| /** |
| */ |
| package org.hl7.fhir; |
| |
| |
| /** |
| * <!-- begin-user-doc --> |
| * A representation of the model object '<em><b>Claim Response Adjudication</b></em>'. |
| * <!-- end-user-doc --> |
| * |
| * <!-- begin-model-doc --> |
| * This resource provides the adjudication details from the processing of a Claim resource. |
| * <!-- end-model-doc --> |
| * |
| * <p> |
| * The following features are supported: |
| * </p> |
| * <ul> |
| * <li>{@link org.hl7.fhir.ClaimResponseAdjudication#getCategory <em>Category</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimResponseAdjudication#getReason <em>Reason</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimResponseAdjudication#getAmount <em>Amount</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimResponseAdjudication#getValue <em>Value</em>}</li> |
| * </ul> |
| * |
| * @see org.hl7.fhir.FhirPackage#getClaimResponseAdjudication() |
| * @model extendedMetaData="name='ClaimResponse.Adjudication' kind='elementOnly'" |
| * @generated |
| */ |
| public interface ClaimResponseAdjudication extends BackboneElement { |
| /** |
| * Returns the value of the '<em><b>Category</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A code to indicate the information type of this adjudication record. Information types may include the value submitted, maximum values or percentages allowed or payable under the plan, amounts that: the patient is responsible for in aggregate or pertaining to this item; amounts paid by other coverages; and, the benefit payable for this item. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Category</em>' containment reference. |
| * @see #setCategory(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getClaimResponseAdjudication_Category() |
| * @model containment="true" required="true" |
| * extendedMetaData="kind='element' name='category' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getCategory(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimResponseAdjudication#getCategory <em>Category</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Category</em>' containment reference. |
| * @see #getCategory() |
| * @generated |
| */ |
| void setCategory(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Reason</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A code supporting the understanding of the adjudication result and explaining variance from expected amount. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Reason</em>' containment reference. |
| * @see #setReason(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getClaimResponseAdjudication_Reason() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='reason' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getReason(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimResponseAdjudication#getReason <em>Reason</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Reason</em>' containment reference. |
| * @see #getReason() |
| * @generated |
| */ |
| void setReason(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Amount</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Monetary amount associated with the category. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Amount</em>' containment reference. |
| * @see #setAmount(Money) |
| * @see org.hl7.fhir.FhirPackage#getClaimResponseAdjudication_Amount() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='amount' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Money getAmount(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimResponseAdjudication#getAmount <em>Amount</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Amount</em>' containment reference. |
| * @see #getAmount() |
| * @generated |
| */ |
| void setAmount(Money value); |
| |
| /** |
| * Returns the value of the '<em><b>Value</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A non-monetary value associated with the category. Mutually exclusive to the amount element above. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Value</em>' containment reference. |
| * @see #setValue(Decimal) |
| * @see org.hl7.fhir.FhirPackage#getClaimResponseAdjudication_Value() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='value' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Decimal getValue(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimResponseAdjudication#getValue <em>Value</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Value</em>' containment reference. |
| * @see #getValue() |
| * @generated |
| */ |
| void setValue(Decimal value); |
| |
| } // ClaimResponseAdjudication |
