ExplanationOfBenefit class
ExplanationOfBenefit 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.
- Mixed in types
- Annotations
-
- @freezed
Constructors
-
ExplanationOfBenefit({@Default(R5ResourceType.ExplanationOfBenefit) @JsonKey(unknownEnumValue: R5ResourceType.ExplanationOfBenefit) R5ResourceType resourceType, @JsonKey(includeFromJson: true, includeToJson: false) int? dbId, @JsonKey(name: 'id') FhirId? fhirId, FhirMeta? meta, FhirUri? implicitRules, @JsonKey(name: '_implicitRules') Element? implicitRulesElement, FhirCode? language, @JsonKey(name: '_language') Element? languageElement, Narrative? text, List<
Resource> ? contained, @JsonKey(name: 'extension') List<FhirExtension> ? extension_, List<FhirExtension> ? modifierExtension, List<Identifier> ? identifier, List<Identifier> ? traceNumber, FhirCode? status, @JsonKey(name: '_status') Element? statusElement, required CodeableConcept type, CodeableConcept? subType, FhirCode? use, @JsonKey(name: '_use') Element? useElement, required Reference patient, Period? billablePeriod, FhirDateTime? created, @JsonKey(name: '_created') Element? createdElement, Reference? enterer, Reference? insurer, Reference? provider, CodeableConcept? priority, CodeableConcept? fundsReserveRequested, CodeableConcept? fundsReserve, Reference? prescription, Reference? originalPrescription, List<ExplanationOfBenefitEvent> ? event, ExplanationOfBenefitPayee? payee, Reference? referral, List<Reference> ? encounter, Reference? facility, Reference? claim, Reference? claimResponse, FhirCode? outcome, @JsonKey(name: '_outcome') Element? outcomeElement, CodeableConcept? decision, String? disposition, @JsonKey(name: '_disposition') Element? dispositionElement, List<String> ? preAuthRef, @JsonKey(name: '_preAuthRef') List<Element> ? preAuthRefElement, List<Period> ? preAuthRefPeriod, CodeableConcept? diagnosisRelatedGroup, List<ExplanationOfBenefitCareTeam> ? careTeam, List<ExplanationOfBenefitSupportingInfo> ? supportingInfo, List<ExplanationOfBenefitDiagnosis> ? diagnosis, List<ExplanationOfBenefitProcedure> ? procedure, FhirPositiveInt? precedence, @JsonKey(name: '_precedence') Element? precedenceElement, List<ExplanationOfBenefitInsurance> ? insurance, ExplanationOfBenefitAccident? accident, Money? patientPaid, List<ExplanationOfBenefitItem> ? item, List<ExplanationOfBenefitAddItem> ? addItem, List<ExplanationOfBenefitAdjudication> ? adjudication, List<ExplanationOfBenefitTotal> ? total, ExplanationOfBenefitPayment? payment, CodeableConcept? formCode, Attachment? form, List<ExplanationOfBenefitProcessNote> ? processNote, Period? benefitPeriod, List<ExplanationOfBenefitBenefitBalance> ? benefitBalance}) -
ExplanationOfBenefit 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.
constfactory
-
ExplanationOfBenefit.fromJson(Map<
String, dynamic> json) -
Factory constructor, accepts Map<String, dynamic> as an argument
factory
- ExplanationOfBenefit.fromJsonString(String source)
-
Acts like a constructor, returns a ExplanationOfBenefit, accepts a
String as an argument, mostly because I got tired of typing it out
factory
- ExplanationOfBenefit.fromYaml(dynamic yaml)
-
Factory constructor that accepts a String in YAML format as an argument
factory
Properties
- accident → ExplanationOfBenefitAccident?
-
accident Details of a accident which resulted in injuries which
required the products and services listed in the claim.
no setterinherited
-
addItem
→ List<
ExplanationOfBenefitAddItem> ? -
addItem The first-tier service adjudications for payor added product
or service lines.
no setterinherited
-
adjudication
→ List<
ExplanationOfBenefitAdjudication> ? -
adjudication The adjudication results which are presented at the
header level rather than at the line-item or add-item levels.
no setterinherited
-
benefitBalance
→ List<
ExplanationOfBenefitBenefitBalance> ? -
benefitBalance Balance by Benefit Category.
no setterinherited
- benefitPeriod → Period?
-
benefitPeriod The term of the benefits documented in this response.
no setterinherited
- billablePeriod → Period?
-
billablePeriod The period for which charges are being submitted.
no setterinherited
-
careTeam
→ List<
ExplanationOfBenefitCareTeam> ? -
careTeam The members of the team who provided the products and
services.
no setterinherited
- claim → Reference?
-
claim The business identifier for the instance of the adjudication
request: claim predetermination or preauthorization.
no setterinherited
- claimResponse → Reference?
-
claimResponse The business identifier for the instance of the
adjudication response: claim, predetermination or preauthorization
response.
no setterinherited
-
contained
→ List<
Resource> ? -
contained 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.
no setterinherited
-
copyWith
→ $ExplanationOfBenefitCopyWith<
ExplanationOfBenefit> -
no setterinherited
- created → FhirDateTime?
-
created The date this resource was created.
no setterinherited
- createdElement → Element?
-
createdElement ("_created") Extensions for created
no setterinherited
- dbId → int?
-
no setterinherited
- decision → CodeableConcept?
-
decision The result of the claim, predetermination, or
preauthorization adjudication.
no setterinherited
-
diagnosis
→ List<
ExplanationOfBenefitDiagnosis> ? -
diagnosis Information about diagnoses relevant to the claim items.
no setterinherited
- diagnosisRelatedGroup → CodeableConcept?
-
diagnosisRelatedGroup A package billing code or bundle code used to
group products and services to a particular health condition (such as
heart attack) which is based on a predetermined grouping code system.
no setterinherited
- disposition → String?
-
disposition A human readable description of the status of the
adjudication.
no setterinherited
- dispositionElement → Element?
-
dispositionElement ("_disposition") Extensions for disposition
no setterinherited
-
encounter
→ List<
Reference> ? -
encounter Healthcare encounters related to this claim.
no setterinherited
- enterer → Reference?
-
enterer Individual who created the claim, predetermination or
preauthorization.
no setterinherited
-
event
→ List<
ExplanationOfBenefitEvent> ? -
event Information code for an event with a corresponding date or
period.
no setterinherited
-
extension_
→ List<
FhirExtension> ? -
extension_ ("extension") 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.
no setterinherited
- facility → Reference?
-
facility Facility where the services were provided.
no setterinherited
- fhirId → FhirId?
-
id The logical id of the resource, as used in the URL for the
resource. Once assigned, this value never changes.
no setterinherited
- form → Attachment?
-
form The actual form, by reference or inclusion, for printing the
content or an EOB.
no setterinherited
- formCode → CodeableConcept?
-
formCode A code for the form to be used for printing the content.
no setterinherited
- fundsReserve → CodeableConcept?
-
fundsReserve A code, used only on a response to a preauthorization,
to indicate whether the benefits payable have been reserved and for
whom.
no setterinherited
- fundsReserveRequested → CodeableConcept?
-
fundsReserveRequested A code to indicate whether and for whom funds
are to be reserved for future claims.
no setterinherited
- hashCode → int
-
The hash code for this object.
no setterinherited
-
identifier
→ List<
Identifier> ? -
identifier A unique identifier assigned to this explanation of
benefit.
no setterinherited
- implicitRules → FhirUri?
-
implicitRules A reference to a set of rules that were followed when
the resource was constructed, and which must be understood when
processing the content. Often, this is a reference to an
implementation guide that defines the special rules along with other
profiles etc.
no setterinherited
- implicitRulesElement → Element?
-
implicitRulesElement ("_implicitRules") Extensions for implicitRules
no setterinherited
-
insurance
→ List<
ExplanationOfBenefitInsurance> ? -
insurance Financial instruments for reimbursement for the health care
products and services specified on the claim.
no setterinherited
- insurer → Reference?
-
insurer The party responsible for authorization, adjudication and
reimbursement.
no setterinherited
-
item
→ List<
ExplanationOfBenefitItem> ? -
item 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.
no setterinherited
- language → FhirCode?
-
language The base language in which the resource is written.
no setterinherited
- languageElement → Element?
-
languageElement ("_language") Extensions for language
no setterinherited
- meta → FhirMeta?
-
meta The metadata about the resource. This is content that is
maintained by the infrastructure. Changes to the content might not
always be associated with version changes to the resource.
no setterinherited
-
modifierExtension
→ List<
FhirExtension> ? -
modifierExtension 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).
no setterinherited
- originalPrescription → Reference?
-
originalPrescription Original prescription which has been superseded
by this prescription to support the dispensing of pharmacy services,
medications or products.
no setterinherited
- outcome → FhirCode?
-
outcome The outcome of the claim, predetermination, or
preauthorization processing.
no setterinherited
- outcomeElement → Element?
-
outcomeElement ("_outcome") Extensions for outcome
no setterinherited
- path → String
-
Local Reference for this Resource, form is "ResourceType/Id"
no setterinherited
- patient → Reference
-
patient The party to whom the professional services and/or products
have been supplied or are being considered and for whom actual for
forecast reimbursement is sought.
no setterinherited
- patientPaid → Money?
-
patientPaid 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.
no setterinherited
- payee → ExplanationOfBenefitPayee?
-
payee The party to be reimbursed for cost of the products and
services according to the terms of the policy.
no setterinherited
- payment → ExplanationOfBenefitPayment?
-
payment Payment details for the adjudication of the claim.
no setterinherited
-
preAuthRef
→ List<
String> ? -
preAuthRef Reference from the Insurer which is used in later
communications which refers to this adjudication.
no setterinherited
-
preAuthRefElement
→ List<
Element> ? -
preAuthRefElement ("_preAuthRef") Extensions for preAuthRef
no setterinherited
-
preAuthRefPeriod
→ List<
Period> ? -
preAuthRefPeriod The timeframe during which the supplied
preauthorization reference may be quoted on claims to obtain the
adjudication as provided.
no setterinherited
- precedence → FhirPositiveInt?
-
precedence This indicates the relative order of a series of EOBs
related to different coverages for the same suite of services.
no setterinherited
- precedenceElement → Element?
-
precedenceElement ("_precedence") Extensions for precedence
no setterinherited
- prescription → Reference?
-
prescription Prescription is the document/authorization given to the
claim author for them to provide products and services for which
consideration (reimbursement) is sought. Could be a RX for
medications, an 'order' for oxygen or wheelchair or physiotherapy
treatments.
no setterinherited
- priority → CodeableConcept?
-
priority The provider-required urgency of processing the request.
Typical values include: stat, normal deferred.
no setterinherited
-
procedure
→ List<
ExplanationOfBenefitProcedure> ? -
procedure Procedures performed on the patient relevant to the billing
items with the claim.
no setterinherited
-
processNote
→ List<
ExplanationOfBenefitProcessNote> ? -
processNote A note that describes or explains adjudication results in
a human readable form.
no setterinherited
- provider → Reference?
-
provider The provider which is responsible for the claim,
predetermination or preauthorization.
no setterinherited
- referral → Reference?
-
referral The referral information received by the claim author, it is
not to be used when the author generates a referral for a patient. A
copy of that referral may be provided as supporting information. Some
insurers require proof of referral to pay for services or to pay
specialist rates for services.
no setterinherited
-
related Other claims which are related to this claim such as prior
submissions or claims for related services or for the same event.
no setterinherited
- resourceType → R5ResourceType
-
resourceType This is a ExplanationOfBenefit resource
no setterinherited
- resourceTypeString → String?
-
produce a string of the resourceType
no setterinherited
- runtimeType → Type
-
A representation of the runtime type of the object.
no setterinherited
- status → FhirCode?
-
status The status of the resource instance.
no setterinherited
- statusElement → Element?
-
statusElement ("_status") Extensions for status
no setterinherited
- subType → CodeableConcept?
-
subType A finer grained suite of claim type codes which may convey
additional information such as Inpatient vs Outpatient and/or a
specialty service.
no setterinherited
-
supportingInfo
→ List<
ExplanationOfBenefitSupportingInfo> ? -
supportingInfo Additional information codes regarding exceptions,
special considerations, the condition, situation, prior or concurrent
issues.
no setterinherited
- text → Narrative?
-
text A human-readable narrative that contains a summary of the
resource and can be used to represent the content of the resource to a
human. The narrative need not encode all the structured data, but is
required to contain sufficient detail to make it "clinically safe" for
a human to just read the narrative. Resource definitions may define
what content should be represented in the narrative to ensure clinical
safety.
no setterinherited
- thisReference → Reference
-
Convenience method to return a Reference referring to that Resource
no setterinherited
-
total
→ List<
ExplanationOfBenefitTotal> ? -
total Categorized monetary totals for the adjudication.
no setterinherited
-
traceNumber
→ List<
Identifier> ? -
traceNumber Trace number for tracking purposes. May be defined at the
jurisdiction level or between trading partners.
no setterinherited
- type → CodeableConcept
-
type The category of claim, e.g. oral, pharmacy, vision,
institutional, professional.
no setterinherited
- use → FhirCode?
-
use A code to indicate whether the nature of the request is: Claim -
A request to an Insurer to adjudicate the supplied charges for health
care goods and services under the identified policy and to pay the
determined Benefit amount, if any; Preauthorization - A request to an
Insurer to adjudicate the supplied proposed future charges for health
care goods and services under the identified policy and to approve the
services and provide the expected benefit amounts and potentially to
reserve funds to pay the benefits when Claims for the indicated
services are later submitted; or, Pre-determination - A request to an
Insurer to adjudicate the supplied 'what if' charges for health care
goods and services under the identified policy and report back what
the Benefit payable would be had the services actually been provided.
no setterinherited
- useElement → Element?
-
useElement ("_use") Extensions for use
no setterinherited
Methods
-
newId(
) → Resource -
returns the same resource with a new ID (even if there is already an ID
present)
inherited
-
newIdIfNoId(
) → Resource -
returns the same resource with a new ID if there is no current ID
inherited
-
noSuchMethod(
Invocation invocation) → dynamic -
Invoked when a nonexistent method or property is accessed.
inherited
-
toDbJson(
) → Map< String, dynamic> -
The normal toJson ignores the dbId, and produces the fhirId as the id
However, if you're going to use this as a database entry, you have to
switch those two ids
inherited
-
toJson(
) → Map< String, dynamic> -
inherited
-
toJsonString(
) → String -
Another convenience method because more and more I'm transmitting FHIR
data as a String and not a Map
override
-
toString(
) → String -
A string representation of this object.
inherited
-
toYaml(
) → String -
Produces a Yaml formatted String version of the object
override
-
updateVersion(
{FhirMeta? oldMeta}) → Resource -
Updates the meta field of this Resource, updates the meta.lastUpdated
field, adds 1 to the version number
inherited
Operators
-
operator ==(
Object other) → bool -
The equality operator.
inherited