/** * FHIR Version R5 * The following is auto generated resource definition. * * OpenAPI spec version: 3.0.1 * * * NOTE: This class is auto generated by the swagger code generator program. * https://github.com/swagger-api/swagger-codegen.git * Do not edit the class manually. */ import { Attachment } from './attachment'; import { Code } from './code'; import { CodeableConcept } from './codeableConcept'; import { DateTime } from './dateTime'; import { ExplanationOfBenefitAccident } from './explanationOfBenefitAccident'; import { ExplanationOfBenefitAddItem } from './explanationOfBenefitAddItem'; import { ExplanationOfBenefitAdjudication } from './explanationOfBenefitAdjudication'; import { ExplanationOfBenefitBenefitBalance } from './explanationOfBenefitBenefitBalance'; import { ExplanationOfBenefitCareTeam } from './explanationOfBenefitCareTeam'; import { ExplanationOfBenefitDiagnosis } from './explanationOfBenefitDiagnosis'; import { ExplanationOfBenefitEvent } from './explanationOfBenefitEvent'; import { ExplanationOfBenefitInsurance } from './explanationOfBenefitInsurance'; import { ExplanationOfBenefitItem } from './explanationOfBenefitItem'; import { ExplanationOfBenefitPayee } from './explanationOfBenefitPayee'; import { ExplanationOfBenefitPayment } from './explanationOfBenefitPayment'; import { ExplanationOfBenefitProcedure } from './explanationOfBenefitProcedure'; import { ExplanationOfBenefitProcessNote } from './explanationOfBenefitProcessNote'; import { ExplanationOfBenefitRelated } from './explanationOfBenefitRelated'; import { ExplanationOfBenefitSupportingInfo } from './explanationOfBenefitSupportingInfo'; import { ExplanationOfBenefitTotal } from './explanationOfBenefitTotal'; import { Extension } from './extension'; import { Id } from './id'; import { Identifier } from './identifier'; import { Meta } from './meta'; import { Money } from './money'; import { Narrative } from './narrative'; import { Period } from './period'; import { PositiveInt } from './positiveInt'; import { Reference } from './reference'; import { ResourceList } from './resourceList'; import { Uri } from './uri'; /** * 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. */ export interface ExplanationOfBenefit { /** * This is a ExplanationOfBenefit resource */ resourceType: 'ExplanationOfBenefit'; id?: Id; meta?: Meta; implicitRules?: Uri; language?: Code; text?: Narrative; /** * These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning. */ contained?: Array; /** * May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. */ extension?: Array; /** * May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). */ modifierExtension?: Array; /** * A unique identifier assigned to this explanation of benefit. */ identifier?: Array; /** * Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners. */ traceNumber?: Array; status?: Code; type: CodeableConcept; subType?: CodeableConcept; use?: Code; patient: Reference; billablePeriod?: Period; created?: Date; enterer?: Reference; insurer?: Reference; provider?: Reference; priority?: CodeableConcept; fundsReserveRequested?: CodeableConcept; fundsReserve?: CodeableConcept; /** * Other claims which are related to this claim such as prior submissions or claims for related services or for the same event. */ related?: Array; prescription?: Reference; originalPrescription?: Reference; /** * Information code for an event with a corresponding date or period. */ event?: Array; payee?: ExplanationOfBenefitPayee; referral?: Reference; /** * Healthcare encounters related to this claim. */ encounter?: Array; facility?: Reference; claim?: Reference; claimResponse?: Reference; outcome?: Code; decision?: CodeableConcept; disposition?: string; /** * Reference from the Insurer which is used in later communications which refers to this adjudication. */ preAuthRef?: Array; /** * The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided. */ preAuthRefPeriod?: Array; diagnosisRelatedGroup?: CodeableConcept; /** * The members of the team who provided the products and services. */ careTeam?: Array; /** * Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues. */ supportingInfo?: Array; /** * Information about diagnoses relevant to the claim items. */ diagnosis?: Array; /** * Procedures performed on the patient relevant to the billing items with the claim. */ procedure?: Array; precedence?: PositiveInt; /** * Financial instruments for reimbursement for the health care products and services specified on the claim. */ insurance?: Array; accident?: ExplanationOfBenefitAccident; patientPaid?: Money; /** * 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. */ item?: Array; /** * The first-tier service adjudications for payor added product or service lines. */ addItem?: Array; /** * The adjudication results which are presented at the header level rather than at the line-item or add-item levels. */ adjudication?: Array; /** * Categorized monetary totals for the adjudication. */ total?: Array; payment?: ExplanationOfBenefitPayment; formCode?: CodeableConcept; form?: Attachment; /** * A note that describes or explains adjudication results in a human readable form. */ processNote?: Array; benefitPeriod?: Period; /** * Balance by Benefit Category. */ benefitBalance?: Array; }