| /** |
| */ |
| package org.hl7.fhir; |
| |
| import org.eclipse.emf.common.util.EList; |
| |
| /** |
| * <!-- begin-user-doc --> |
| * A representation of the model object '<em><b>Claim Coverage</b></em>'. |
| * <!-- end-user-doc --> |
| * |
| * <!-- begin-model-doc --> |
| * A provider issued list of services and products provided, or to be provided, to a patient which is provided to an insurer for payment recovery. |
| * <!-- end-model-doc --> |
| * |
| * <p> |
| * The following features are supported: |
| * </p> |
| * <ul> |
| * <li>{@link org.hl7.fhir.ClaimCoverage#getSequence <em>Sequence</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimCoverage#getFocal <em>Focal</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimCoverage#getCoverage <em>Coverage</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimCoverage#getBusinessArrangement <em>Business Arrangement</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimCoverage#getRelationship <em>Relationship</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimCoverage#getPreAuthRef <em>Pre Auth Ref</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimCoverage#getClaimResponse <em>Claim Response</em>}</li> |
| * <li>{@link org.hl7.fhir.ClaimCoverage#getOriginalRuleset <em>Original Ruleset</em>}</li> |
| * </ul> |
| * |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage() |
| * @model extendedMetaData="name='Claim.Coverage' kind='elementOnly'" |
| * @generated |
| */ |
| public interface ClaimCoverage extends BackboneElement { |
| /** |
| * Returns the value of the '<em><b>Sequence</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A service line item. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Sequence</em>' containment reference. |
| * @see #setSequence(PositiveInt) |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage_Sequence() |
| * @model containment="true" required="true" |
| * extendedMetaData="kind='element' name='sequence' namespace='##targetNamespace'" |
| * @generated |
| */ |
| PositiveInt getSequence(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimCoverage#getSequence <em>Sequence</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Sequence</em>' containment reference. |
| * @see #getSequence() |
| * @generated |
| */ |
| void setSequence(PositiveInt value); |
| |
| /** |
| * Returns the value of the '<em><b>Focal</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The instance number of the Coverage which is the focus for adjudication. The Coverage against which the claim is to be adjudicated. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Focal</em>' containment reference. |
| * @see #setFocal(org.hl7.fhir.Boolean) |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage_Focal() |
| * @model containment="true" required="true" |
| * extendedMetaData="kind='element' name='focal' namespace='##targetNamespace'" |
| * @generated |
| */ |
| org.hl7.fhir.Boolean getFocal(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimCoverage#getFocal <em>Focal</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Focal</em>' containment reference. |
| * @see #getFocal() |
| * @generated |
| */ |
| void setFocal(org.hl7.fhir.Boolean value); |
| |
| /** |
| * Returns the value of the '<em><b>Coverage</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * Reference to the program or plan identification, underwriter or payor. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Coverage</em>' containment reference. |
| * @see #setCoverage(Reference) |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage_Coverage() |
| * @model containment="true" required="true" |
| * extendedMetaData="kind='element' name='coverage' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Reference getCoverage(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimCoverage#getCoverage <em>Coverage</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Coverage</em>' containment reference. |
| * @see #getCoverage() |
| * @generated |
| */ |
| void setCoverage(Reference value); |
| |
| /** |
| * Returns the value of the '<em><b>Business Arrangement</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The contract number of a business agreement which describes the terms and conditions. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Business Arrangement</em>' containment reference. |
| * @see #setBusinessArrangement(org.hl7.fhir.String) |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage_BusinessArrangement() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='businessArrangement' namespace='##targetNamespace'" |
| * @generated |
| */ |
| org.hl7.fhir.String getBusinessArrangement(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimCoverage#getBusinessArrangement <em>Business Arrangement</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Business Arrangement</em>' containment reference. |
| * @see #getBusinessArrangement() |
| * @generated |
| */ |
| void setBusinessArrangement(org.hl7.fhir.String value); |
| |
| /** |
| * Returns the value of the '<em><b>Relationship</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The relationship of the patient to the subscriber. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Relationship</em>' containment reference. |
| * @see #setRelationship(Coding) |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage_Relationship() |
| * @model containment="true" required="true" |
| * extendedMetaData="kind='element' name='relationship' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Coding getRelationship(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimCoverage#getRelationship <em>Relationship</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Relationship</em>' containment reference. |
| * @see #getRelationship() |
| * @generated |
| */ |
| void setRelationship(Coding value); |
| |
| /** |
| * Returns the value of the '<em><b>Pre Auth Ref</b></em>' containment reference list. |
| * The list contents are of type {@link org.hl7.fhir.String}. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * A list of references from the Insurer to which these services pertain. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Pre Auth Ref</em>' containment reference list. |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage_PreAuthRef() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='preAuthRef' namespace='##targetNamespace'" |
| * @generated |
| */ |
| EList<org.hl7.fhir.String> getPreAuthRef(); |
| |
| /** |
| * Returns the value of the '<em><b>Claim Response</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The Coverages adjudication details. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Claim Response</em>' containment reference. |
| * @see #setClaimResponse(Reference) |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage_ClaimResponse() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='claimResponse' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Reference getClaimResponse(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimCoverage#getClaimResponse <em>Claim Response</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Claim Response</em>' containment reference. |
| * @see #getClaimResponse() |
| * @generated |
| */ |
| void setClaimResponse(Reference value); |
| |
| /** |
| * Returns the value of the '<em><b>Original Ruleset</b></em>' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * <!-- begin-model-doc --> |
| * The style (standard) and version of the original material which was converted into this resource. |
| * <!-- end-model-doc --> |
| * @return the value of the '<em>Original Ruleset</em>' containment reference. |
| * @see #setOriginalRuleset(Coding) |
| * @see org.hl7.fhir.FhirPackage#getClaimCoverage_OriginalRuleset() |
| * @model containment="true" |
| * extendedMetaData="kind='element' name='originalRuleset' namespace='##targetNamespace'" |
| * @generated |
| */ |
| Coding getOriginalRuleset(); |
| |
| /** |
| * Sets the value of the '{@link org.hl7.fhir.ClaimCoverage#getOriginalRuleset <em>Original Ruleset</em>}' containment reference. |
| * <!-- begin-user-doc --> |
| * <!-- end-user-doc --> |
| * @param value the new value of the '<em>Original Ruleset</em>' containment reference. |
| * @see #getOriginalRuleset() |
| * @generated |
| */ |
| void setOriginalRuleset(Coding value); |
| |
| } // ClaimCoverage |
