:py:mod:`spark_auto_mapper_fhir.resources.explanation_of_benefit` ================================================================= .. py:module:: spark_auto_mapper_fhir.resources.explanation_of_benefit Module Contents --------------- Classes ~~~~~~~ .. autoapisummary:: spark_auto_mapper_fhir.resources.explanation_of_benefit.ExplanationOfBenefit .. py:class:: ExplanationOfBenefit(*, id_ = None, meta = None, implicitRules = None, language = None, text = None, contained = None, extension = None, modifierExtension = None, identifier = None, status, type_, subType = None, use, patient, billablePeriod = None, created, enterer = None, insurer, provider, priority = None, fundsReserveRequested = None, fundsReserve = None, related = None, prescription = None, originalPrescription = None, payee = None, referral = None, facility = None, claim = None, claimResponse = None, outcome, disposition = None, preAuthRef = None, preAuthRefPeriod = None, careTeam = None, supportingInfo = None, diagnosis = None, procedure = None, precedence = None, insurance, accident = None, item = None, addItem = None, adjudication = None, total = None, payment = None, formCode = None, form = None, processNote = None, benefitPeriod = None, benefitBalance = None) Bases: :py:obj:`spark_auto_mapper_fhir.base_types.fhir_resource_base.FhirResourceBase` ExplanationOfBenefit explanationofbenefit.xsd This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided. If the element is present, it must have either a @value, an @id, or extensions This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided. If the element is present, it must have either a @value, an @id, or extensions :param id_: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. :param meta: 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. :param implicitRules: 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. :param language: The base language in which the resource is written. :param text: 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. :param contained: 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. :param extension: 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. :param modifierExtension: 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). :param identifier: A unique identifier assigned to this explanation of benefit. :param status: The status of the resource instance. :param type_: The category of claim, e.g. oral, pharmacy, vision, institutional, professional. :param subType: A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service. :param use: A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future. :param patient: The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought. :param billablePeriod: The period for which charges are being submitted. :param created: The date this resource was created. :param enterer: Individual who created the claim, predetermination or preauthorization. :param insurer: The party responsible for authorization, adjudication and reimbursement. :param provider: The provider which is responsible for the claim, predetermination or preauthorization. :param priority: The provider-required urgency of processing the request. Typical values include: stat, routine deferred. :param fundsReserveRequested: A code to indicate whether and for whom funds are to be reserved for future claims. :param fundsReserve: A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom. :param related: Other claims which are related to this claim such as prior submissions or claims for related services or for the same event. :param prescription: Prescription to support the dispensing of pharmacy, device or vision products. :param originalPrescription: Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products. :param payee: The party to be reimbursed for cost of the products and services according to the terms of the policy. :param referral: A reference to a referral resource. :param facility: Facility where the services were provided. :param claim: The business identifier for the instance of the adjudication request: claim predetermination or preauthorization. :param claimResponse: The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response. :param outcome: The outcome of the claim, predetermination, or preauthorization processing. :param disposition: A human readable description of the status of the adjudication. :param preAuthRef: Reference from the Insurer which is used in later communications which refers to this adjudication. :param preAuthRefPeriod: The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided. :param careTeam: The members of the team who provided the products and services. :param supportingInfo: Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues. :param diagnosis: Information about diagnoses relevant to the claim items. :param procedure: Procedures performed on the patient relevant to the billing items with the claim. :param precedence: This indicates the relative order of a series of EOBs related to different coverages for the same suite of services. :param insurance: Financial instruments for reimbursement for the health care products and services specified on the claim. :param accident: Details of a accident which resulted in injuries which required the products and services listed in the claim. :param item: A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details. :param addItem: The first-tier service adjudications for payor added product or service lines. :param adjudication: The adjudication results which are presented at the header level rather than at the line-item or add-item levels. :param total: Categorized monetary totals for the adjudication. :param payment: Payment details for the adjudication of the claim. :param formCode: A code for the form to be used for printing the content. :param form: The actual form, by reference or inclusion, for printing the content or an EOB. :param processNote: A note that describes or explains adjudication results in a human readable form. :param benefitPeriod: The term of the benefits documented in this response. :param benefitBalance: Balance by Benefit Category. .. py:method:: get_schema(self, include_extension)