| /** |
| */ |
| package org.hl7.fhir; |
| |
| import org.eclipse.emf.common.util.EList; |
| |
| /** |
| * <!-- begin-user-doc --> |
| * A representation of the model object '<em><b>Coverage Eligibility Response Item</b></em>'. |
| * <!-- end-user-doc --> |
| * |
| * <!-- begin-model-doc --> |
| * This resource provides eligibility and plan details from the processing of an CoverageEligibilityRequest resource. |
| * <!-- end-model-doc --> |
| * |
| * <p> |
| * The following features are supported: |
| * </p> |
| * <ul> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getCategory <em>Category</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getProductOrService <em>Product Or Service</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getModifier <em>Modifier</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getProvider <em>Provider</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getExcluded <em>Excluded</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getName <em>Name</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getDescription <em>Description</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getNetwork <em>Network</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getUnit <em>Unit</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getTerm <em>Term</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getBenefit <em>Benefit</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getAuthorizationRequired <em>Authorization Required</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getAuthorizationSupporting <em>Authorization Supporting</em>}</li> |
| * <li>{@link org.hl7.fhir.CoverageEligibilityResponseItem#getAuthorizationUrl <em>Authorization Url</em>}</li> |
| * </ul> |
| * |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem() |
| * @model extendedMetaData="name='CoverageEligibilityResponse.Item' kind='elementOnly'" |
| * @generated |
| */ |
| public interface CoverageEligibilityResponseItem extends BackboneElement { |
| /** |
| * Returns the value of the '<em><b>Category</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Code to identify the general type of benefits under which products and services are provided. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Category</em>' containment reference. |
| * @see #setCategory(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Category() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='category' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getCategory(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#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>Product Or Service</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * This contains the product, service, drug or other billing code for the item. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Product Or Service</em>' containment reference. |
| * @see #setProductOrService(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_ProductOrService() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='productOrService' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getProductOrService(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getProductOrService <em>Product Or Service</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Product Or Service</em>' containment reference. |
| * @see #getProductOrService() |
| * @generated |
| */ |
| void setProductOrService(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Modifier</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.CodeableConcept}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Item typification or modifiers codes to convey additional context for the product or service. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Modifier</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Modifier() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='modifier' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<CodeableConcept> getModifier(); |
| |
| /** |
| * Returns the value of the '<em><b>Provider</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The practitioner who is eligible for the provision of the product or service. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Provider</em>' containment reference. |
| * @see #setProvider(Reference) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Provider() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='provider' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Reference getProvider(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getProvider <em>Provider</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Provider</em>' containment reference. |
| * @see #getProvider() |
| * @generated |
| */ |
| void setProvider(Reference value); |
| |
| /** |
| * Returns the value of the '<em><b>Excluded</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * 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. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Excluded</em>' containment reference. |
| * @see #setExcluded(org.hl7.fhir.Boolean) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Excluded() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='excluded' namespace='##targetNamespace'" |
| * @generated |
| */ |
| org.hl7.fhir.Boolean getExcluded(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getExcluded <em>Excluded</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Excluded</em>' containment reference. |
| * @see #getExcluded() |
| * @generated |
| */ |
| void setExcluded(org.hl7.fhir.Boolean value); |
| |
| /** |
| * Returns the value of the '<em><b>Name</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A short name or tag for the benefit. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Name</em>' containment reference. |
| * @see #setName(org.hl7.fhir.String) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Name() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='name' namespace='##targetNamespace'" |
| * @generated |
| */ |
| org.hl7.fhir.String getName(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getName <em>Name</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Name</em>' containment reference. |
| * @see #getName() |
| * @generated |
| */ |
| void setName(org.hl7.fhir.String value); |
| |
| /** |
| * Returns the value of the '<em><b>Description</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A richer description of the benefit or services covered. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Description</em>' containment reference. |
| * @see #setDescription(org.hl7.fhir.String) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Description() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='description' namespace='##targetNamespace'" |
| * @generated |
| */ |
| org.hl7.fhir.String getDescription(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getDescription <em>Description</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Description</em>' containment reference. |
| * @see #getDescription() |
| * @generated |
| */ |
| void setDescription(org.hl7.fhir.String value); |
| |
| /** |
| * Returns the value of the '<em><b>Network</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Is a flag to indicate whether the benefits refer to in-network providers or out-of-network providers. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Network</em>' containment reference. |
| * @see #setNetwork(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Network() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='network' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getNetwork(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getNetwork <em>Network</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Network</em>' containment reference. |
| * @see #getNetwork() |
| * @generated |
| */ |
| void setNetwork(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Unit</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Indicates if the benefits apply to an individual or to the family. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Unit</em>' containment reference. |
| * @see #setUnit(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Unit() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='unit' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getUnit(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getUnit <em>Unit</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Unit</em>' containment reference. |
| * @see #getUnit() |
| * @generated |
| */ |
| void setUnit(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Term</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The term or period of the values such as 'maximum lifetime benefit' or 'maximum annual visits'. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Term</em>' containment reference. |
| * @see #setTerm(CodeableConcept) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Term() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='term' namespace='##targetNamespace'" |
| * @generated |
| */ |
| CodeableConcept getTerm(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getTerm <em>Term</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Term</em>' containment reference. |
| * @see #getTerm() |
| * @generated |
| */ |
| void setTerm(CodeableConcept value); |
| |
| /** |
| * Returns the value of the '<em><b>Benefit</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.CoverageEligibilityResponseBenefit}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Benefits used to date. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Benefit</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_Benefit() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='benefit' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<CoverageEligibilityResponseBenefit> getBenefit(); |
| |
| /** |
| * Returns the value of the '<em><b>Authorization Required</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A boolean flag indicating whether a preauthorization is required prior to actual service delivery. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Authorization Required</em>' containment reference. |
| * @see #setAuthorizationRequired(org.hl7.fhir.Boolean) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_AuthorizationRequired() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='authorizationRequired' namespace='##targetNamespace'" |
| * @generated |
| */ |
| org.hl7.fhir.Boolean getAuthorizationRequired(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getAuthorizationRequired <em>Authorization Required</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Authorization Required</em>' containment reference. |
| * @see #getAuthorizationRequired() |
| * @generated |
| */ |
| void setAuthorizationRequired(org.hl7.fhir.Boolean value); |
| |
| /** |
| * Returns the value of the '<em><b>Authorization Supporting</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.CodeableConcept}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Codes or comments regarding information or actions associated with the preauthorization. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Authorization Supporting</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_AuthorizationSupporting() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='authorizationSupporting' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<CodeableConcept> getAuthorizationSupporting(); |
| |
| /** |
| * Returns the value of the '<em><b>Authorization Url</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A web location for obtaining requirements or descriptive information regarding the preauthorization. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Authorization Url</em>' containment reference. |
| * @see #setAuthorizationUrl(Uri) |
| * @see org.hl7.fhir.FhirPackage#getCoverageEligibilityResponseItem_AuthorizationUrl() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='authorizationUrl' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Uri getAuthorizationUrl(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.CoverageEligibilityResponseItem#getAuthorizationUrl <em>Authorization Url</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Authorization Url</em>' containment reference. |
| * @see #getAuthorizationUrl() |
| * @generated |
| */ |
| void setAuthorizationUrl(Uri value); |
| |
| } // CoverageEligibilityResponseItem |
