Besa Fhir Help File

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Identifiers

Class TCoverage

Description
Hierarchy
Fields
Methods
Properties

Unit

bsFhir_r5

Declaration

type TCoverage = class(TDomainResource)

Description

Financial instrument which may be used to reimburse or pay for health care products and services. Includes both insurance and self-payment. 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 kind : string read Getkind write Setkind;
Public property kindElement : TKind read GetkindElement write SetkindElement;
Public property paymentBy : TCoveragePaymentByArray read GetpaymentByArray;
Public property type_ : TCodeableConcept read Gettype_ write Settype_;
Public property policyHolder : TReference read GetpolicyHolder write SetpolicyHolder;
Public property subscriber : TReference read Getsubscriber write Setsubscriber;
Public property subscriberId : TIdentifierArray read GetsubscriberIdArray;
Public property beneficiary : TReference read Getbeneficiary write Setbeneficiary;
Public property dependent : string read Getdependent write Setdependent;
Public property dependentElement : Tstring read GetdependentElement write SetdependentElement;
Public property relationship : TCodeableConcept read Getrelationship write Setrelationship;
Public property period : TPeriod read Getperiod write Setperiod;
Public property insurer : TReference read Getinsurer write Setinsurer;
Public property class_ : TCoverageClassArray read Getclass_Array;
Public property order : Int64 read Getorder write Setorder;
Public property orderElement : TpositiveInt read GetorderElement write SetorderElement;
Public property network : string read Getnetwork write Setnetwork;
Public property networkElement : Tstring read GetnetworkElement write SetnetworkElement;
Public property costToBeneficiary : TCoverageCostToBeneficiaryArray read GetcostToBeneficiaryArray;
Public property subrogation : boolean read Getsubrogation write Setsubrogation;
Public property subrogationElement : Tboolean read GetsubrogationElement write SetsubrogationElement;
Public property contract : TReferenceArray read GetcontractArray;
Public property insurancePlan : TReference read GetinsurancePlan write SetinsurancePlan;

Description

Methods

Public constructor Create; override;
 

Properties

Public property identifier : TIdentifierArray read GetidentifierArray;

The identifier of the coverage as issued by the insurer.

Public property status : string read Getstatus write Setstatus;

The status of the resource instance.

Public property statusElement : TFinancialResourceStatusCodes read GetstatusElement write SetstatusElement;
 
Public property kind : string read Getkind write Setkind;

The nature of the coverage be it insurance, or cash payment such as self-pay.

Public property kindElement : TKind read GetkindElement write SetkindElement;
 
Public property paymentBy : TCoveragePaymentByArray read GetpaymentByArray;

Link to the paying party and optionally what specifically they will be responsible to pay.

Public property type_ : TCodeableConcept read Gettype_ write Settype_;

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

Public property policyHolder : TReference read GetpolicyHolder write SetpolicyHolder;

The party who 'owns' the insurance policy.

Public property subscriber : TReference read Getsubscriber write Setsubscriber;

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.

Public property subscriberId : TIdentifierArray read GetsubscriberIdArray;

The insurer assigned ID for the Subscriber.

Public property beneficiary : TReference read Getbeneficiary write Setbeneficiary;

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

Public property dependent : string read Getdependent write Setdependent;

A designator for a dependent under the coverage.

Public property dependentElement : Tstring read GetdependentElement write SetdependentElement;
 
Public property relationship : TCodeableConcept read Getrelationship write Setrelationship;

The relationship of beneficiary (patient) to the subscriber.

Public property period : TPeriod read Getperiod write Setperiod;

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.

Public property insurer : TReference read Getinsurer write Setinsurer;

The program or plan underwriter, payor, insurance company.

Public property class_ : TCoverageClassArray read Getclass_Array;

A suite of underwriter specific classifiers.

Public property order : Int64 read Getorder write Setorder;

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.

Public property orderElement : TpositiveInt read GetorderElement write SetorderElement;
 
Public property network : string read Getnetwork write Setnetwork;

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.

Public property networkElement : Tstring read GetnetworkElement write SetnetworkElement;
 
Public property costToBeneficiary : TCoverageCostToBeneficiaryArray read GetcostToBeneficiaryArray;

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.

Public property subrogation : boolean read Getsubrogation write Setsubrogation;

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

Public property subrogationElement : Tboolean read GetsubrogationElement write SetsubrogationElement;
 
Public property contract : TReferenceArray read GetcontractArray;

The policy(s) which constitute this insurance coverage.

Public property insurancePlan : TReference read GetinsurancePlan write SetinsurancePlan;

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

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