Besa Fhir Help File

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Identifiers

Class TClaim

Description
Hierarchy
Fields
Methods
Properties

Unit

bsFhir_stu3

Declaration

type TClaim = class(TDomainResource)

Description

A provider issued list of services and products provided, or to be provided, to a patient which is provided to an insurer for payment recovery. 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 : TCodeableConceptArray read GetsubTypeArray;
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 billablePeriod : TPeriod read GetbillablePeriod write SetbillablePeriod;
Public property created : string read Getcreated write Setcreated;
Public property createdElement : TdateTime_ read GetcreatedElement write SetcreatedElement;
Public property enterer : TReference read Getenterer write Setenterer;
Public property insurer : TReference read Getinsurer write Setinsurer;
Public property provider : TReference read Getprovider write Setprovider;
Public property organization : TReference read Getorganization write Setorganization;
Public property priority : TCodeableConcept read Getpriority write Setpriority;
Public property fundsReserve : TCodeableConcept read GetfundsReserve write SetfundsReserve;
Public property related : TClaimRelatedArray read GetrelatedArray;
Public property prescription : TReference read Getprescription write Setprescription;
Public property originalPrescription : TReference read GetoriginalPrescription write SetoriginalPrescription;
Public property payee : TClaimPayee read Getpayee write Setpayee;
Public property referral : TReference read Getreferral write Setreferral;
Public property facility : TReference read Getfacility write Setfacility;
Public property careTeam : TClaimCareTeamArray read GetcareTeamArray;
Public property information : TClaimInformationArray read GetinformationArray;
Public property diagnosis : TClaimDiagnosisArray read GetdiagnosisArray;
Public property procedure_ : TClaimProcedureArray read Getprocedure_Array;
Public property insurance : TClaimInsuranceArray read GetinsuranceArray;
Public property accident : TClaimAccident read Getaccident write Setaccident;
Public property employmentImpacted : TPeriod read GetemploymentImpacted write SetemploymentImpacted;
Public property hospitalization : TPeriod read Gethospitalization write Sethospitalization;
Public property item : TClaimItemArray read GetitemArray;
Public property total : TMoney read Gettotal write Settotal;

Description

Methods

Public constructor Create; override;
 

Properties

Public property identifier : TIdentifierArray read GetidentifierArray;

The business identifier for the instance: claim number, pre-determination or pre-authorization number.

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_;

The category of claim, eg, oral, pharmacy, vision, insitutional, professional.

Public property subType : TCodeableConceptArray read GetsubTypeArray;

A finer grained suite of claim subtype codes which may convey Inpatient vs Outpatient and/or a specialty service. In the US the BillType.

Public property use : string read Getuse write Setuse;

Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination).

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

Patient Resource.

Public property billablePeriod : TPeriod read GetbillablePeriod write SetbillablePeriod;

The billable period for which charges are being submitted.

Public property created : string read Getcreated write Setcreated;

The date when the enclosed suite of services were performed or completed.

Public property createdElement : TdateTime_ read GetcreatedElement write SetcreatedElement;
 
Public property enterer : TReference read Getenterer write Setenterer;

Person who created the invoice/claim/pre-determination or pre-authorization.

Public property insurer : TReference read Getinsurer write Setinsurer;

The Insurer who is target of the request.

Public property provider : TReference read Getprovider write Setprovider;

The provider which is responsible for the bill, claim pre-determination, pre-authorization.

Public property organization : TReference read Getorganization write Setorganization;

The organization which is responsible for the bill, claim pre-determination, pre-authorization.

Public property priority : TCodeableConcept read Getpriority write Setpriority;

Immediate (STAT), best effort (NORMAL), deferred (DEFER).

Public property fundsReserve : TCodeableConcept read GetfundsReserve write SetfundsReserve;

In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved ('Patient' or 'Provider') to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested.

Public property related : TClaimRelatedArray read GetrelatedArray;

Other claims which are related to this claim such as prior claim versions or for related services.

Public property prescription : TReference read Getprescription write Setprescription;

Prescription to support the dispensing of Pharmacy or Vision products.

Public property originalPrescription : TReference read GetoriginalPrescription write SetoriginalPrescription;

Original prescription which has been superceded by this prescription to support the dispensing of pharmacy services, medications or products. For example, a physician may prescribe a medication which the pharmacy determines is contraindicated, or for which the patient has an intolerance, and therefor issues a new precription for an alternate medication which has the same theraputic intent. The prescription from the pharmacy becomes the 'prescription' and that from the physician becomes the 'original prescription'.

Public property payee : TClaimPayee read Getpayee write Setpayee;

The party to be reimbursed for the services.

Public property referral : TReference read Getreferral write Setreferral;

The referral resource which lists the date, practitioner, reason and other supporting information.

Public property facility : TReference read Getfacility write Setfacility;

Facility where the services were provided.

Public property careTeam : TClaimCareTeamArray read GetcareTeamArray;

The members of the team who provided the overall service as well as their role and whether responsible and qualifications.

Public property information : TClaimInformationArray read GetinformationArray;

Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues. Often there are mutiple jurisdiction specific valuesets which are required.

Public property diagnosis : TClaimDiagnosisArray read GetdiagnosisArray;

List of patient diagnosis for which care is sought.

Public property procedure_ : TClaimProcedureArray read Getprocedure_Array;

Ordered list of patient procedures performed to support the adjudication.

Public property insurance : TClaimInsuranceArray read GetinsuranceArray;

Financial instrument by which payment information for health care.

Public property accident : TClaimAccident read Getaccident write Setaccident;

An accident which resulted in the need for healthcare services.

Public property employmentImpacted : TPeriod read GetemploymentImpacted write SetemploymentImpacted;

The start and optional end dates of when the patient was precluded from working due to the treatable condition(s).

Public property hospitalization : TPeriod read Gethospitalization write Sethospitalization;

The start and optional end dates of when the patient was confined to a treatment center.

Public property item : TClaimItemArray read GetitemArray;

First tier of goods and services.

Public property total : TMoney read Gettotal write Settotal;

The total value of the claim.

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