance

        public List<ClaimResponse.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 ClaimResponse.Insurance that may be empty.

      • getError

        public List<ClaimResponse.Error> getError()
        Errors encountered during the processing of the adjudication.
        Returns:
        An unmodifiable list containing immutable objects of type ClaimResponse.Error that may be empty.

      • accept

        public void accept​(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

      • hashCode

        public int hashCode()
        Overrides:
        hashCode in class Object