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

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

All Implemented Interfaces:

NullFlavorSupport, InvoiceElementChoice, Serializable

public class SubmittedInvoiceGroupBean
extends MessagePartBean
implements InvoiceElementChoice, InvoiceElementChoice

FICR_MT620000CA.InvoiceElementGroup: Invoice Type

Cancel reasons are noted in the control wrapper

FICR_MT600201CA.InvoiceElementGroup: Invoice Grouping Information

There are some situations where all items for a patient need to be included in 1 Invoice Grouping, as the final determination (adjudication results) will not be made until all invoice elements are considered for that patient.

The statement and justification of the Total Billed Amount. For an invoice it is the statement and justification of the Total Billed amount requesting the determination of the amount owed by the payor for the service(s) that either have occurred or are on-going. For an authorization it represents the statement and justification of an invoice for a future service requesting the determination of the amount owed that is guaranteed by the payor. For a pre-determination, it represents the statement and possible justification for an invoice for a future service to determine the possible amount owed by the payor.

FICR_MT610201CA.InvoiceElementGroup: Submitted Invoice Group

Unique number generated by the pharmacy software for the specific invoice element group

See Also:

Serialized Form

Constructor Summary

SubmittedInvoiceGroupBean()

Method Summary

ActInvoiceGroupCode	getCode() Business Name: InvoiceType
List<InvoiceComponentBean>	getComponent() Un-merged Business Name: (no business name specified)
List<PolicyIdentifierBean>	getCoveragePolicyOrAccount() Un-merged Business Name: (no business name specified)
Interval<Date>	getEffectiveTime() Business Name: TimePeriodForInvoice
Identifier	getId() Un-merged Business Name: InvoiceGroupingIdentifiers
BusinessArrangementBean	getInFulfillmentOfFinancialContract() Un-merged Business Name: (no business name specified)
Money	getNetAmt() Business Name: InvoiceSubTotal
List<AttachmentsBean>	getPertinentInformation() Un-merged Business Name: (no business name specified)
List<CrossReferenceIdentifierBean>	getPredecessorInvoiceElementCrossReference() Un-merged Business Name: (no business name specified)
List<A_BillableActChoice>	getReasonOfBillableActChoice() Un-merged Business Name: (no business name specified)
List<AdjudicatedInvoiceElementGroupBean>	getReferenceAdjudicatedInvoiceElementGroup() Un-merged Business Name: (no business name specified)
List<InvoiceOverrideDetailsBean>	getTriggerForInvoiceElementOverride() Un-merged Business Name: (no business name specified)
void	setCode(ActInvoiceGroupCode code) Business Name: InvoiceType
void	setEffectiveTime(Interval<Date> effectiveTime) Business Name: TimePeriodForInvoice
void	setId(Identifier id) Un-merged Business Name: InvoiceGroupingIdentifiers
void	setInFulfillmentOfFinancialContract(BusinessArrangementBean inFulfillmentOfFinancialContract) Un-merged Business Name: (no business name specified)
void	setNetAmt(Money netAmt) Business Name: InvoiceSubTotal

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

SubmittedInvoiceGroupBean

public SubmittedInvoiceGroupBean()

Method Detail

getId

public Identifier getId()

Un-merged Business Name: InvoiceGroupingIdentifiers

Relationship: FICR_MT620000CA.InvoiceElementGroup.id

Conformance/Cardinality: MANDATORY (1)

There are some situations where more than 1 identifier for this object can be included in a message.

For example:

1. unique invoice group identifier, independent of adjudicator recipient.

2. sequential invoice grouping identifier by adjudicator.

Obligation on adjudicator is to return and communicate about this item with all identifiers (i.e. identifier 1. and 2.).

Un-merged Business Name: InvoiceGroupID

Relationship: QUCR_MT830201CA.InvoiceElementGroup.id

Conformance/Cardinality: MANDATORY (1)

For example:

1. unique invoice group identifier, independent of adjudicator recipient.

2. sequential invoice grouping identifier by adjudicator.

Obligation on adjudicator is to return and communicate about this item with all identifiers (i.e. identifier 1. and 2.).

Set of identifiers that uniquely identify the Invoice Grouping.

Un-merged Business Name: InvoiceGroupingIdentifierS

Relationship: FICR_MT600201CA.InvoiceElementGroup.id

Conformance/Cardinality: MANDATORY (1)

For example:

1. unique invoice group identifier, independent of adjudicator recipient.

2. sequential invoice grouping identifier by adjudicator.

Obligation on adjudicator is to return and communicate about this item with all identifiers (i.e. identifier 1. and 2.).

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

For child Invoice Element Groups, 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 InvoiceElementDetail.id.

Set of identifiers that uniquely identify the Invoice Grouping.

Un-merged Business Name: InvoiceGroupingIdentifier

Relationship: FICR_MT610201CA.InvoiceElementGroup.id

Conformance/Cardinality: MANDATORY (1)

For example:

1. unique invoice group identifier, independent of adjudicator recipient.

2. sequential invoice grouping identifier by adjudicator.

Obligation on adjudicator is to return and communicate about this item with all identifiers (i.e. identifier 1. and 2.).

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

For child Invoice Element Groups, 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 InvoiceElementDetail.id.

Set of identifiers that uniquely identify the Invoice Grouping.

setId

public void setId(Identifier id)

Un-merged Business Name: InvoiceGroupingIdentifiers

Relationship: FICR_MT620000CA.InvoiceElementGroup.id

Conformance/Cardinality: MANDATORY (1)

There are some situations where more than 1 identifier for this object can be included in a message.

For example:

1. unique invoice group identifier, independent of adjudicator recipient.

2. sequential invoice grouping identifier by adjudicator.

Obligation on adjudicator is to return and communicate about this item with all identifiers (i.e. identifier 1. and 2.).

Un-merged Business Name: InvoiceGroupID

Relationship: QUCR_MT830201CA.InvoiceElementGroup.id

Conformance/Cardinality: MANDATORY (1)

For example:

1. unique invoice group identifier, independent of adjudicator recipient.

2. sequential invoice grouping identifier by adjudicator.

Obligation on adjudicator is to return and communicate about this item with all identifiers (i.e. identifier 1. and 2.).

Set of identifiers that uniquely identify the Invoice Grouping.

Un-merged Business Name: InvoiceGroupingIdentifierS

Relationship: FICR_MT600201CA.InvoiceElementGroup.id

Conformance/Cardinality: MANDATORY (1)

For example:

1. unique invoice group identifier, independent of adjudicator recipient.

2. sequential invoice grouping identifier by adjudicator.

Obligation on adjudicator is to return and communicate about this item with all identifiers (i.e. identifier 1. and 2.).

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

For child Invoice Element Groups, 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 InvoiceElementDetail.id.

Set of identifiers that uniquely identify the Invoice Grouping.

Un-merged Business Name: InvoiceGroupingIdentifier

Relationship: FICR_MT610201CA.InvoiceElementGroup.id

Conformance/Cardinality: MANDATORY (1)

For example:

1. unique invoice group identifier, independent of adjudicator recipient.

2. sequential invoice grouping identifier by adjudicator.

Obligation on adjudicator is to return and communicate about this item with all identifiers (i.e. identifier 1. and 2.).

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

For child Invoice Element Groups, 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 InvoiceElementDetail.id.

Set of identifiers that uniquely identify the Invoice Grouping.

getCode

public ActInvoiceGroupCode getCode()

Business Name: InvoiceType

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

Relationship: FICR_MT620000CA.InvoiceElementGroup.code

Conformance/Cardinality: MANDATORY (1)

Each Invoice Type is used to specify 1. vocabulary, 2. structure of the Invoice Element Choice and 3. which Billable Act(s) can be included for the specified Invoice Type.

Information on constraints for the Invoice Type will be found in the NeCST Message Specifications. Each Benefit Group will indicate which Invoice Types will be supported by that Benefit Group.

Invoice Types will not generate unique and distinct XML schemas that can tested independent of each other. They must be tested together within an Message Type.

Invoice Type e.g. Healthcare Services, Rx Dispense, Rx Compound, Healthcare Goods, Preferred Accomodation

Un-merged Business Name: InvoiceType

Relationship: FICR_MT600201CA.InvoiceElementGroup.code

Conformance/Cardinality: MANDATORY (1)

RXDINV, RXCINV, CSINV, CPINV, CSPINV only for root invoice element group. RXDINV only for root invoice element group. DRGING for specify drug group.

Invoice Type is the indication to the payor as to the content rules to apply when processing and adjudicating the invoice. Basically, the structure of the invoice grouping. Ie. Clinical Product, Clinical Service, Preferred Accom, Rx Dispense, Rx Compound

This is used to indicate the type of Invoice Grouping.

Each Invoice Type is used to specify 1. vocabulary, 2. structure of the Invoice Element Choice and 3. which Billable Act(s) can be included for the specified Invoice Type.

Information on constraints for the Invoice Type will be found in the NeCST Message Specifications. Each Benefit Group will indicate which Invoice Types will be supported by that Benefit Group.

Invoice Types will not generate unique and distinct XML schemas that can tested independent of each other. They must be tested together within an Message Type.

Invoice Type e.g. Healthcare Services, Rx Dispense, Rx Compound, Healthcare Goods, Preferred Accomodation

Un-merged Business Name: InvoiceType

Relationship: FICR_MT610201CA.InvoiceElementGroup.code

Conformance/Cardinality: MANDATORY (1)

of Invoice Grouping.

Each Invoice Type is used to specify 1. vocabulary, 2. structure of the Invoice Element Choice and 3. which Billable Act(s) can be included for the specified Invoice Type.

Information on constraints for the Invoice Type will be found in the NeCST Message Specifications. Each Benefit Group will indicate which Invoice Types will be supported by that Benefit Group.

Invoice Types will not generate unique and distinct XML schemas that can tested independent of each other. They must be tested together within an Message Type.

RXDINV, RXCINV, CSINV, CPINV, CSPINV only for root invoice element group.

RxS1: RXDINV only for root invoice element group. DRGING for specify drug group.

Invoice Type is the indication to the payor as to the content rules to apply when processing and adjudicating the invoice. Basically, the structure of the invoice grouping. Ie. Clinical Product, Clinical Service, Preferred Accom, Rx Dispense, Rx Compound

setCode

public void setCode(ActInvoiceGroupCode code)

Business Name: InvoiceType

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

Relationship: FICR_MT620000CA.InvoiceElementGroup.code

Conformance/Cardinality: MANDATORY (1)

Each Invoice Type is used to specify 1. vocabulary, 2. structure of the Invoice Element Choice and 3. which Billable Act(s) can be included for the specified Invoice Type.

Information on constraints for the Invoice Type will be found in the NeCST Message Specifications. Each Benefit Group will indicate which Invoice Types will be supported by that Benefit Group.

Invoice Types will not generate unique and distinct XML schemas that can tested independent of each other. They must be tested together within an Message Type.

Invoice Type e.g. Healthcare Services, Rx Dispense, Rx Compound, Healthcare Goods, Preferred Accomodation

Un-merged Business Name: InvoiceType

Relationship: FICR_MT600201CA.InvoiceElementGroup.code

Conformance/Cardinality: MANDATORY (1)

RXDINV, RXCINV, CSINV, CPINV, CSPINV only for root invoice element group. RXDINV only for root invoice element group. DRGING for specify drug group.

Invoice Type is the indication to the payor as to the content rules to apply when processing and adjudicating the invoice. Basically, the structure of the invoice grouping. Ie. Clinical Product, Clinical Service, Preferred Accom, Rx Dispense, Rx Compound

This is used to indicate the type of Invoice Grouping.

Each Invoice Type is used to specify 1. vocabulary, 2. structure of the Invoice Element Choice and 3. which Billable Act(s) can be included for the specified Invoice Type.

Information on constraints for the Invoice Type will be found in the NeCST Message Specifications. Each Benefit Group will indicate which Invoice Types will be supported by that Benefit Group.

Invoice Types will not generate unique and distinct XML schemas that can tested independent of each other. They must be tested together within an Message Type.

Invoice Type e.g. Healthcare Services, Rx Dispense, Rx Compound, Healthcare Goods, Preferred Accomodation

Un-merged Business Name: InvoiceType

Relationship: FICR_MT610201CA.InvoiceElementGroup.code

Conformance/Cardinality: MANDATORY (1)

of Invoice Grouping.

Each Invoice Type is used to specify 1. vocabulary, 2. structure of the Invoice Element Choice and 3. which Billable Act(s) can be included for the specified Invoice Type.

Information on constraints for the Invoice Type will be found in the NeCST Message Specifications. Each Benefit Group will indicate which Invoice Types will be supported by that Benefit Group.

Invoice Types will not generate unique and distinct XML schemas that can tested independent of each other. They must be tested together within an Message Type.

RXDINV, RXCINV, CSINV, CPINV, CSPINV only for root invoice element group.

RxS1: RXDINV only for root invoice element group. DRGING for specify drug group.

Invoice Type is the indication to the payor as to the content rules to apply when processing and adjudicating the invoice. Basically, the structure of the invoice grouping. Ie. Clinical Product, Clinical Service, Preferred Accom, Rx Dispense, Rx Compound

getNetAmt

public Money getNetAmt()

Business Name: InvoiceSubTotal

Un-merged Business Name: InvoiceSubTotal

Relationship: FICR_MT620000CA.InvoiceElementGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

For Cancel Request: This would serve as a cross-check for the Adjudicator for the Invoice Grouping that is being cancelled.

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

Invoice sub-total - This is the sum of the Submitted Invoice Line amounts; Identifies the total monetary amount billed for the invoice element.

Un-merged Business Name: InvoiceSubTotal

Relationship: FICR_MT600201CA.InvoiceElementGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

For Cancel Request: This would serve as a cross-check for the Adjudicator for the Invoice Grouping that is being cancelled.

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

For Coverage Extension Results: Some adjudicators will indicate a dollar amount allowed for the coverage extension.

RxS1: Sum of InvoiceElementDetail.netAmt for all immediate child invoice elements. The root invoice element group will be the transaction total (invoice total).

Identifies the total monetary amount billed for the invoice element. This is the sum of the Submitted Invoice Line amounts.

Un-merged Business Name: InvoiceSubTotal

Relationship: FICR_MT610201CA.InvoiceElementGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

For Cancel Request: This would serve as a cross-check for the Adjudicator for the Invoice Grouping that is being cancelled.

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

For Coverage Extension Results: Some adjudicators will indicate a dollar amount allowed for the coverage extension.

RxS1: Sum of InvoiceElementDetail.netAmt for all immediate child invoice elements. The root invoice element group will be the transaction total (invoice total).

Identifies the total monetary amount billed for the invoice element. This is the sum of the Submitted Invoice Line amounts.

setNetAmt

public void setNetAmt(Money netAmt)

Business Name: InvoiceSubTotal

Un-merged Business Name: InvoiceSubTotal

Relationship: FICR_MT620000CA.InvoiceElementGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

For Cancel Request: This would serve as a cross-check for the Adjudicator for the Invoice Grouping that is being cancelled.

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

Invoice sub-total - This is the sum of the Submitted Invoice Line amounts; Identifies the total monetary amount billed for the invoice element.

Un-merged Business Name: InvoiceSubTotal

Relationship: FICR_MT600201CA.InvoiceElementGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

For Cancel Request: This would serve as a cross-check for the Adjudicator for the Invoice Grouping that is being cancelled.

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

For Coverage Extension Results: Some adjudicators will indicate a dollar amount allowed for the coverage extension.

RxS1: Sum of InvoiceElementDetail.netAmt for all immediate child invoice elements. The root invoice element group will be the transaction total (invoice total).

Identifies the total monetary amount billed for the invoice element. This is the sum of the Submitted Invoice Line amounts.

Un-merged Business Name: InvoiceSubTotal

Relationship: FICR_MT610201CA.InvoiceElementGroup.netAmt

Conformance/Cardinality: MANDATORY (1)

For Cancel Request: This would serve as a cross-check for the Adjudicator for the Invoice Grouping that is being cancelled.

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

For Coverage Extension Results: Some adjudicators will indicate a dollar amount allowed for the coverage extension.

RxS1: Sum of InvoiceElementDetail.netAmt for all immediate child invoice elements. The root invoice element group will be the transaction total (invoice total).

Identifies the total monetary amount billed for the invoice element. This is the sum of the Submitted Invoice Line amounts.

getReasonOfBillableActChoice

public List<A_BillableActChoice> getReasonOfBillableActChoice()

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

Relationship: FICR_MT600201CA.InvoiceElementReason.billableActChoice

Conformance/Cardinality: POPULATED (1)

getEffectiveTime

public Interval<Date> getEffectiveTime()

Business Name: TimePeriodForInvoice

Un-merged Business Name: TimePeriodForInvoice

Relationship: FICR_MT600201CA.InvoiceElementGroup.effectiveTime

Conformance/Cardinality: REQUIRED (0-1)

Transmission of this information suggests a transfer of liability for how this information/invoice is used/communicated.

Legislation and service level agreements typically cover the requirement to send this code with every invoice.

This will be required for Alberta physician invoices only.

This may be useful for nursing homes. For example, they get paid so much $ per patient per month and would need to specify the time period for the invoice.

The period of time that the invoice pertains to. This may be a specific date or a date range (as in the month of January) for the invoice.

setEffectiveTime

public void setEffectiveTime(Interval<Date> effectiveTime)

Business Name: TimePeriodForInvoice

Un-merged Business Name: TimePeriodForInvoice

Relationship: FICR_MT600201CA.InvoiceElementGroup.effectiveTime

Conformance/Cardinality: REQUIRED (0-1)

Transmission of this information suggests a transfer of liability for how this information/invoice is used/communicated.

Legislation and service level agreements typically cover the requirement to send this code with every invoice.

This will be required for Alberta physician invoices only.

This may be useful for nursing homes. For example, they get paid so much $ per patient per month and would need to specify the time period for the invoice.

The period of time that the invoice pertains to. This may be a specific date or a date range (as in the month of January) for the invoice.

getInFulfillmentOfFinancialContract

public BusinessArrangementBean getInFulfillmentOfFinancialContract()

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

Relationship: FICR_MT600201CA.InvoiceElementGroupInFulfillmentOf.financialContract

Conformance/Cardinality: POPULATED (1)

setInFulfillmentOfFinancialContract

public void setInFulfillmentOfFinancialContract(BusinessArrangementBean inFulfillmentOfFinancialContract)

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

Relationship: FICR_MT600201CA.InvoiceElementGroupInFulfillmentOf.financialContract

Conformance/Cardinality: POPULATED (1)

getPredecessorInvoiceElementCrossReference

public List<CrossReferenceIdentifierBean> getPredecessorInvoiceElementCrossReference()

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

Relationship: FICR_MT600201CA.Predecessor.invoiceElementCrossReference

Conformance/Cardinality: POPULATED (1)

getReferenceAdjudicatedInvoiceElementGroup

public List<AdjudicatedInvoiceElementGroupBean> getReferenceAdjudicatedInvoiceElementGroup()

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

Relationship: FICR_MT600201CA.Reference.adjudicatedInvoiceElementGroup

Conformance/Cardinality: POPULATED (1)

getCoveragePolicyOrAccount

public List<PolicyIdentifierBean> getCoveragePolicyOrAccount()

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

Relationship: FICR_MT600201CA.InvoiceElementCoverage.policyOrAccount

Conformance/Cardinality: POPULATED (1)

getPertinentInformation

public List<AttachmentsBean> getPertinentInformation()

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

Relationship: FICR_MT600201CA.InvoiceElementGroup.pertinentInformation

Conformance/Cardinality: REQUIRED (0-10)

getComponent

public List<InvoiceComponentBean> getComponent()

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

Relationship: FICR_MT600201CA.InvoiceElementGroup.component

Conformance/Cardinality: MANDATORY (1-10)

getTriggerForInvoiceElementOverride

public List<InvoiceOverrideDetailsBean> getTriggerForInvoiceElementOverride()

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

Relationship: FICR_MT600201CA.Suggests.invoiceElementOverride

Conformance/Cardinality: POPULATED (1)