Data Model Libraries
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    Class CoverageEligibilityResponseInsuranceComponent

    CoverageEligibilityResponseInsuranceComponent Class

    FHIR Specification

    • Short: Patient insurance information
    • Definition: Financial instruments for reimbursement for the health care products and services.
    • Comment: All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local 'coordination of benefit' rules. One coverage (and only one) with 'focal=true' is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where 'subrogation=false', should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.
    • Requirements: There must be at least one coverage for which eligibility is requested.

    Hierarchy (View Summary)

    Implements

    Index

    Constructors

    Properties

    coverage: null | Reference

    CoverageEligibilityResponse.insurance.coverage Element

    FHIR Specification

    • Short: Insurance information
    • Definition: Reference to the insurance card level information contained in the Coverage resource. The coverage issuing insurer will use these details to locate the patient's actual coverage within the insurer's information system.
    • Requirements: Required to allow the adjudicator to locate the correct policy and history within their information system.
    • FHIR Type: Reference
    • Cardinality: 1..1
    • isModifier: false
    • isSummary: true
    inforce?: BooleanType

    CoverageEligibilityResponse.insurance.inforce Element

    FHIR Specification

    • Short: Coverage inforce indicator
    • Definition: Flag indicating if the coverage provided is inforce currently if no service date(s) specified or for the whole duration of the service dates.
    • Requirements: Needed to convey the answer to the eligibility validation request.
    • FHIR Type: boolean
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    benefitPeriod?: Period

    CoverageEligibilityResponse.insurance.benefitPeriod Element

    FHIR Specification

    • Short: When the benefits are applicable
    • Definition: The term of the benefits documented in this response.
    • Requirements: Needed as coverages may be multi-year while benefits tend to be annual therefore a separate expression of the benefit period is needed.
    • FHIR Type: Period
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false

    CoverageEligibilityResponse.insurance.item Element

    FHIR Specification

    • Short: Benefits and authorization details
    • Definition: Benefits and optionally current balances, and authorization details by category or service.
    • FHIR Type: BackboneElement
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false

    Methods

    • Parse the provided CoverageEligibilityResponseInsuranceComponent JSON to instantiate the CoverageEligibilityResponseInsuranceComponent data model.

      Parameters

      • sourceJson: Value

        JSON representing FHIR CoverageEligibilityResponseInsuranceComponent

      • OptionaloptSourceField: string

        Optional data source field (e.g. <complexTypeName>.<complexTypeFieldName>); defaults to CoverageEligibilityResponseInsuranceComponent

      Returns undefined | CoverageEligibilityResponseInsuranceComponent

      CoverageEligibilityResponseInsuranceComponent data model or undefined for CoverageEligibilityResponseInsuranceComponent

      JsonError if the provided JSON is not a valid JSON object

    • Determines if the modifierExtension property exists.

      Parameters

      • Optionalurl: string

        the url that identifies a specific Extension

      Returns boolean

      true if an Extension has the provided url; false otherwise

      If the url is provided, determines if an Extension having the provided url exists. If the url is not provided, determines if the modifierExtension property exists and has any values.

      AssertionError for invalid url

    • Returns undefined | string

      the id property value

    • Assigns the provided value to the id property.

      Parameters

      • value: undefined | string

        the id value

      Returns this

      this

      PrimitiveTypeError for invalid value

    • Returns boolean

      true if id exists and has a value; false otherwise

    • Determines if the extension property exists.

      Parameters

      • Optionalurl: string

        the url that identifies a specific Extension

      Returns boolean

      true if an Extension has the provided url; false otherwise

      If the url is provided, determines if an Extension having the provided url exists. If the url is not provided, determines if the extension property exists and has any values.

      AssertionError for invalid url

    • Determines if the extension property exists.

      Parameters

      • url: string

        the url that identifies a specific Extension

      Returns undefined | IExtension

      an Extension having the provided url

      If the url is provided, determines if an Extension having the provided url exists. If the url is not provided, determines if the extension property exists and has any values.

      AssertionError for invalid url

    • Adds the provided Extension to the extension property array.

      Parameters

      • extension: undefined | IExtension

        the Extension value to add to the extension property array

      Returns this

      this

    • Removes the Extension having the provided url from the extension property array.

      Parameters

      • url: string

        the url that identifies a specific Extension to remove

      Returns void

      AssertionError for invalid url

    • Returns boolean

      true if the instance is a FHIR complex or primitive datatype; false otherwise