Struct ClaimResponseBuilder 

pub struct ClaimResponseBuilder { /* private fields */ }

Builder for ClaimResponseInner.

Implementations

impl ClaimResponseBuilder

pub fn id(self, value: String) -> ClaimResponseBuilder

Logical id of this artifact

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

pub fn meta(self, value: Meta) -> ClaimResponseBuilder

Metadata about the resource

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.

pub fn implicit_rules(self, value: String) -> ClaimResponseBuilder

A set of rules under which this content was created

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.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

pub fn language(self, value: String) -> ClaimResponseBuilder

Language; Language of the resource content

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

pub fn text(self, value: Narrative) -> ClaimResponseBuilder

Text summary of the resource, for human interpretation

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.

Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a “text blob” or where text is additionally entered raw or narrated and encoded information is added later.

pub fn contained(self, value: Vec<Resource>) -> ClaimResponseBuilder

Contained, inline Resources

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

pub fn extension(self, value: Vec<Extension>) -> ClaimResponseBuilder

Additional content defined by implementations

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 managable, 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.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

pub fn modifier_extension(self, value: Vec<Extension>) -> ClaimResponseBuilder

Extensions that cannot be ignored

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 managable, 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).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

pub fn identifier(self, value: Vec<Option<Identifier>>) -> ClaimResponseBuilder

Business Identifier for a claim response

A unique identifier assigned to this claim response.

pub fn identifier_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn trace_number( self, value: Vec<Option<Identifier>>, ) -> ClaimResponseBuilder

Number for tracking

Trace number for tracking purposes. May be defined at the jurisdiction level or between trading partners.

pub fn trace_number_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn status(self, value: String) -> ClaimResponseBuilder

ClaimResponseStatus; active | cancelled | draft | entered-in-error

The status of the resource instance.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

pub fn status_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn type(self, value: CodeableConcept) -> ClaimResponseBuilder

ClaimType; More granular claim type

A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.

This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.

pub fn type_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn sub_type(self, value: CodeableConcept) -> ClaimResponseBuilder

ClaimSubType; More granular claim type

A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.

This may contain the local bill type codes, for example the US UB-04 bill type code or the CMS bill type.

pub fn sub_type_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn use(self, value: Use) -> ClaimResponseBuilder

Use; claim | preauthorization | predetermination

A code to indicate whether the nature of the request is: Claim - A request to an Insurer to adjudicate the supplied charges for health care goods and services under the identified policy and to pay the determined Benefit amount, if any; Preauthorization - A request to an Insurer to adjudicate the supplied proposed future charges for health care goods and services under the identified policy and to approve the services and provide the expected benefit amounts and potentially to reserve funds to pay the benefits when Claims for the indicated services are later submitted; or, Pre-determination - A request to an Insurer to adjudicate the supplied ‘what if’ charges for health care goods and services under the identified policy and report back what the Benefit payable would be had the services actually been provided.

pub fn use_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn patient(self, value: Reference) -> ClaimResponseBuilder

The recipient of the products and services

The party to whom the professional services and/or products have been supplied or are being considered and for whom actual for facast reimbursement is sought.

pub fn patient_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn created(self, value: DateTime) -> ClaimResponseBuilder

Response creation date

The date this resource was created.

pub fn created_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn insurer(self, value: Reference) -> ClaimResponseBuilder

Party responsible for reimbursement

The party responsible for authorization, adjudication and reimbursement.

pub fn insurer_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn requestor(self, value: Reference) -> ClaimResponseBuilder

Party responsible for the claim

The provider which is responsible for the claim, predetermination or preauthorization.

Typically this field would be 1..1 where this party is accountable for the data content within the claim but is not necessarily the facility, provider group or practitioner who provided the products and services listed within this claim resource. This field is the Billing Provider, for example, a facility, provider group, lab or practitioner..

pub fn requestor_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn request(self, value: Reference) -> ClaimResponseBuilder

Id of resource triggering adjudication

Original request resource reference.

pub fn request_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn outcome(self, value: RemittanceOutcome) -> ClaimResponseBuilder

RemittanceOutcome; queued | complete | error | partial

The outcome of the claim, predetermination, or preauthorization processing.

The resource may be used to indicate that the Claim/Preauthorization/Pre-determination has been received but processing has not begun (queued); that it has been processed and one or more errors have been detected (error); no errors were detected and some of the adjudication processing has been performed (partial); or all of the adjudication processing has completed without errors (complete).

pub fn outcome_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn decision(self, value: CodeableConcept) -> ClaimResponseBuilder

AdjudicationDecision; Result of the adjudication

The result of the claim, predetermination, or preauthorization adjudication.

The element is used to indicate the current state of the adjudication overall for the claim resource, for example: the request has been held (pended) for adjudication processing, for manual review or other reasons; that it has been processed and will be paid, or the outstanding paid, as submitted (approved); that no amount will be paid (denied); or that some amount between zero and the submitted amount will be paid (partial).

pub fn decision_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn disposition(self, value: String) -> ClaimResponseBuilder

Disposition Message

A human readable description of the status of the adjudication.

pub fn disposition_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn pre_auth_ref(self, value: String) -> ClaimResponseBuilder

Preauthorization reference

Reference from the Insurer which is used in later communications which refers to this adjudication.

This value is only present on preauthorization adjudications.

pub fn pre_auth_ref_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn pre_auth_period(self, value: Period) -> ClaimResponseBuilder

Preauthorization reference effective period

The time frame during which this authorization is effective.

pub fn pre_auth_period_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn event( self, value: Vec<Option<ClaimResponseEvent>>, ) -> ClaimResponseBuilder

Event information

Information code for an event with a corresponding date or period.

pub fn event_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn payee_type(self, value: CodeableConcept) -> ClaimResponseBuilder

PayeeType; Party to be paid any benefits payable

Type of Party to be reimbursed: subscriber, provider, other.

pub fn payee_type_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn encounter(self, value: Vec<Option<Reference>>) -> ClaimResponseBuilder

Encounters associated with the listed treatments

Healthcare encounters related to this claim.

This will typically be the encounter the event occurred within, but some activities may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter.

pub fn encounter_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn diagnosis_related_group( self, value: CodeableConcept, ) -> ClaimResponseBuilder

DiagnosisRelatedGroup; Package billing code

A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.

For example DRG (Diagnosis Related Group) or a bundled billing code. A patient may have a diagnosis of a Myocardial Infarction and a DRG for HeartAttack would be assigned. The Claim item (and possible subsequent claims) would refer to the DRG for those line items that were for services related to the heart attack event.

pub fn diagnosis_related_group_ext( self, value: FieldExtension, ) -> ClaimResponseBuilder

Extension field.

pub fn item(self, value: Vec<Option<ClaimResponseItem>>) -> ClaimResponseBuilder

Adjudication for claim line items

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.

pub fn item_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn add_item( self, value: Vec<Option<ClaimResponseAddItem>>, ) -> ClaimResponseBuilder

Insurer added line items

The first-tier service adjudications for payor added product or service lines.

pub fn add_item_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn adjudication( self, value: Vec<Option<ClaimResponseItemAdjudication>>, ) -> ClaimResponseBuilder

Header-level adjudication

The adjudication results which are presented at the header level rather than at the line-item or add-item levels.

pub fn adjudication_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn total( self, value: Vec<Option<ClaimResponseTotal>>, ) -> ClaimResponseBuilder

Adjudication totals

Categorized monetary totals for the adjudication.

Totals for amounts submitted, co-pays, benefits payable etc.

pub fn total_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn payment(self, value: ClaimResponsePayment) -> ClaimResponseBuilder

Payment Details

Payment details for the adjudication of the claim.

pub fn payment_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn funds_reserve(self, value: CodeableConcept) -> ClaimResponseBuilder

FundsReserve; Funds reserved status

A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.

Fund would be release by a future claim quoting the preAuthRef of this response. Examples of values include: provider, patient, none.

pub fn funds_reserve_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn form_code(self, value: CodeableConcept) -> ClaimResponseBuilder

Forms; Printed form identifier

A code for the form to be used for printing the content.

May be needed to identify specific jurisdictional forms.

pub fn form_code_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn form(self, value: Attachment) -> ClaimResponseBuilder

Printed reference or actual form

The actual form, by reference or inclusion, for printing the content or an EOB.

Needed to permit insurers to include the actual form.

pub fn form_ext(self, value: FieldExtension) -> ClaimResponseBuilder

Extension field.

pub fn process_note( self, value: Vec<Option<ClaimResponseProcessNote>>, ) -> ClaimResponseBuilder

Note concerning adjudication

A note that describes or explains adjudication results in a human readable form.

pub fn process_note_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn communication_request( self, value: Vec<Option<Reference>>, ) -> ClaimResponseBuilder

Request for additional information

Request for additional supporting or authorizing information.

For example: professional reports, documents, images, clinical resources, or accident reports.

pub fn communication_request_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn insurance( self, value: Vec<Option<ClaimResponseInsurance>>, ) -> ClaimResponseBuilder

Patient insurance information

Financial instruments for reimbursement for the health care products and services specified on the claim.

All insurance coverages for the patient which may be applicable for reimbursement, of the products and services listed in the claim, are typically provided in the claim to allow insurers to confirm the ordering of the insurance coverages relative to local ‘coordination of benefit’ rules. One coverage (and only one) with ‘focal=true’ is to be used in the adjudication of this claim. Coverages appearing before the focal Coverage in the list, and where ‘subrogation=false’, should provide a reference to the ClaimResponse containing the adjudication results of the prior claim.

pub fn insurance_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn error( self, value: Vec<Option<ClaimResponseError>>, ) -> ClaimResponseBuilder

Processing errors

Errors encountered during the processing of the adjudication.

If the request contains errors then an error element should be provided and no adjudication related sections (item, addItem, or payment) should be present.

pub fn error_ext( self, value: Vec<Option<FieldExtension>>, ) -> ClaimResponseBuilder

Extension field.

pub fn build_inner(self) -> Result<ClaimResponseInner, BuilderError>

Builds a new ClaimResponseInner.

Errors

If a required field has not been initialized.

impl ClaimResponseBuilder

pub fn build(self) -> Result<ClaimResponse, BuilderError>

Finalize building ClaimResponse.

Trait Implementations

impl Default for ClaimResponseBuilder

fn default() -> ClaimResponseBuilder

Returns the “default value” for a type.