ca.infoway.messagebuilder.model.pcs_mr2007_v02_r02.claims.merged
Class SubmittedInvoiceElementDetailsBean

java.lang.Object
  ca.infoway.messagebuilder.model.MessagePartBean
      ca.infoway.messagebuilder.model.pcs_mr2007_v02_r02.claims.merged.SubmittedInvoiceElementDetailsBean

All Implemented Interfaces:

NullFlavorSupport, InvoiceElementChoice, Serializable

public class SubmittedInvoiceElementDetailsBean
extends MessagePartBean
implements InvoiceElementChoice, InvoiceElementChoice

Business Name: InvoiceElementDetails

FICR_MT600201CA.InvoiceElementDetail: Invoice Element Details

Domain for InvoiceElementDetail.code is GenericBillableItemModifier

RTO used to specify 15 pills (each) out of a bottle of 100 pills (each) to reflect billing for a portion of a package (e.g. 0.15 of a bottle)

The details of the Invoice item billed for, as in the product or service.

See Also:

Serialized Form

Constructor Summary

SubmittedInvoiceElementDetailsBean()

Method Summary

ActInvoiceDetailCode	getCode() Business Name: SubmittedProductServiceCode
Integer	getFactorNumber() Un-merged Business Name: (no business name specified)
Identifier	getId() Business Name: SubmittedInvoiceLineIdentifier
Money	getNetAmt() Business Name: SubmittedInvoiceLineAmount
List<A_BillableActChoice>	getReasonOfBillableActChoice() Un-merged Business Name: (no business name specified)
Ratio<Money,PhysicalQuantity>	getUnitPriceAmt() Business Name: SubmittedUnitAmountPrice
PhysicalQuantity	getUnitQuantity() Business Name: SubmittedUnitQuantity
void	setCode(ActInvoiceDetailCode code) Business Name: SubmittedProductServiceCode
void	setFactorNumber(Integer factorNumber) Un-merged Business Name: (no business name specified)
void	setId(Identifier id) Business Name: SubmittedInvoiceLineIdentifier
void	setNetAmt(Money netAmt) Business Name: SubmittedInvoiceLineAmount
void	setUnitPriceAmt(Ratio<Money,PhysicalQuantity> unitPriceAmt) Business Name: SubmittedUnitAmountPrice
void	setUnitQuantity(PhysicalQuantity unitQuantity) Business Name: SubmittedUnitQuantity

Methods inherited from class ca.infoway.messagebuilder.model.MessagePartBean

getField, getNullFlavor, getNullFlavor, getSpecializationType, hasNullFlavor, hasNullFlavor, setNullFlavor, setNullFlavor, setSpecializationType

Methods inherited from class java.lang.Object

clone, equals, finalize, getClass, hashCode, notify, notifyAll, toString, wait, wait, wait

Constructor Detail

SubmittedInvoiceElementDetailsBean

public SubmittedInvoiceElementDetailsBean()

Method Detail

getId

public Identifier getId()

Business Name: SubmittedInvoiceLineIdentifier

Un-merged Business Name: SubmittedInvoiceLineIdentifier

Relationship: FICR_MT610201CA.InvoiceElementDetail.id

Conformance/Cardinality: MANDATORY (1)

Only one identifier for an Invoice Detail is allowed.

OID (object identifier) + unique number generated by the pharmacy software for the specific invoice element detail.

The identifier will be the same as its parent Invoice Element Group, appended with a ".x", where "x" is a number siginifying the occurence of this item under its parent. For example, the parent id is "12942" and this is the 2nd item under the parent. Therefore, the id for this item would be "12942.2".

Must not be the same identifier as the PaymentRequest.id or the InvoiceElementGroup.id.

Submitted Invoice Line Identifier. OID (object identifier) + unique number generated by the pharmacy software for the specific invoice element detail

Un-merged Business Name: SubmittedInvoiceLineIdentifier

Relationship: FICR_MT600201CA.InvoiceElementDetail.id

Conformance/Cardinality: MANDATORY (1)

Only one identifier for an Invoice Detail is allowed.

OID (object identifier) + unique number generated by the pharmacy software for the specific invoice element detail.

The identifier will be the same as its parent Invoice Element Group, appended with a ".x", where "x" is a number siginifying the occurence of this item under its parent. For example, the parent id is "12942" and this is the 2nd item under the parent. Therefore, the id for this item would be "12942.2".

Must not be the same identifier as the PaymentRequest.id or the InvoiceElementGroup.id.

Set of identifiers that uniquely identify the Invoice Line item.

setId

public void setId(Identifier id)

Business Name: SubmittedInvoiceLineIdentifier

Un-merged Business Name: SubmittedInvoiceLineIdentifier

Relationship: FICR_MT610201CA.InvoiceElementDetail.id

Conformance/Cardinality: MANDATORY (1)

Only one identifier for an Invoice Detail is allowed.

OID (object identifier) + unique number generated by the pharmacy software for the specific invoice element detail.

The identifier will be the same as its parent Invoice Element Group, appended with a ".x", where "x" is a number siginifying the occurence of this item under its parent. For example, the parent id is "12942" and this is the 2nd item under the parent. Therefore, the id for this item would be "12942.2".

Must not be the same identifier as the PaymentRequest.id or the InvoiceElementGroup.id.

Submitted Invoice Line Identifier. OID (object identifier) + unique number generated by the pharmacy software for the specific invoice element detail

Un-merged Business Name: SubmittedInvoiceLineIdentifier

Relationship: FICR_MT600201CA.InvoiceElementDetail.id

Conformance/Cardinality: MANDATORY (1)

Only one identifier for an Invoice Detail is allowed.

OID (object identifier) + unique number generated by the pharmacy software for the specific invoice element detail.

The identifier will be the same as its parent Invoice Element Group, appended with a ".x", where "x" is a number siginifying the occurence of this item under its parent. For example, the parent id is "12942" and this is the 2nd item under the parent. Therefore, the id for this item would be "12942.2".

Must not be the same identifier as the PaymentRequest.id or the InvoiceElementGroup.id.

Set of identifiers that uniquely identify the Invoice Line item.

getCode

public ActInvoiceDetailCode getCode()

Business Name: SubmittedProductServiceCode

Un-merged Business Name: SubmittedProductServiceCode

Relationship: FICR_MT610201CA.InvoiceElementDetail.code

Conformance/Cardinality: MANDATORY (1)

For Adjudication Results: each Invoice Element Group or Detail that has been submitted must have a corresponding response with the same Invoice Element code. There may be additional Invoice Elements in the adjudication results for situations like code substitution.

Modifiers for the codes are taken from the same domain (i.e ActPoductServiceBillableItemCode).

Codes for this domain include intervention/procedure codes (e.g. CCI), product codes (e.g. HCPCS), pharmacy product codes (e.g. DIN). The code set also includes generic codes, applicable to all benefit groups, for specification of taxes, surcharges and discounts.

There are specific rules, by code set, for specification of these codes (e.g. CCI codes are stripped of punctuation).

RxS1: Select one of MARKUP (markup), PROFFEE (professional fee), or <DIN>/<GTIN>/<UPC> (drug), depending on what invoice element detail is being described.).

Product/Service Code, e.g. Office Visit ,Taxes, Markup, Dispense. Modifier e.g. northern isolation,off hours specialty, on call.

Un-merged Business Name: SubmittedProductServiceCode

Relationship: FICR_MT600201CA.InvoiceElementDetail.code

Conformance/Cardinality: MANDATORY (1)

RxS1: Select one of MARKUP (markup), PROFFEE (professional fee), or <DIN>/<GTIN>/<UPC> (drug), depending on what invoice element detail is being described.

There are specific rules, by code set, for specification of these codes (e.g. CCI codes are stripped of punctuation).

For Adjudication Results: each Invoice Element Group or Detail that has been submitted must have a corresponding response with the same Invoice Element code. There may be additional Invoice Elements in the adjudication results for situations like code substitution.

Modifiers for the codes are taken from the same domain (i.e ActPoductServiceBillableItemCode).

Codes for this domain include intervention/procedure codes (e.g. CCI), product codes (e.g. HCPCS), pharmacy product codes (e.g. DIN). The code set also includes generic codes, applicable to all benefit groups, for specification of taxes, surcharges and discounts.

There are specific rules, by code set, for specification of these codes (e.g. CCI codes are stripped of punctuation).

Product/Service Code e.g. Office Visit ,Taxes, Markup, Dispense + Product/Service Code Modifier e.g. northern isolation, off hours, specialty, on call. Also allows for specification of equivalents for each code for each Payor

setCode

public void setCode(ActInvoiceDetailCode code)

Business Name: SubmittedProductServiceCode

Un-merged Business Name: SubmittedProductServiceCode

Relationship: FICR_MT610201CA.InvoiceElementDetail.code

Conformance/Cardinality: MANDATORY (1)

For Adjudication Results: each Invoice Element Group or Detail that has been submitted must have a corresponding response with the same Invoice Element code. There may be additional Invoice Elements in the adjudication results for situations like code substitution.

Modifiers for the codes are taken from the same domain (i.e ActPoductServiceBillableItemCode).

Codes for this domain include intervention/procedure codes (e.g. CCI), product codes (e.g. HCPCS), pharmacy product codes (e.g. DIN). The code set also includes generic codes, applicable to all benefit groups, for specification of taxes, surcharges and discounts.

There are specific rules, by code set, for specification of these codes (e.g. CCI codes are stripped of punctuation).

RxS1: Select one of MARKUP (markup), PROFFEE (professional fee), or <DIN>/<GTIN>/<UPC> (drug), depending on what invoice element detail is being described.).

Product/Service Code, e.g. Office Visit ,Taxes, Markup, Dispense. Modifier e.g. northern isolation,off hours specialty, on call.

Un-merged Business Name: SubmittedProductServiceCode

Relationship: FICR_MT600201CA.InvoiceElementDetail.code

Conformance/Cardinality: MANDATORY (1)

RxS1: Select one of MARKUP (markup), PROFFEE (professional fee), or <DIN>/<GTIN>/<UPC> (drug), depending on what invoice element detail is being described.

There are specific rules, by code set, for specification of these codes (e.g. CCI codes are stripped of punctuation).

For Adjudication Results: each Invoice Element Group or Detail that has been submitted must have a corresponding response with the same Invoice Element code. There may be additional Invoice Elements in the adjudication results for situations like code substitution.

Modifiers for the codes are taken from the same domain (i.e ActPoductServiceBillableItemCode).

Codes for this domain include intervention/procedure codes (e.g. CCI), product codes (e.g. HCPCS), pharmacy product codes (e.g. DIN). The code set also includes generic codes, applicable to all benefit groups, for specification of taxes, surcharges and discounts.

There are specific rules, by code set, for specification of these codes (e.g. CCI codes are stripped of punctuation).

Product/Service Code e.g. Office Visit ,Taxes, Markup, Dispense + Product/Service Code Modifier e.g. northern isolation, off hours, specialty, on call. Also allows for specification of equivalents for each code for each Payor

getNetAmt

public Money getNetAmt()

Business Name: SubmittedInvoiceLineAmount

Un-merged Business Name: SubmittedInvoiceLineAmount

Relationship: FICR_MT610201CA.InvoiceElementDetail.netAmt

Conformance/Cardinality: MANDATORY (1)

Attribute cannot be mandatory as it may not be present for a Coverage Extension Request.

Field length for value (amount) includes a decimal point. Decimal point MUST be specified with 2 and only 2 digits of precision. Example: "150.12".

RxS1: For the <DIN>/<GTIN>/<UPC> invoice element detail, specifiy as "x" dollars. E.g. "50.00" "CAD".

RxS1: For the MARKUP, PROFFEE invoice element details, specify as "x" dollars. E.g. "12.00" "CAD"

The amount billed for the Invoice Line product or service. This is the result of Submitted Unit Quantity * Submitted Unit Amount Price.

Un-merged Business Name: SubmittedInvoiceLineAmount

Relationship: FICR_MT600201CA.InvoiceElementDetail.netAmt

Conformance/Cardinality: MANDATORY (1)

Derived as numerator of UnitQuantity * UnitPriceAmt.

Attribute cannot be mandatory as it may not be present for a Coverage Extension Request.

Field length for value (amount) includes a decimal point. Decimal point MUST be specified with 2 and only 2 digits of precision. Example: "150.12".

Example: <netAmt value="5000.00" currency="CAD"/>

RxS1: For the <DIN>/<GTIN>/<UPC> invoice element detail, specifiy as "x" dollars. E.g. "50.00" "CAD".

RxS1: For the MARKUP, PROFFEE invoice element details, specify as "x" dollars. E.g. "12.00" "CAD"

The amount billed for the Invoice Line product or service. This is the result of Submitted Unit Quantity * Submitted Unit Amount Price.

setNetAmt

public void setNetAmt(Money netAmt)

Business Name: SubmittedInvoiceLineAmount

Un-merged Business Name: SubmittedInvoiceLineAmount

Relationship: FICR_MT610201CA.InvoiceElementDetail.netAmt

Conformance/Cardinality: MANDATORY (1)

Attribute cannot be mandatory as it may not be present for a Coverage Extension Request.

Field length for value (amount) includes a decimal point. Decimal point MUST be specified with 2 and only 2 digits of precision. Example: "150.12".

RxS1: For the <DIN>/<GTIN>/<UPC> invoice element detail, specifiy as "x" dollars. E.g. "50.00" "CAD".

RxS1: For the MARKUP, PROFFEE invoice element details, specify as "x" dollars. E.g. "12.00" "CAD"

The amount billed for the Invoice Line product or service. This is the result of Submitted Unit Quantity * Submitted Unit Amount Price.

Un-merged Business Name: SubmittedInvoiceLineAmount

Relationship: FICR_MT600201CA.InvoiceElementDetail.netAmt

Conformance/Cardinality: MANDATORY (1)

Derived as numerator of UnitQuantity * UnitPriceAmt.

Attribute cannot be mandatory as it may not be present for a Coverage Extension Request.

Field length for value (amount) includes a decimal point. Decimal point MUST be specified with 2 and only 2 digits of precision. Example: "150.12".

Example: <netAmt value="5000.00" currency="CAD"/>

RxS1: For the <DIN>/<GTIN>/<UPC> invoice element detail, specifiy as "x" dollars. E.g. "50.00" "CAD".

RxS1: For the MARKUP, PROFFEE invoice element details, specify as "x" dollars. E.g. "12.00" "CAD"

The amount billed for the Invoice Line product or service. This is the result of Submitted Unit Quantity * Submitted Unit Amount Price.

getReasonOfBillableActChoice

public List<A_BillableActChoice> getReasonOfBillableActChoice()

Un-merged Business Name: (no business name specified)

Relationship: FICR_MT600201CA.InvoiceElementReason.billableActChoice

Conformance/Cardinality: POPULATED (1)

getUnitQuantity

public PhysicalQuantity getUnitQuantity()

Business Name: SubmittedUnitQuantity

Un-merged Business Name: SubmittedUnitQuantity

Relationship: FICR_MT600201CA.InvoiceElementDetail.unitQuantity

Conformance/Cardinality: POPULATED (1)

Field length for value (value) may include a decimal point (e.g. 3.5 hours) with no restriction on the number of digits past the decimal point.

Attribute cannot be mandatory as it may not be present for a Coverage Extension Request.

Unit of measure for "each" is left null.

Example: <numerator value="10" unit="MG"/> <denominator value="100" unit="MG"/>

RxS1: For the <DIN>/<GTIN>/<UPC> invoice element detail, specifiy as "x" over "y" with no units of measure, where "x" is the number of pills and "y" is the package size. E.g. "10" over "100".

RxS1: For the MARKUP, PROFFEE invoice element details, specify as 1 over 1. E.g. "1" over "1".

A description of the number of instances of a product or service. I.e.. 4 hours, 4 mg, 4 boxes, 15 each of a container of 1000 each

setUnitQuantity

public void setUnitQuantity(PhysicalQuantity unitQuantity)

Business Name: SubmittedUnitQuantity

Un-merged Business Name: SubmittedUnitQuantity

Relationship: FICR_MT600201CA.InvoiceElementDetail.unitQuantity

Conformance/Cardinality: POPULATED (1)

Field length for value (value) may include a decimal point (e.g. 3.5 hours) with no restriction on the number of digits past the decimal point.

Attribute cannot be mandatory as it may not be present for a Coverage Extension Request.

Unit of measure for "each" is left null.

Example: <numerator value="10" unit="MG"/> <denominator value="100" unit="MG"/>

RxS1: For the <DIN>/<GTIN>/<UPC> invoice element detail, specifiy as "x" over "y" with no units of measure, where "x" is the number of pills and "y" is the package size. E.g. "10" over "100".

RxS1: For the MARKUP, PROFFEE invoice element details, specify as 1 over 1. E.g. "1" over "1".

A description of the number of instances of a product or service. I.e.. 4 hours, 4 mg, 4 boxes, 15 each of a container of 1000 each

getUnitPriceAmt

public Ratio<Money,PhysicalQuantity> getUnitPriceAmt()

Business Name: SubmittedUnitAmountPrice

Un-merged Business Name: SubmittedUnitAmountPrice

Relationship: FICR_MT600201CA.InvoiceElementDetail.unitPriceAmt

Conformance/Cardinality: POPULATED (1)

Field length for value (amount) includes a decimal point. Decimal point MUST be specified with 2 and only 2 digits of precision. Example: "150.12".

Attribute cannot be mandatory as it may not be present for a Coverage Extension Request.

Units for denominator must be the same as the units for the denominator of UnitPriceAmt. Value for denominator must be 1.

Example: <numerator value="500.00" currency="CAD"/> <denominator value="1" unit="MG"/>

RxS1: For the <DIN>/<GTIN>/<UPC> invoice element detail, specifiy as "x" dollars over (per) "1" pill, with no units of measure. E.g. "5.00" "CAD" over (per) "1".

RxS1: For the MARKUP, PROFFEE invoice element details, specify as "x" dollars over (per) "1" unit, with no units of measure. E.g. "12.00" "CAD" over (per) "1"

The monetary cost per unit of the product or service. I.e.. $0.20/mg, $250/day, $50

setUnitPriceAmt

public void setUnitPriceAmt(Ratio<Money,PhysicalQuantity> unitPriceAmt)

Business Name: SubmittedUnitAmountPrice

Un-merged Business Name: SubmittedUnitAmountPrice

Relationship: FICR_MT600201CA.InvoiceElementDetail.unitPriceAmt

Conformance/Cardinality: POPULATED (1)

Field length for value (amount) includes a decimal point. Decimal point MUST be specified with 2 and only 2 digits of precision. Example: "150.12".

Attribute cannot be mandatory as it may not be present for a Coverage Extension Request.

Units for denominator must be the same as the units for the denominator of UnitPriceAmt. Value for denominator must be 1.

Example: <numerator value="500.00" currency="CAD"/> <denominator value="1" unit="MG"/>

RxS1: For the <DIN>/<GTIN>/<UPC> invoice element detail, specifiy as "x" dollars over (per) "1" pill, with no units of measure. E.g. "5.00" "CAD" over (per) "1".

RxS1: For the MARKUP, PROFFEE invoice element details, specify as "x" dollars over (per) "1" unit, with no units of measure. E.g. "12.00" "CAD" over (per) "1"

The monetary cost per unit of the product or service. I.e.. $0.20/mg, $250/day, $50

getFactorNumber

public Integer getFactorNumber()

Un-merged Business Name: (no business name specified)

Relationship: FICR_MT600201CA.InvoiceElementDetail.factorNumber

Conformance/Cardinality: REQUIRED (0-1)

Factor numbers are used for taxes. They represent the percentage of tax applied to unitPriceAmt.

RxS1: Not permitted, as taxes are not included in this scenario.

Tax percentage applied to unitPriceAmt

setFactorNumber

public void setFactorNumber(Integer factorNumber)

Un-merged Business Name: (no business name specified)

Relationship: FICR_MT600201CA.InvoiceElementDetail.factorNumber

Conformance/Cardinality: REQUIRED (0-1)

Factor numbers are used for taxes. They represent the percentage of tax applied to unitPriceAmt.

RxS1: Not permitted, as taxes are not included in this scenario.

Tax percentage applied to unitPriceAmt