import { IExplanationOfBenefitAccident, IExplanationOfBenefitAddItem, IExplanationOfBenefitAdjudication, IExplanationOfBenefitBenefitBalance, IExplanationOfBenefitCareTeam, IExplanationOfBenefitDiagnosis, IExplanationOfBenefitInsurance, IExplanationOfBenefitItem, IExplanationOfBenefitPayee, IExplanationOfBenefitPayment, IExplanationOfBenefitProcedure, IExplanationOfBenefitProcessNote, IExplanationOfBenefitRelated, IExplanationOfBenefitSupportingInfo, IExplanationOfBenefitTotal } from '../backbones';
import { IDomainResource, IElement } from '../base';
import { IAttachment, ICodeableConcept, IIdentifier, IPeriod, IReference } from '../datatypes';
import { ClaimUseType, ExplanationOfBenefitStatusType, RemittanceOutcomeType } from '../types';
/**
 * @name IExplanationOfBenefit
 * @description 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.
 * @see <a href="https://hl7.org/fhir/R4/explanationofbenefit.html">ExplanationOfBenefit</a>
 * @version R4
 * @extends {IDomainResource}
 * @author Claudia Alarcón Lazo
 */
export interface IExplanationOfBenefit extends IDomainResource {
    /**
     * @description A unique identifier assigned to this explanation of benefit.
     */
    identifier?: IIdentifier[];
    /**
     * @description The status of the resource instance.
     * @description active | cancelled | draft | entered-in-error
     * @see <a href="https://hl7.org/fhir/R4/valueset-explanationofbenefit-status.html">ExplanationOfBenefitStatus</a>
     */
    status: ExplanationOfBenefitStatusType;
    /**
     * @description Extensions for status
     */
    _status?: IElement;
    /**
     * @description The category of claim, e.g. oral, pharmacy, vision, institutional, professional.
     */
    type: ICodeableConcept;
    /**
     * @description A finer grained suite of claim type codes which may convey additional information such as Inpatient vs Outpatient and/or a specialty service.
     */
    subType?: ICodeableConcept;
    /**
     * @description 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.
     * @description claim | preauthorization | predetermination
     * @see <a href="https://hl7.org/fhir/R4/valueset-claim-use.html">ClaimUse</a>
     */
    use: ClaimUseType;
    /**
     * @description Extensions for use
     */
    _use?: IElement;
    /**
     * @description 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.
     */
    patient: IReference;
    /**
     * @description The period for which charges are being submitted.
     */
    billablePeriod?: IPeriod;
    /**
     * @description The date this resource was created.
     */
    created: string;
    /**
     * @description Extensions for created
     */
    _created?: IElement;
    /**
     * @description Individual who created the claim, predetermination or preauthorization.
     */
    enterer?: IReference;
    /**
     * @description The party responsible for authorization, adjudication and reimbursement.
     */
    insurer: IReference;
    /**
     * @description The provider which is responsible for the claim, predetermination or preauthorization.
     */
    provider: IReference;
    /**
     * @description The provider-required urgency of processing the request. Typical values include: stat, routine deferred.
     */
    priority?: ICodeableConcept;
    /**
     * @description A code to indicate whether and for whom funds are to be reserved for future claims.
     */
    fundsReserveRequested?: ICodeableConcept;
    /**
     * @description A code, used only on a response to a preauthorization, to indicate whether the benefits payable have been reserved and for whom.
     */
    fundsReserve?: ICodeableConcept;
    /**
     * @description Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
     */
    related?: IExplanationOfBenefitRelated[];
    /**
     * @description Prescription to support the dispensing of pharmacy, device or vision products.
     */
    prescription?: IReference;
    /**
     * @description Original prescription which has been superseded by this prescription to support the dispensing of pharmacy services, medications or products.
     */
    originalPrescription?: IReference;
    /**
     * @description The party to be reimbursed for cost of the products and services according to the terms of the policy.
     */
    payee?: IExplanationOfBenefitPayee;
    /**
     * @description A reference to a referral resource.
     */
    referral?: IReference;
    /**
     * @description Facility where the services were provided.
     */
    facility?: IReference;
    /**
     * @description The business identifier for the instance of the adjudication request: claim predetermination or preauthorization.
     */
    claim?: IReference;
    /**
     * @description The business identifier for the instance of the adjudication response: claim, predetermination or preauthorization response.
     */
    claimResponse?: IReference;
    /**
     * @description The outcome of the claim, predetermination, or preauthorization processing.
     * @description queued | complete | error | partial
     * @see <a href="https://hl7.org/fhir/R4/valueset-remittance-outcome.html">RemittanceOutcome</a>
     */
    outcome: RemittanceOutcomeType;
    /**
     * @description Extensions for outcome
     */
    _outcome?: IElement;
    /**
     * @description A human readable description of the status of the adjudication.
     */
    disposition?: string;
    /**
     * @description Extensions for disposition
     */
    _disposition?: IElement;
    /**
     * @description Reference from the Insurer which is used in later communications which refers to this adjudication.
     */
    preAuthRef?: string[];
    /**
     * @description Extensions for preAuthRef
     */
    _preAuthRef?: IElement[];
    /**
     * @description The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.
     */
    preAuthPeriod?: IPeriod[];
    /**
     * @description The members of the team who provided the products and services.
     */
    careTeam?: IExplanationOfBenefitCareTeam[];
    /**
     * @description Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
     */
    supportingInfo?: IExplanationOfBenefitSupportingInfo[];
    /**
     * @description Information about diagnoses relevant to the claim items.
     */
    diagnosis?: IExplanationOfBenefitDiagnosis[];
    /**
     * @description Procedures performed on the patient relevant to the billing items with the claim.
     */
    procedure?: IExplanationOfBenefitProcedure[];
    /**
     * @description This indicates the relative order of a series of EOBs related to different coverages for the same suite of services.
     */
    precedence?: number;
    /**
     * @description Extensions for precedence
     */
    _precedence?: IElement;
    /**
     * @description Financial instruments for reimbursement for the health care products and services specified on the claim.
     */
    insurance: IExplanationOfBenefitInsurance[];
    /**
     * @description Details of a accident which resulted in injuries which required the products and services listed in the claim.
     */
    accident?: IExplanationOfBenefitAccident;
    /**
     * @description A claim line. Either a simple (a product or service) or a \u0027group\u0027 of details which can also be a simple items or groups of sub-details.
     */
    item?: IExplanationOfBenefitItem[];
    /**
     * @description The first-tier service adjudications for payor added product or service lines.
     */
    addItem?: IExplanationOfBenefitAddItem[];
    /**
     * @description The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
     */
    adjudication?: IExplanationOfBenefitAdjudication[];
    /**
     * @description Categorized monetary totals for the adjudication.
     */
    total?: IExplanationOfBenefitTotal[];
    /**
     * @description Payment details for the adjudication of the claim.
     */
    payment?: IExplanationOfBenefitPayment;
    /**
     * @description A code for the form to be used for printing the content.
     */
    formCode?: ICodeableConcept;
    /**
     * @description The actual form, by reference or inclusion, for printing the content or an EOB.
     */
    form?: IAttachment;
    /**
     * @description A note that describes or explains adjudication results in a human readable form.
     */
    processNote?: IExplanationOfBenefitProcessNote[];
    /**
     * @description The term of the benefits documented in this response.
     */
    benefitPeriod?: IPeriod;
    /**
     * @description Balance by Benefit Category.
     */
    benefitBalance?: IExplanationOfBenefitBenefitBalance[];
}