@medplum/fhirtypes 0.3.0

package/dist/CoverageEligibilityRequest.d.ts

@@ -0,0 +1,468 @@
+/*
+ * Generated by @medplum/generator
+ * Do not edit manually.
+ */
+
+import { CodeableConcept } from './CodeableConcept';
+import { Condition } from './Condition';
+import { Coverage } from './Coverage';
+import { Extension } from './Extension';
+import { Identifier } from './Identifier';
+import { Location } from './Location';
+import { Meta } from './Meta';
+import { Money } from './Money';
+import { Narrative } from './Narrative';
+import { Organization } from './Organization';
+import { Patient } from './Patient';
+import { Period } from './Period';
+import { Practitioner } from './Practitioner';
+import { PractitionerRole } from './PractitionerRole';
+import { Quantity } from './Quantity';
+import { Reference } from './Reference';
+import { Resource } from './Resource';
+
+/**
+ * The CoverageEligibilityRequest provides patient and insurance coverage
+ * information to an insurer for them to respond, in the form of an
+ * CoverageEligibilityResponse, with information regarding whether the
+ * stated coverage is valid and in-force and optionally to provide the
+ * insurance details of the policy.
+ */
+export interface CoverageEligibilityRequest {
+
+  /**
+   * This is a CoverageEligibilityRequest resource
+   */
+  readonly resourceType: 'CoverageEligibilityRequest';
+
+  /**
+   * The logical id of the resource, as used in the URL for the resource.
+   * Once assigned, this value never changes.
+   */
+  readonly id?: string;
+
+  /**
+   * 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.
+   */
+  readonly meta?: Meta;
+
+  /**
+   * 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.
+   */
+  readonly implicitRules?: string;
+
+  /**
+   * The base language in which the resource is written.
+   */
+  readonly language?: string;
+
+  /**
+   * 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.
+   */
+  readonly text?: Narrative;
+
+  /**
+   * These resources do not have an independent existence apart from the
+   * resource that contains them - they cannot be identified independently,
+   * and nor can they have their own independent transaction scope.
+   */
+  readonly contained?: Resource[];
+
+  /**
+   * 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 manageable, 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * 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 manageable, 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A unique identifier assigned to this coverage eligiblity request.
+   */
+  readonly identifier?: Identifier[];
+
+  /**
+   * The status of the resource instance.
+   */
+  readonly status?: string;
+
+  /**
+   * When the requestor expects the processor to complete processing.
+   */
+  readonly priority?: CodeableConcept;
+
+  /**
+   * Code to specify whether requesting: prior authorization requirements
+   * for some service categories or billing codes; benefits for coverages
+   * specified or discovered; discovery and return of coverages for the
+   * patient; and/or validation that the specified coverage is in-force at
+   * the date/period specified or 'now' if not specified.
+   */
+  readonly purpose?: string[];
+
+  /**
+   * The party who is the beneficiary of the supplied coverage and for whom
+   * eligibility is sought.
+   */
+  readonly patient?: Reference<Patient>;
+
+  /**
+   * The date or dates when the enclosed suite of services were performed
+   * or completed.
+   */
+  readonly servicedDate?: string;
+
+  /**
+   * The date or dates when the enclosed suite of services were performed
+   * or completed.
+   */
+  readonly servicedPeriod?: Period;
+
+  /**
+   * The date when this resource was created.
+   */
+  readonly created?: string;
+
+  /**
+   * Person who created the request.
+   */
+  readonly enterer?: Reference<Practitioner | PractitionerRole>;
+
+  /**
+   * The provider which is responsible for the request.
+   */
+  readonly provider?: Reference<Practitioner | PractitionerRole | Organization>;
+
+  /**
+   * The Insurer who issued the coverage in question and is the recipient
+   * of the request.
+   */
+  readonly insurer?: Reference<Organization>;
+
+  /**
+   * Facility where the services are intended to be provided.
+   */
+  readonly facility?: Reference<Location>;
+
+  /**
+   * Additional information codes regarding exceptions, special
+   * considerations, the condition, situation, prior or concurrent issues.
+   */
+  readonly supportingInfo?: CoverageEligibilityRequestSupportingInfo[];
+
+  /**
+   * Financial instruments for reimbursement for the health care products
+   * and services.
+   */
+  readonly insurance?: CoverageEligibilityRequestInsurance[];
+
+  /**
+   * Service categories or billable services for which benefit details
+   * and/or an authorization prior to service delivery may be required by
+   * the payor.
+   */
+  readonly item?: CoverageEligibilityRequestItem[];
+}
+
+/**
+ * Financial instruments for reimbursement for the health care products
+ * and services.
+ */
+export interface CoverageEligibilityRequestInsurance {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * May be used to represent additional information that is not part of
+   * the basic definition of the element. To make the use of extensions
+   * safe and manageable, 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * May be used to represent additional information that is not part of
+   * the basic definition of the element and that modifies the
+   * understanding of the element in which it is contained 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 manageable, 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.
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A flag to indicate that this Coverage is to be used for evaluation of
+   * this request when set to true.
+   */
+  readonly focal?: boolean;
+
+  /**
+   * 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.
+   */
+  readonly coverage?: Reference<Coverage>;
+
+  /**
+   * A business agreement number established between the provider and the
+   * insurer for special business processing purposes.
+   */
+  readonly businessArrangement?: string;
+}
+
+/**
+ * Service categories or billable services for which benefit details
+ * and/or an authorization prior to service delivery may be required by
+ * the payor.
+ */
+export interface CoverageEligibilityRequestItem {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * May be used to represent additional information that is not part of
+   * the basic definition of the element. To make the use of extensions
+   * safe and manageable, 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * May be used to represent additional information that is not part of
+   * the basic definition of the element and that modifies the
+   * understanding of the element in which it is contained 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 manageable, 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.
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * Exceptions, special conditions and supporting information applicable
+   * for this service or product line.
+   */
+  readonly supportingInfoSequence?: number[];
+
+  /**
+   * Code to identify the general type of benefits under which products and
+   * services are provided.
+   */
+  readonly category?: CodeableConcept;
+
+  /**
+   * This contains the product, service, drug or other billing code for the
+   * item.
+   */
+  readonly productOrService?: CodeableConcept;
+
+  /**
+   * Item typification or modifiers codes to convey additional context for
+   * the product or service.
+   */
+  readonly modifier?: CodeableConcept[];
+
+  /**
+   * The practitioner who is responsible for the product or service to be
+   * rendered to the patient.
+   */
+  readonly provider?: Reference<Practitioner | PractitionerRole>;
+
+  /**
+   * The number of repetitions of a service or product.
+   */
+  readonly quantity?: Quantity;
+
+  /**
+   * The amount charged to the patient by the provider for a single unit.
+   */
+  readonly unitPrice?: Money;
+
+  /**
+   * Facility where the services will be provided.
+   */
+  readonly facility?: Reference<Location | Organization>;
+
+  /**
+   * Patient diagnosis for which care is sought.
+   */
+  readonly diagnosis?: CoverageEligibilityRequestItemDiagnosis[];
+
+  /**
+   * The plan/proposal/order describing the proposed service in detail.
+   */
+  readonly detail?: Reference<Resource>[];
+}
+
+/**
+ * Patient diagnosis for which care is sought.
+ */
+export interface CoverageEligibilityRequestItemDiagnosis {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * May be used to represent additional information that is not part of
+   * the basic definition of the element. To make the use of extensions
+   * safe and manageable, 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * May be used to represent additional information that is not part of
+   * the basic definition of the element and that modifies the
+   * understanding of the element in which it is contained 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 manageable, 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.
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * The nature of illness or problem in a coded form or as a reference to
+   * an external defined Condition.
+   */
+  readonly diagnosisCodeableConcept?: CodeableConcept;
+
+  /**
+   * The nature of illness or problem in a coded form or as a reference to
+   * an external defined Condition.
+   */
+  readonly diagnosisReference?: Reference<Condition>;
+}
+
+/**
+ * Additional information codes regarding exceptions, special
+ * considerations, the condition, situation, prior or concurrent issues.
+ */
+export interface CoverageEligibilityRequestSupportingInfo {
+
+  /**
+   * Unique id for the element within a resource (for internal references).
+   * This may be any string value that does not contain spaces.
+   */
+  readonly id?: string;
+
+  /**
+   * May be used to represent additional information that is not part of
+   * the basic definition of the element. To make the use of extensions
+   * safe and manageable, 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.
+   */
+  readonly extension?: Extension[];
+
+  /**
+   * May be used to represent additional information that is not part of
+   * the basic definition of the element and that modifies the
+   * understanding of the element in which it is contained 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 manageable, 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.
+   * 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).
+   */
+  readonly modifierExtension?: Extension[];
+
+  /**
+   * A number to uniquely identify supporting information entries.
+   */
+  readonly sequence?: number;
+
+  /**
+   * Additional data or information such as resources, documents, images
+   * etc. including references to the data or the actual inclusion of the
+   * data.
+   */
+  readonly information?: Reference<Resource>;
+
+  /**
+   * The supporting materials are applicable for all detail items,
+   * product/servce categories and specific billing codes.
+   */
+  readonly appliesToAll?: boolean;
+}