Class TExplanationOfBenefitItem

Unit

Declaration

type TExplanationOfBenefitItem = class(TBackboneElement)

Description

This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.

Hierarchy

Overview

Methods

Public constructor Create; override;

Properties

Public property sequence : Int64 read Getsequence write Setsequence;
Public property sequenceElement : TpositiveInt read GetsequenceElement write SetsequenceElement;
Public property careTeamSequence : TBSFHIRPrimitiveStringArray read GetcareTeamSequenceArray;
Public property diagnosisSequence : TBSFHIRPrimitiveStringArray read GetdiagnosisSequenceArray;
Public property procedureSequence : TBSFHIRPrimitiveStringArray read GetprocedureSequenceArray;
Public property informationSequence : TBSFHIRPrimitiveStringArray read GetinformationSequenceArray;
Public property traceNumber : TIdentifierArray read GettraceNumberArray;
Public property revenue : TCodeableConcept read Getrevenue write Setrevenue;
Public property category : TCodeableConcept read Getcategory write Setcategory;
Public property productOrService : TCodeableConcept read GetproductOrService write SetproductOrService;
Public property productOrServiceEnd : TCodeableConcept read GetproductOrServiceEnd write SetproductOrServiceEnd;
Public property request : TReferenceArray read GetrequestArray;
Public property modifier : TCodeableConceptArray read GetmodifierArray;
Public property programCode : TCodeableConceptArray read GetprogramCodeArray;
Public property servicedDate : string read GetservicedDate write SetservicedDate;
Public property servicedDateElement : Tdate_ read GetservicedDateElement write SetservicedDateElement;
Public property servicedPeriod : TPeriod read GetservicedPeriod write SetservicedPeriod;
Public property locationCodeableConcept : TCodeableConcept read GetlocationCodeableConcept write SetlocationCodeableConcept;
Public property locationAddress : TAddress read GetlocationAddress write SetlocationAddress;
Public property locationReference : TReference read GetlocationReference write SetlocationReference;
Public property patientPaid : TMoney read GetpatientPaid write SetpatientPaid;
Public property quantity : TQuantity read Getquantity write Setquantity;
Public property unitPrice : TMoney read GetunitPrice write SetunitPrice;
Public property factor : Double read Getfactor write Setfactor;
Public property factorElement : Tdecimal read GetfactorElement write SetfactorElement;
Public property tax : TMoney read Gettax write Settax;
Public property net : TMoney read Getnet write Setnet;
Public property udi : TReferenceArray read GetudiArray;
Public property bodySite : TExplanationOfBenefitBodySiteArray read GetbodySiteArray;
Public property encounter : TReferenceArray read GetencounterArray;
Public property noteNumber : TBSFHIRPrimitiveStringArray read GetnoteNumberArray;
Public property reviewOutcome : TExplanationOfBenefitReviewOutcome read GetreviewOutcome write SetreviewOutcome;
Public property adjudication : TExplanationOfBenefitAdjudicationArray read GetadjudicationArray;
Public property detail : TExplanationOfBenefitDetailArray read GetdetailArray;

Description

Methods

Public constructor Create; override;
 

Properties

Public property sequence : Int64 read Getsequence write Setsequence;

A number to uniquely identify item entries.

Public property sequenceElement : TpositiveInt read GetsequenceElement write SetsequenceElement;
 
Public property careTeamSequence : TBSFHIRPrimitiveStringArray read GetcareTeamSequenceArray;

Care team members related to this service or product.

Public property diagnosisSequence : TBSFHIRPrimitiveStringArray read GetdiagnosisSequenceArray;

Diagnoses applicable for this service or product.

Public property procedureSequence : TBSFHIRPrimitiveStringArray read GetprocedureSequenceArray;

Procedures applicable for this service or product.

Public property informationSequence : TBSFHIRPrimitiveStringArray read GetinformationSequenceArray;

Exceptions, special conditions and supporting information applicable for this service or product.

Public property traceNumber : TIdentifierArray read GettraceNumberArray;

Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

Public property revenue : TCodeableConcept read Getrevenue write Setrevenue;

The type of revenue or cost center providing the product and/or service.

Public property category : TCodeableConcept read Getcategory write Setcategory;

Code to identify the general type of benefits under which products and services are provided.

Public property productOrService : TCodeableConcept read GetproductOrService write SetproductOrService;

When the value is a group code then this item collects a set of related item details, otherwise this contains the product, service, drug or other billing code for the item. This element may be the start of a range of .productOrService codes used in conjunction with .productOrServiceEnd or it may be a solo element where .productOrServiceEnd is not used.

Public property productOrServiceEnd : TCodeableConcept read GetproductOrServiceEnd write SetproductOrServiceEnd;

This contains the end of a range of product, service, drug or other billing codes for the item. This element is not used when the .productOrService is a group code. This value may only be present when a .productOfService code has been provided to convey the start of the range. Typically this value may be used only with preauthorizations and not with claims.

Public property request : TReferenceArray read GetrequestArray;

Request or Referral for Goods or Service to be rendered.

Public property modifier : TCodeableConceptArray read GetmodifierArray;

Item typification or modifiers codes to convey additional context for the product or service.

Public property programCode : TCodeableConceptArray read GetprogramCodeArray;

Identifies the program under which this may be recovered.

Public property servicedDate : string read GetservicedDate write SetservicedDate;

The date or dates when the service or product was supplied, performed or completed. (choose any one of serviced*, but only one)

Public property servicedDateElement : Tdate_ read GetservicedDateElement write SetservicedDateElement;
 
Public property servicedPeriod : TPeriod read GetservicedPeriod write SetservicedPeriod;

The date or dates when the service or product was supplied, performed or completed. (choose any one of serviced*, but only one)

Public property locationCodeableConcept : TCodeableConcept read GetlocationCodeableConcept write SetlocationCodeableConcept;

Where the product or service was provided. (choose any one of location*, but only one)

Public property locationAddress : TAddress read GetlocationAddress write SetlocationAddress;

Where the product or service was provided. (choose any one of location*, but only one)

Public property locationReference : TReference read GetlocationReference write SetlocationReference;

Where the product or service was provided. (choose any one of location*, but only one)

Public property patientPaid : TMoney read GetpatientPaid write SetpatientPaid;

The amount paid by the patient, in total at the claim claim level or specifically for the item and detail level, to the provider for goods and services.

Public property quantity : TQuantity read Getquantity write Setquantity;

The number of repetitions of a service or product.

Public property unitPrice : TMoney read GetunitPrice write SetunitPrice;

If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

Public property factor : Double read Getfactor write Setfactor;

A real number that represents a multiplier used in determining the overall value of services delivered and/or goods received. The concept of a Factor allows for a discount or surcharge multiplier to be applied to a monetary amount.

Public property factorElement : Tdecimal read GetfactorElement write SetfactorElement;
 
Public property tax : TMoney read Gettax write Settax;

The total of taxes applicable for this product or service.

Public property net : TMoney read Getnet write Setnet;

The total amount claimed for the group (if a grouper) or the line item. Net = unit price * quantity * factor.

Public property udi : TReferenceArray read GetudiArray;

Unique Device Identifiers associated with this line item.

Public property bodySite : TExplanationOfBenefitBodySiteArray read GetbodySiteArray;

Physical location where the service is performed or applies.

Public property encounter : TReferenceArray read GetencounterArray;

Healthcare encounters related to this claim.

Public property noteNumber : TBSFHIRPrimitiveStringArray read GetnoteNumberArray;

The numbers associated with notes below which apply to the adjudication of this item.

Public property reviewOutcome : TExplanationOfBenefitReviewOutcome read GetreviewOutcome write SetreviewOutcome;

The high-level results of the adjudication if adjudication has been performed.

Public property adjudication : TExplanationOfBenefitAdjudicationArray read GetadjudicationArray;

If this item is a group then the values here are a summary of the adjudication of the detail items. If this item is a simple product or service then this is the result of the adjudication of this item.

Public property detail : TExplanationOfBenefitDetailArray read GetdetailArray;

Second-tier of goods and services.


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