Data Model Libraries
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    Class ExplanationOfBenefitBenefitBalanceComponent

    ExplanationOfBenefitBenefitBalanceComponent Class

    FHIR Specification

    • Short: Balance by Benefit Category
    • Definition: Balance by Benefit Category.

    Hierarchy (View Summary)

    Implements

    Index

    Constructors

    Properties

    category: null | CodeableConcept

    ExplanationOfBenefit.benefitBalance.category Element

    FHIR Specification

    • Short: Benefit classification
    • Definition: Code to identify the general type of benefits under which products and services are provided.
    • Comment: Examples include Medical Care, Periodontics, Renal Dialysis, Vision Coverage.
    • Requirements: Needed to convey the category of service or product for which eligibility is sought.
    • FHIR Type: CodeableConcept
    • Cardinality: 1..1
    • isModifier: false
    • isSummary: false
    excluded?: BooleanType

    ExplanationOfBenefit.benefitBalance.excluded Element

    FHIR Specification

    • Short: Excluded from the plan
    • Definition: True if the indicated class of service is excluded from the plan, missing or False indicates the product or service is included in the coverage.
    • Requirements: Needed to identify items that are specifically excluded from the coverage.
    • FHIR Type: boolean
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    name?: StringType

    FHIR Specification

    • Short: Short name for the benefit
    • Definition: A short name or tag for the benefit.
    • Comment: For example: MED01, or DENT2.
    • Requirements: Required to align with other plan names.
    • FHIR Type: string
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    description?: StringType

    ExplanationOfBenefit.benefitBalance.description Element

    FHIR Specification

    • Short: Description of the benefit or services covered
    • Definition: A richer description of the benefit or services covered.
    • Comment: For example, 'DENT2 covers 100% of basic, 50% of major but excludes Ortho, Implants and Cosmetic services'.
    • Requirements: Needed for human readable reference.
    • FHIR Type: string
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false
    network?: CodeableConcept

    ExplanationOfBenefit.benefitBalance.network Element

    FHIR Specification

    • Short: In or out of network
    • Definition: Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers.
    • Requirements: Needed as in or out of network providers are treated differently under the coverage.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false

    ExplanationOfBenefit.benefitBalance.unit Element

    FHIR Specification

    • Short: Individual or family
    • Definition: Indicates if the benefits apply to an individual or to the family.
    • Requirements: Needed for the understanding of the benefits.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false

    ExplanationOfBenefit.benefitBalance.term Element

    FHIR Specification

    • Short: Annual or lifetime
    • Definition: The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'.
    • Requirements: Needed for the understanding of the benefits.
    • FHIR Type: CodeableConcept
    • Cardinality: 0..1
    • isModifier: false
    • isSummary: false

    ExplanationOfBenefit.benefitBalance.financial Element

    FHIR Specification

    • Short: Benefit Summary
    • Definition: Benefits Used to date.
    • FHIR Type: BackboneElement
    • Cardinality: 0..*
    • isModifier: false
    • isSummary: false

    Methods

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

      Parameters

      • sourceJson: Value

        JSON representing FHIR ExplanationOfBenefitBenefitBalanceComponent

      • OptionaloptSourceField: string

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

      Returns undefined | ExplanationOfBenefitBenefitBalanceComponent

      ExplanationOfBenefitBenefitBalanceComponent data model or undefined for ExplanationOfBenefitBenefitBalanceComponent

      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