EnrollEligCOB UML Documentation

Element

EnrollEligCOB
Class Claim

"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." - HL7 FHIR, Claim

Attributes
Accident	accident	"An accident which resulted in the need for healthcare services." - HL7 FHIR, Claim.accident
«IVL_TS» Period	billablePeriod	"The billable period for which charges are being submitted." - HL7 FHIR, Claim.billablePeriod
«TS» PointInTime	dateCreated	"The date when the enclosed suite of services were performed or completed." - HL7 FHIR, Claim.created
DiagnosisListEntry	diagnosis	"List of patient diagnosis for which care is sought." - HL7 FHIR, Claim.diagnosis
Participation	enterer	"Person who created the invoice/claim/pre-determination or pre-authorization." - HL7 FHIR, Claim.enterer
«CS» Code	fundsReserve	"In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved (Patient or Provider) to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested." - HL7 FHIR, Claim.fundsReserve
«II» Id	identifier	"The business identifier for the instance: claim number, pre-determination or pre-authorization number." - HL7 FHIR, Claim.identifier
«IVL_TS» Period	periodEmploymentImpacted	"The start and optional end dates of when the patient was precluded from working due to the treatable condition(s)." - HL7 FHIR, Claim.employmentImpacted
«IVL_TS» Period	periodHospitalized	"The start and optional end dates of when the patient was confined to a treatment center." - HL7 FHIR, Claim.hospitalization
«CS» Code	priority	"Immediate (STAT), best effort (NORMAL), deferred (DEFER)." - HL7 FHIR, Claim.priority
OrganizationalProvider	requestOrganization
HealthcareProvider	requestProvider
«CS» Code	status	"The status of the resource instance." - HL7 FHIR, Claim.status
«CS» Code	subType	"A finer grained suite of claim subtype codes which may convey Inpatient vs Outpatient and/or a specialty service. In the US the BillType." - HL7 FHIR, Claim.subType
«MO» MonetaryAmount	total	"The total value of the claim." - HL7 FHIR, Claim.total
«CS» Code	type	"The category of claim, eg, oral, pharmacy, vision, insitutional, professional." - HL7 FHIR, Claim.type
«CS» Code	use	"Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination)." - HL7 FHIR, Claim.use

Properties:

Alias
Classifier Behavior
Is Abstract	false
Is Active	false
Is Leaf	false
Keywords
Name	Claim
Name Expression
Namespace	EnrollEligCOB
Owned Template Signature
Owner	EnrollEligCOB
Owning Template Parameter
Package	EnrollEligCOB
Qualified Name	FHIM::EnrollEligCOB::Claim
Representation
Stereotype
Template Parameter
Visibility	Public

Attribute Details

accident

Public Accident accident

"An accident which resulted in the need for healthcare services." - HL7 FHIR, Claim.accident

Constraints:

Properties:

Aggregation	None
Alias
Association	claim_accident
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	accident
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::accident
Stereotype
Template Parameter
Type	Accident
Upper	1
Upper Value	(1)
Visibility	Public

billablePeriod

Public «IVL_TS» Period billablePeriod

"The billable period for which charges are being submitted." - HL7 FHIR, Claim.billablePeriod

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	billablePeriod
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::billablePeriod
Stereotype
Template Parameter
Type	«IVL_TS» Period
Upper	1
Upper Value	(1)
Visibility	Public

dateCreated

Public «TS» PointInTime dateCreated

"The date when the enclosed suite of services were performed or completed." - HL7 FHIR, Claim.created

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	dateCreated
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::dateCreated
Stereotype
Template Parameter
Type	«TS» PointInTime
Upper	1
Upper Value	(1)
Visibility	Public

diagnosis

Public DiagnosisListEntry diagnosis

"List of patient diagnosis for which care is sought." - HL7 FHIR, Claim.diagnosis

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	diagnosis
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::diagnosis
Stereotype
Template Parameter
Type	DiagnosisListEntry
Upper	*
Upper Value	(*)
Visibility	Public

enterer

Public Participation enterer

"Person who created the invoice/claim/pre-determination or pre-authorization." - HL7 FHIR, Claim.enterer

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	enterer
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::enterer
Stereotype
Template Parameter
Type	Participation
Upper	1
Upper Value	(1)
Visibility	Public

fundsReserve

Public «CS» Code fundsReserve

"In the case of a Pre-Determination/Pre-Authorization the provider may request that funds in the amount of the expected Benefit be reserved (Patient or Provider) to pay for the Benefits determined on the subsequent claim(s). 'None' explicitly indicates no funds reserving is requested." - HL7 FHIR, Claim.fundsReserve

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Terminologies	[ HL7_FHIR_R4 Funds Reservation Codes http://hl7.org/fhir/ValueSet/fundsreserve ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	fundsReserve
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::fundsReserve
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

identifier

Public «II» Id identifier

"The business identifier for the instance: claim number, pre-determination or pre-authorization number." - HL7 FHIR, Claim.identifier

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	identifier
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::identifier
Stereotype
Template Parameter
Type	«II» Id
Upper	*
Upper Value	(*)
Visibility	Public

periodEmploymentImpacted

Public «IVL_TS» Period periodEmploymentImpacted

"The start and optional end dates of when the patient was precluded from working due to the treatable condition(s)." - HL7 FHIR, Claim.employmentImpacted

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	periodEmploymentImpacted
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::periodEmploymentImpacted
Stereotype
Template Parameter
Type	«IVL_TS» Period
Upper	1
Upper Value	(1)
Visibility	Public

periodHospitalized

Public «IVL_TS» Period periodHospitalized

"The start and optional end dates of when the patient was confined to a treatment center." - HL7 FHIR, Claim.hospitalization

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	periodHospitalized
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::periodHospitalized
Stereotype
Template Parameter
Type	«IVL_TS» Period
Upper	1
Upper Value	(1)
Visibility	Public

priority

Public «CS» Code priority

"Immediate (STAT), best effort (NORMAL), deferred (DEFER)." - HL7 FHIR, Claim.priority

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Terminologies	[ HL7_FHIR_R4 Process Priority Codes http://hl7.org/fhir/ValueSet/process-priority ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	priority
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::priority
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

requestOrganization

Public OrganizationalProvider requestOrganization

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	requestOrganization
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::requestOrganization
Stereotype
Template Parameter
Type	OrganizationalProvider
Upper	1
Upper Value	(1)
Visibility	Public

requestProvider

Public HealthcareProvider requestProvider

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	requestProvider
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::requestProvider
Stereotype
Template Parameter
Type	HealthcareProvider
Upper	1
Upper Value	(1)
Visibility	Public

status

Public «CS» Code status

"The status of the resource instance." - HL7 FHIR, Claim.status

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Terminologies	[ HL7_FHIR_R4 Financial Resource Status Codes http://hl7.org/fhir/ValueSet/fm-status ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	status
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::status
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

subType

Public «CS» Code subType

"A finer grained suite of claim subtype codes which may convey Inpatient vs Outpatient and/or a specialty service. In the US the BillType." - HL7 FHIR, Claim.subType

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Terminologies	[ HL7_FHIR_R4 Example Claim SubType Codes http://hl7.org/fhir/ValueSet/claim-subtype ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	*
Name	subType
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::subType
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	*
Upper Value	(*)
Visibility	Public

total

Public «MO» MonetaryAmount total

"The total value of the claim." - HL7 FHIR, Claim.total

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	total
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::total
Stereotype
Template Parameter
Type	«MO» MonetaryAmount
Upper	1
Upper Value	(1)
Visibility	Public

type

Public «CS» Code type

"The category of claim, eg, oral, pharmacy, vision, insitutional, professional." - HL7 FHIR, Claim.type

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Terminologies	[ HL7_FHIR_R4 Claim Type Codes http://hl7.org/fhir/ValueSet/claim-type ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	type
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::type
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

use

Public «CS» Code use

"Complete (Bill or Claim), Proposed (Pre-Authorization), Exploratory (Pre-determination)." - HL7 FHIR, Claim.use

Constraints:

Properties:

Aggregation	None
Alias
Association
Association End
Class	Claim
Terminologies	[ HL7_FHIR_R4 Use http://hl7.org/fhir/ValueSet/claim-use ]
Datatype
Default
Default Value
Is Composite	false
Is Derived	false
Is Derived Union	false
Is Leaf	false
Is Ordered	false
Is Read Only	false
Is Static	false
Is Unique	true
Keywords
Lower	0
Lower Value	(0)
Multiplicity	0..1
Name	use
Name Expression
Namespace	Claim
Opposite
Owner	Claim
Owning Association
Owning Template Parameter
Qualified Name	FHIM::EnrollEligCOB::Claim::use
Stereotype	ValueSetConstraints
Template Parameter
Type	«CS» Code
Upper	1
Upper Value	(1)
Visibility	Public

Overview

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Element

EnrollEligCOB UML Documentation

Summary:AttributesProperties

Detail:Attributes