@medplum/fhirtypes 0.3.0

package/dist/CoverageEligibilityResponse.d.ts

@@ -0,0 +1,507 @@
+/*
+ * Generated by @medplum/generator
+ * Do not edit manually.
+ */
+
+import { CodeableConcept } from './CodeableConcept';
+import { Coverage } from './Coverage';
+import { CoverageEligibilityRequest } from './CoverageEligibilityRequest';
+import { Extension } from './Extension';
+import { Identifier } from './Identifier';
+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 { Reference } from './Reference';
+import { Resource } from './Resource';
+
+/**
+ * This resource provides eligibility and plan details from the
+ * processing of an CoverageEligibilityRequest resource.
+ */
+export interface CoverageEligibilityResponse {
+
+  /**
+   * This is a CoverageEligibilityResponse resource
+   */
+  readonly resourceType: 'CoverageEligibilityResponse';
+
+  /**
+   * 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;
+
+  /**
+   * 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 this resource was created.
+   */
+  readonly created?: string;
+
+  /**
+   * The provider which is responsible for the request.
+   */
+  readonly requestor?: Reference<Practitioner | PractitionerRole | Organization>;
+
+  /**
+   * Reference to the original request resource.
+   */
+  readonly request?: Reference<CoverageEligibilityRequest>;
+
+  /**
+   * The outcome of the request processing.
+   */
+  readonly outcome?: string;
+
+  /**
+   * A human readable description of the status of the adjudication.
+   */
+  readonly disposition?: string;
+
+  /**
+   * The Insurer who issued the coverage in question and is the author of
+   * the response.
+   */
+  readonly insurer?: Reference<Organization>;
+
+  /**
+   * Financial instruments for reimbursement for the health care products
+   * and services.
+   */
+  readonly insurance?: CoverageEligibilityResponseInsurance[];
+
+  /**
+   * A reference from the Insurer to which these services pertain to be
+   * used on further communication and as proof that the request occurred.
+   */
+  readonly preAuthRef?: string;
+
+  /**
+   * A code for the form to be used for printing the content.
+   */
+  readonly form?: CodeableConcept;
+
+  /**
+   * Errors encountered during the processing of the request.
+   */
+  readonly error?: CoverageEligibilityResponseError[];
+}
+
+/**
+ * Errors encountered during the processing of the request.
+ */
+export interface CoverageEligibilityResponseError {
+
+  /**
+   * 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[];
+
+  /**
+   * An error code,from a specified code system, which details why the
+   * eligibility check could not be performed.
+   */
+  readonly code?: CodeableConcept;
+}
+
+/**
+ * Financial instruments for reimbursement for the health care products
+ * and services.
+ */
+export interface CoverageEligibilityResponseInsurance {
+
+  /**
+   * 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[];
+
+  /**
+   * 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>;
+
+  /**
+   * Flag indicating if the coverage provided is inforce currently if no
+   * service date(s) specified or for the whole duration of the service
+   * dates.
+   */
+  readonly inforce?: boolean;
+
+  /**
+   * The term of the benefits documented in this response.
+   */
+  readonly benefitPeriod?: Period;
+
+  /**
+   * Benefits and optionally current balances, and authorization details by
+   * category or service.
+   */
+  readonly item?: CoverageEligibilityResponseInsuranceItem[];
+}
+
+/**
+ * Benefits and optionally current balances, and authorization details by
+ * category or service.
+ */
+export interface CoverageEligibilityResponseInsuranceItem {
+
+  /**
+   * 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[];
+
+  /**
+   * 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 eligible for the provision of the product or
+   * service.
+   */
+  readonly provider?: Reference<Practitioner | PractitionerRole>;
+
+  /**
+   * 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.
+   */
+  readonly excluded?: boolean;
+
+  /**
+   * A short name or tag for the benefit.
+   */
+  readonly name?: string;
+
+  /**
+   * A richer description of the benefit or services covered.
+   */
+  readonly description?: string;
+
+  /**
+   * Is a flag to indicate whether the benefits refer to in-network
+   * providers or out-of-network providers.
+   */
+  readonly network?: CodeableConcept;
+
+  /**
+   * Indicates if the benefits apply to an individual or to the family.
+   */
+  readonly unit?: CodeableConcept;
+
+  /**
+   * The term or period of the values such as 'maximum lifetime benefit' or
+   * 'maximum annual visits'.
+   */
+  readonly term?: CodeableConcept;
+
+  /**
+   * Benefits used to date.
+   */
+  readonly benefit?: CoverageEligibilityResponseInsuranceItemBenefit[];
+
+  /**
+   * A boolean flag indicating whether a preauthorization is required prior
+   * to actual service delivery.
+   */
+  readonly authorizationRequired?: boolean;
+
+  /**
+   * Codes or comments regarding information or actions associated with the
+   * preauthorization.
+   */
+  readonly authorizationSupporting?: CodeableConcept[];
+
+  /**
+   * A web location for obtaining requirements or descriptive information
+   * regarding the preauthorization.
+   */
+  readonly authorizationUrl?: string;
+}
+
+/**
+ * Benefits used to date.
+ */
+export interface CoverageEligibilityResponseInsuranceItemBenefit {
+
+  /**
+   * 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[];
+
+  /**
+   * Classification of benefit being provided.
+   */
+  readonly type?: CodeableConcept;
+
+  /**
+   * The quantity of the benefit which is permitted under the coverage.
+   */
+  readonly allowedUnsignedInt?: number;
+
+  /**
+   * The quantity of the benefit which is permitted under the coverage.
+   */
+  readonly allowedString?: string;
+
+  /**
+   * The quantity of the benefit which is permitted under the coverage.
+   */
+  readonly allowedMoney?: Money;
+
+  /**
+   * The quantity of the benefit which have been consumed to date.
+   */
+  readonly usedUnsignedInt?: number;
+
+  /**
+   * The quantity of the benefit which have been consumed to date.
+   */
+  readonly usedString?: string;
+
+  /**
+   * The quantity of the benefit which have been consumed to date.
+   */
+  readonly usedMoney?: Money;
+}