Class Claim

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.

Inheritance

System.Object

Resource

DomainResource

Claim

Implements

IFhirJsonSerializable

Inherited Members

DomainResource.Contained

DomainResource.Extension

DomainResource.ModifierExtension

DomainResource.Text

Resource.Id

Resource._Id

Resource.ImplicitRules

Resource._ImplicitRules

Resource.Language

Resource._Language

Resource.Meta

Namespace: fhirCsR2.Models

Assembly: fhirCsR2.dll

Syntax

public class Claim : DomainResource, IFhirJsonSerializable

Properties

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_Accident

Extension container element for Accident

Declaration

public Element _Accident { get; set; }

Property Value

Type	Description
Element

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_Created

Extension container element for Created

Declaration

public Element _Created { get; set; }

Property Value

Type	Description
Element

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_School

Extension container element for School

Declaration

public Element _School { get; set; }

Property Value

Type	Description
Element

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_Type

Extension container element for Type

Declaration

public Element _Type { get; set; }

Property Value

Type	Description
Element

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_Use

Extension container element for Use

Declaration

public Element _Use { get; set; }

Property Value

Type	Description
Element

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Accident

Coverage may be dependent on accidents.

Declaration

public string Accident { get; set; }

Property Value

Type	Description
System.String

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AccidentType

Coverage may be dependent on the type of accident.

Declaration

public Coding AccidentType { get; set; }

Property Value

Type	Description
Coding

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AdditionalMaterials

Code to indicate that Xrays, images, emails, documents, models or attachments are being sent in support of this submission.

Declaration

public List<Coding> AdditionalMaterials { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<Coding>

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Condition

List of patient conditions for which care is sought.

Declaration

public List<Coding> Condition { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<Coding>

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Coverage

Health care programs and insurers are significant payors of health service costs.

Declaration

public List<ClaimCoverage> Coverage { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<ClaimCoverage>

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Created

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

Declaration

public string Created { get; set; }

Property Value

Type	Description
System.String

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Diagnosis

Ordered list of patient diagnosis for which care is sought.

Declaration

public List<ClaimDiagnosis> Diagnosis { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<ClaimDiagnosis>

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Enterer

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

Declaration

public Reference Enterer { get; set; }

Property Value

Type	Description
Reference

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Exception

To determine extenuating circumstances for coverage.

Declaration

public List<Coding> Exception { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<Coding>

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Facility

Facility where the services were provided.

Declaration

public Reference Facility { get; set; }

Property Value

Type	Description
Reference

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FundsReserve

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.

Declaration

public Coding FundsReserve { get; set; }

Property Value

Type	Description
Coding

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Identifier

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

Declaration

public List<Identifier> Identifier { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<Identifier>

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InterventionException

Coverage may be modified based on exception information provided.

Declaration

public List<Coding> InterventionException { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<Coding>

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Item

First tier of goods and services.

Declaration

public List<ClaimItem> Item { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<ClaimItem>

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MissingTeeth

The list of missing teeth may influence the adjudication of services for example with Bridges.

Declaration

public List<ClaimMissingTeeth> MissingTeeth { get; set; }

Property Value

Type	Description
fhirCsR2.Models.List<ClaimMissingTeeth>

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Organization

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

Declaration

public Reference Organization { get; set; }

Property Value

Type	Description
Reference

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OriginalPrescription

Original prescription to support the dispensing of pharmacy services, medications or products.

Declaration

public Reference OriginalPrescription { get; set; }

Property Value

Type	Description
Reference

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OriginalRuleset

The version of the specification from which the original instance was created.

Declaration

public Coding OriginalRuleset { get; set; }

Property Value

Type	Description
Coding

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Patient

Patient Resource.

Declaration

public Reference Patient { get; set; }

Property Value

Type	Description
Reference

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Payee

The party to be reimbursed for the services.

Declaration

public ClaimPayee Payee { get; set; }

Property Value

Type	Description
ClaimPayee

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Prescription

For type=Pharmacy and Vision only.

Declaration

public Reference Prescription { get; set; }

Property Value

Type	Description
Reference

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Priority

Immediate (stat), best effort (normal), deferred (deferred).

Declaration

public Coding Priority { get; set; }

Property Value

Type	Description
Coding

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Provider

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

Declaration

public Reference Provider { get; set; }

Property Value

Type	Description
Reference

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Referral

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

Declaration

public Reference Referral { get; set; }

Property Value

Type	Description
Reference

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ResourceType

Resource Type Name

Declaration

public override string ResourceType { get; }

Property Value

Type	Description
System.String

Overrides

Resource.ResourceType

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Ruleset

The version of the specification on which this instance relies.

Declaration

public Coding Ruleset { get; set; }

Property Value

Type	Description
Coding

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School

Often required for over-age dependents.

Declaration

public string School { get; set; }

Property Value

Type	Description
System.String

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Target

Insurer Identifier, typical BIN number (6 digit).

Declaration

public Reference Target { get; set; }

Property Value

Type	Description
Reference

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Type

The category of claim this is.

Declaration

public string Type { get; set; }

Property Value

Type	Description
System.String

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Use

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

Declaration

public string Use { get; set; }

Property Value

Type	Description
System.String

Methods

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DeserializeJson(ref Utf8JsonReader, JsonSerializerOptions)

Deserialize a JSON object

Declaration

public void DeserializeJson(ref Utf8JsonReader reader, JsonSerializerOptions options)

Parameters

Type	Name	Description
Utf8JsonReader	reader
JsonSerializerOptions	options

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DeserializeJsonProperty(ref Utf8JsonReader, JsonSerializerOptions, String)

Deserialize a JSON property

Declaration

public void DeserializeJsonProperty(ref Utf8JsonReader reader, JsonSerializerOptions options, string propertyName)

Parameters

Type	Name	Description
Utf8JsonReader	reader
JsonSerializerOptions	options
System.String	propertyName

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SerializeJson(Utf8JsonWriter, JsonSerializerOptions, Boolean)

Serialize to a JSON object

Declaration

public void SerializeJson(Utf8JsonWriter writer, JsonSerializerOptions options, bool includeStartObject = true)

Parameters

Type	Name	Description
Utf8JsonWriter	writer
JsonSerializerOptions	options
System.Boolean	includeStartObject

Implements

IFhirJsonSerializable