ClaimResponse constructor

const ClaimResponse({ @Default(R5ResourceType.ClaimResponse) @JsonKey(unknownEnumValue: R5ResourceType.ClaimResponse) 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, FhirDateTime? created, @JsonKey(name: '_created') Element? createdElement, Reference? insurer, Reference? requestor, Reference? request, FhirCode? outcome, @JsonKey(name: '_outcome') Element? outcomeElement, CodeableConcept? decision, String? disposition, @JsonKey(name: '_disposition') Element? dispositionElement, String? preAuthRef, @JsonKey(name: '_preAuthRef') Element? preAuthRefElement, Period? preAuthPeriod, List<ClaimResponseEvent>? event, CodeableConcept? payeeType, List<Reference>? encounter, CodeableConcept? diagnosisRelatedGroup, List<ClaimResponseItem>? item, List<ClaimResponseAddItem>? addItem, List<ClaimResponseAdjudication>? adjudication, List<ClaimResponseTotal>? total, ClaimResponsePayment? payment, CodeableConcept? fundsReserve, CodeableConcept? formCode, Attachment? form, List<ClaimResponseProcessNote>? processNote, List<Reference>? communicationRequest, List<ClaimResponseInsurance>? insurance, List<ClaimResponseError>? error, })

ClaimResponse This resource provides the adjudication details from the processing of a Claim resource.

resourceType This is a ClaimResponse resource

id The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

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.

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.

implicitRulesElement ("_implicitRules") Extensions for implicitRules

language The base language in which the resource is written.

languageElement ("_language") Extensions for language

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.

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.

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.

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).

identifier A unique identifier assigned to this claim response.

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

status The status of the resource instance.

statusElement ("_status") Extensions for status

type A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.

subType A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.

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.

useElement ("_use") Extensions for use

patient The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.

created The date this resource was created.

createdElement ("_created") Extensions for created

insurer The party responsible for authorization, adjudication and reimbursement.

requestor The provider which is responsible for the claim, predetermination or preauthorization.

request Original request resource reference.

outcome The outcome of the claim, predetermination, or preauthorization processing.

outcomeElement ("_outcome") Extensions for outcome

decision The result of the claim, predetermination, or preauthorization adjudication.

disposition A human readable description of the status of the adjudication.

dispositionElement ("_disposition") Extensions for disposition

preAuthRef Reference from the Insurer which is used in later communications which refers to this adjudication.

preAuthRefElement ("_preAuthRef") Extensions for preAuthRef

preAuthPeriod The time frame during which this authorization is effective.

event Information code for an event with a corresponding date or period.

payeeType Type of Party to be reimbursed: subscriber, provider, other.

encounter Healthcare encounters related to this claim.

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.

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.

addItem The first-tier service adjudications for payor added product or service lines.

adjudication The adjudication results which are presented at the header level rather than at the line-item or add-item levels.

total Categorized monetary totals for the adjudication.

payment Payment details for the adjudication of the claim.

fundsReserve A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.

formCode A code for the form to be used for printing the content.

form The actual form, by reference or inclusion, for printing the content or an EOB.

processNote A note that describes or explains adjudication results in a human readable form.

communicationRequest Request for additional supporting or authorizing information.

insurance Financial instruments for reimbursement for the health care products and services specified on the claim.

error Errors encountered during the processing of the adjudication.

Implementation

const factory ClaimResponse({
  /// [resourceType] This is a ClaimResponse resource
  @Default(R5ResourceType.ClaimResponse)
  @JsonKey(unknownEnumValue: R5ResourceType.ClaimResponse)
  R5ResourceType resourceType,
  @JsonKey(includeFromJson: true, includeToJson: false) int? dbId,

  /// [id] The logical id of the resource, as used in the URL for the
  ///  resource. Once assigned, this value never changes.
  @JsonKey(name: 'id') FhirId? fhirId,

  /// [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.
  FhirMeta? meta,

  /// [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.
  FhirUri? implicitRules,

  /// [implicitRulesElement] ("_implicitRules") Extensions for implicitRules
  @JsonKey(name: '_implicitRules') Element? implicitRulesElement,

  /// [language] The base language in which the resource is written.
  FhirCode? language,

  /// [languageElement] ("_language") Extensions for language
  @JsonKey(name: '_language') Element? languageElement,

  /// [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.
  Narrative? text,

  /// [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.
  List<Resource>? contained,

  /// [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.
  @JsonKey(name: 'extension') List<FhirExtension>? extension_,

  /// [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).
  List<FhirExtension>? modifierExtension,

  /// [identifier] A unique identifier assigned to this claim response.
  List<Identifier>? identifier,

  /// [traceNumber] Trace number for tracking purposes. May be defined at the
  ///  jurisdiction level or between trading partners.
  List<Identifier>? traceNumber,

  /// [status] The status of the resource instance.
  FhirCode? status,

  /// [statusElement] ("_status") Extensions for status
  @JsonKey(name: '_status') Element? statusElement,

  /// [type] A finer grained suite of claim type codes which may convey
  ///  additional information such as Inpatient vs Outpatient and/or a
  ///  specialty service.
  required CodeableConcept type,

  /// [subType] A finer grained suite of claim type codes which may convey
  ///  additional information such as Inpatient vs Outpatient and/or a
  ///  specialty service.
  CodeableConcept? subType,

  /// [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.
  FhirCode? use,

  /// [useElement] ("_use") Extensions for use
  @JsonKey(name: '_use') Element? useElement,

  /// [patient] The party to whom the professional services and/or products
  ///  have been supplied or are being considered and for whom actual for
  ///  facast reimbursement is sought.
  required Reference patient,

  /// [created] The date this resource was created.
  FhirDateTime? created,

  /// [createdElement] ("_created") Extensions for created
  @JsonKey(name: '_created') Element? createdElement,

  /// [insurer] The party responsible for authorization, adjudication and
  ///  reimbursement.
  Reference? insurer,

  /// [requestor] The provider which is responsible for the claim,
  ///  predetermination or preauthorization.
  Reference? requestor,

  /// [request] Original request resource reference.
  Reference? request,

  /// [outcome] The outcome of the claim, predetermination, or
  ///  preauthorization processing.
  FhirCode? outcome,

  /// [outcomeElement] ("_outcome") Extensions for outcome
  @JsonKey(name: '_outcome') Element? outcomeElement,

  /// [decision] The result of the claim, predetermination, or
  ///  preauthorization adjudication.
  CodeableConcept? decision,

  /// [disposition] A human readable description of the status of the
  ///  adjudication.
  String? disposition,

  /// [dispositionElement] ("_disposition") Extensions for disposition
  @JsonKey(name: '_disposition') Element? dispositionElement,

  /// [preAuthRef] Reference from the Insurer which is used in later
  ///  communications which refers to this adjudication.
  String? preAuthRef,

  /// [preAuthRefElement] ("_preAuthRef") Extensions for preAuthRef
  @JsonKey(name: '_preAuthRef') Element? preAuthRefElement,

  /// [preAuthPeriod] The time frame during which this authorization is
  ///  effective.
  Period? preAuthPeriod,

  /// [event] Information code for an event with a corresponding date or
  ///  period.
  List<ClaimResponseEvent>? event,

  /// [payeeType] Type of Party to be reimbursed: subscriber, provider, other.
  CodeableConcept? payeeType,

  /// [encounter] Healthcare encounters related to this claim.
  List<Reference>? encounter,

  /// [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.
  CodeableConcept? diagnosisRelatedGroup,

  /// [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.
  List<ClaimResponseItem>? item,

  /// [addItem] The first-tier service adjudications for payor added product
  ///  or service lines.
  List<ClaimResponseAddItem>? addItem,

  /// [adjudication] The adjudication results which are presented at the
  ///  header level rather than at the line-item or add-item levels.
  List<ClaimResponseAdjudication>? adjudication,

  /// [total] Categorized monetary totals for the adjudication.
  List<ClaimResponseTotal>? total,

  /// [payment] Payment details for the adjudication of the claim.
  ClaimResponsePayment? payment,

  /// [fundsReserve] A code, used only on a response to a preauthorization,
  ///  to indicate whether the benefits payable have been reserved and for
  ///  whom.
  CodeableConcept? fundsReserve,

  /// [formCode] A code for the form to be used for printing the content.
  CodeableConcept? formCode,

  /// [form] The actual form, by reference or inclusion, for printing the
  ///  content or an EOB.
  Attachment? form,

  /// [processNote] A note that describes or explains adjudication results in
  ///  a human readable form.
  List<ClaimResponseProcessNote>? processNote,

  /// [communicationRequest] Request for additional supporting or authorizing
  ///  information.
  List<Reference>? communicationRequest,

  /// [insurance] Financial instruments for reimbursement for the health care
  ///  products and services specified on the claim.
  List<ClaimResponseInsurance>? insurance,

  /// [error] Errors encountered during the processing of the adjudication.
  List<ClaimResponseError>? error,
}) = _ClaimResponse;