Besa Fhir Help File

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Identifiers

Class TClaimResponse

Description
Hierarchy
Fields
Methods
Properties

Unit

bsFhir_r4

Declaration

type TClaimResponse = class(TDomainResource)

Description

This resource provides the adjudication details from the processing of a Claim resource. If the element is present, it must have either a @value, an @id, or extensions

Hierarchy

Overview

Methods

Public constructor Create; override;

Properties

Public property identifier : TIdentifierArray read GetidentifierArray;
Public property status : string read Getstatus write Setstatus;
Public property statusElement : TFinancialResourceStatusCodes read GetstatusElement write SetstatusElement;
Public property type_ : TCodeableConcept read Gettype_ write Settype_;
Public property subType : TCodeableConcept read GetsubType write SetsubType;
Public property use : string read Getuse write Setuse;
Public property useElement : TUse read GetuseElement write SetuseElement;
Public property patient : TReference read Getpatient write Setpatient;
Public property created : string read Getcreated write Setcreated;
Public property createdElement : TdateTime_ read GetcreatedElement write SetcreatedElement;
Public property insurer : TReference read Getinsurer write Setinsurer;
Public property requestor : TReference read Getrequestor write Setrequestor;
Public property request : TReference read Getrequest write Setrequest;
Public property outcome : string read Getoutcome write Setoutcome;
Public property outcomeElement : TClaimProcessingCodes read GetoutcomeElement write SetoutcomeElement;
Public property disposition : string read Getdisposition write Setdisposition;
Public property dispositionElement : Tstring read GetdispositionElement write SetdispositionElement;
Public property preAuthRef : string read GetpreAuthRef write SetpreAuthRef;
Public property preAuthRefElement : Tstring read GetpreAuthRefElement write SetpreAuthRefElement;
Public property preAuthPeriod : TPeriod read GetpreAuthPeriod write SetpreAuthPeriod;
Public property payeeType : TCodeableConcept read GetpayeeType write SetpayeeType;
Public property item : TClaimResponseItemArray read GetitemArray;
Public property addItem : TClaimResponseAddItemArray read GetaddItemArray;
Public property adjudication : TClaimResponseAdjudicationArray read GetadjudicationArray;
Public property total : TClaimResponseTotalArray read GettotalArray;
Public property payment : TClaimResponsePayment read Getpayment write Setpayment;
Public property fundsReserve : TCodeableConcept read GetfundsReserve write SetfundsReserve;
Public property formCode : TCodeableConcept read GetformCode write SetformCode;
Public property form : TAttachment read Getform write Setform;
Public property processNote : TClaimResponseProcessNoteArray read GetprocessNoteArray;
Public property communicationRequest : TReferenceArray read GetcommunicationRequestArray;
Public property insurance : TClaimResponseInsuranceArray read GetinsuranceArray;
Public property error : TClaimResponseErrorArray read GeterrorArray;

Description

Methods

Public constructor Create; override;
 

Properties

Public property identifier : TIdentifierArray read GetidentifierArray;

A unique identifier assigned to this claim response.

Public property status : string read Getstatus write Setstatus;

The status of the resource instance.

Public property statusElement : TFinancialResourceStatusCodes read GetstatusElement write SetstatusElement;
 
Public property type_ : TCodeableConcept read Gettype_ write Settype_;

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

Public property subType : TCodeableConcept read GetsubType write SetsubType;

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

Public property use : string read Getuse write Setuse;

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.

Public property useElement : TUse read GetuseElement write SetuseElement;
 
Public property patient : TReference read Getpatient write Setpatient;

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.

Public property created : string read Getcreated write Setcreated;

The date this resource was created.

Public property createdElement : TdateTime_ read GetcreatedElement write SetcreatedElement;
 
Public property insurer : TReference read Getinsurer write Setinsurer;

The party responsible for authorization, adjudication and reimbursement.

Public property requestor : TReference read Getrequestor write Setrequestor;

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

Public property request : TReference read Getrequest write Setrequest;

Original request resource reference.

Public property outcome : string read Getoutcome write Setoutcome;

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

Public property outcomeElement : TClaimProcessingCodes read GetoutcomeElement write SetoutcomeElement;
 
Public property disposition : string read Getdisposition write Setdisposition;

A human readable description of the status of the adjudication.

Public property dispositionElement : Tstring read GetdispositionElement write SetdispositionElement;
 
Public property preAuthRef : string read GetpreAuthRef write SetpreAuthRef;

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

Public property preAuthRefElement : Tstring read GetpreAuthRefElement write SetpreAuthRefElement;
 
Public property preAuthPeriod : TPeriod read GetpreAuthPeriod write SetpreAuthPeriod;

The time frame during which this authorization is effective.

Public property payeeType : TCodeableConcept read GetpayeeType write SetpayeeType;

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

Public property item : TClaimResponseItemArray read GetitemArray;

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.

Public property addItem : TClaimResponseAddItemArray read GetaddItemArray;

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

Public property adjudication : TClaimResponseAdjudicationArray read GetadjudicationArray;

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

Public property total : TClaimResponseTotalArray read GettotalArray;

Categorized monetary totals for the adjudication.

Public property payment : TClaimResponsePayment read Getpayment write Setpayment;

Payment details for the adjudication of the claim.

Public property fundsReserve : TCodeableConcept read GetfundsReserve write SetfundsReserve;

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

Public property formCode : TCodeableConcept read GetformCode write SetformCode;

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

Public property form : TAttachment read Getform write Setform;

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

Public property processNote : TClaimResponseProcessNoteArray read GetprocessNoteArray;

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

Public property communicationRequest : TReferenceArray read GetcommunicationRequestArray;

Request for additional supporting or authorizing information.

Public property insurance : TClaimResponseInsuranceArray read GetinsuranceArray;

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

Public property error : TClaimResponseErrorArray read GeterrorArray;

Errors encountered during the processing of the adjudication.

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