Definition Type: Element
Name: Claim.Submission
Containing Schema: ClaimSubmission.xsd
Abstract
Collapse XSD Schema Diagram:
Drilldown into Claim Drilldown into HeaderXSD Diagram of Claim.Submission
Collapse XSD Schema Code:
<xs:element name="Claim.Submission">
    <xs:complexType>
        <xs:sequence>
            <xs:element name="Header">
                <xs:complexType>
                    <xs:sequence>
                        <xs:element minOccurs="1" maxOccurs="1" name="SenderID" type="tns:HeaderSenderID" />
                        <xs:element minOccurs="1" maxOccurs="1" name="ReceiverID" type="tns:HeaderReceiverID" />
                        <xs:element minOccurs="1" maxOccurs="1" name="TransactionDate" type="tns:HeaderTransactionDate" />
                        <xs:element minOccurs="1" maxOccurs="1" name="RecordCount" type="tns:HeaderRecordCount" />
                        <xs:element minOccurs="1" maxOccurs="1" name="DispositionFlag" type="tns:HeaderDispositionFlag" />
                    </xs:sequence>
                </xs:complexType>
            </xs:element>
            <xs:element minOccurs="1" maxOccurs="unbounded" name="Claim">
                <xs:complexType>
                    <xs:sequence>
                        <xs:element minOccurs="1" maxOccurs="1" name="ID" type="tns:ClaimID" />
                        <xs:element minOccurs="0" maxOccurs="1" name="IDPayer" type="tns:ClaimIDPayer" />
                        <xs:element minOccurs="0" maxOccurs="1" name="MemberID" type="tns:ClaimMemberID" />
                        <xs:element minOccurs="1" maxOccurs="1" name="PayerID" type="tns:ClaimPayerID" />
                        <xs:element minOccurs="1" maxOccurs="1" name="ProviderID" type="tns:ClaimProviderID" />
                        <xs:element minOccurs="0" maxOccurs="1" name="Weight" type="tns:PatientWeight" />
                        <xs:element minOccurs="1" maxOccurs="1" name="EmiratesIDNumber" type="tns:ClaimEmiratesIDNumber" />
                        <xs:element minOccurs="1" maxOccurs="1" name="Gross" type="tns:ClaimGross" />
                        <xs:element minOccurs="1" maxOccurs="1" name="PatientShare" type="tns:ClaimPatientShare" />
                        <xs:element minOccurs="1" maxOccurs="1" name="Net" type="tns:ClaimNet" />
                        <xs:element minOccurs="0" maxOccurs="1" name="Encounter">
                            <xs:complexType>
                                <xs:sequence>
                                    <xs:element minOccurs="1" maxOccurs="1" name="FacilityID" type="tns:EncounterFacilityID" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Type" type="tns:EncounterType" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="PatientID" type="tns:EncounterPatientID" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Start" type="tns:EncounterStart" />
                                    <xs:element minOccurs="0" maxOccurs="1" name="End" type="tns:EncounterEnd" />
                                    <xs:element minOccurs="0" maxOccurs="1" name="StartType" type="tns:EncounterStartType" />
                                    <xs:element minOccurs="0" maxOccurs="1" name="EndType" type="tns:EncounterEndType" />
                                    <xs:element minOccurs="0" maxOccurs="1" name="TransferSource" type="tns:EncounterTransferSource" />
                                    <xs:element minOccurs="0" maxOccurs="1" name="TransferDestination" type="tns:EncounterTransferDestination" />
                                </xs:sequence>
                            </xs:complexType>
                        </xs:element>
                        <xs:element minOccurs="1" maxOccurs="unbounded" name="Diagnosis">
                            <xs:complexType>
                                <xs:sequence>
                                    <xs:element minOccurs="1" maxOccurs="1" name="Type" type="tns:DiagnosisType" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Code" type="tns:DiagnosisCode" />
                                    <xs:element name="DxInfo" minOccurs="0" maxOccurs="unbounded">
                                        <xs:complexType>
                                            <xs:sequence>
                                                <xs:element minOccurs="1" name="Type" type="tns:DxInfoType" />
                                                <xs:element minOccurs="1" name="Code" type="tns:DxInfoCode" />
                                            </xs:sequence>
                                        </xs:complexType>
                                    </xs:element>
                                </xs:sequence>
                            </xs:complexType>
                        </xs:element>
                        <xs:element minOccurs="1" maxOccurs="unbounded" name="Activity">
                            <xs:complexType>
                                <xs:sequence>
                                    <xs:element minOccurs="1" maxOccurs="1" name="ID" type="tns:ActivityID" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Start" type="tns:ActivityStart" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Type" type="tns:ActivityType" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Code" type="tns:ActivityCode" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Quantity" type="tns:ActivityQuantity" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Net" type="tns:ActivityNet" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Clinician" type="tns:ActivityClinician" />
                                    <xs:element minOccurs="0" maxOccurs="1" name="PriorAuthorizationID" type="tns:ActivityPriorAuthorizationID" />
                                    <xs:element minOccurs="0" maxOccurs="unbounded" name="Observation">
                                        <xs:complexType>
                                            <xs:sequence>
                                                <xs:element minOccurs="1" maxOccurs="1" name="Type" type="tns:ObservationType" />
                                                <xs:element minOccurs="1" maxOccurs="1" name="Code" type="tns:ObservationCode" />
                                                <xs:element minOccurs="0" maxOccurs="1" name="Value" type="tns:ObservationValue" />
                                                <xs:element minOccurs="0" maxOccurs="1" name="ValueType" type="tns:ObservationValueType" />
                                            </xs:sequence>
                                        </xs:complexType>
                                    </xs:element>
                                </xs:sequence>
                            </xs:complexType>
                        </xs:element>
                        <xs:element minOccurs="0" maxOccurs="1" name="Resubmission">
                            <xs:complexType>
                                <xs:sequence>
                                    <xs:element minOccurs="1" maxOccurs="1" name="Type" type="tns:ResubmissionType" />
                                    <xs:element minOccurs="1" maxOccurs="1" name="Comment" type="tns:ResubmissionComment" />
                                    <xs:element minOccurs="0" maxOccurs="1" name="Attachment" type="tns:ResubmissionAttachments" />
                                </xs:sequence>
                            </xs:complexType>
                        </xs:element>
                        <xs:element minOccurs="0" maxOccurs="1" name="Contract">
                            <xs:complexType>
                                <xs:sequence>
                                    <xs:element minOccurs="0" maxOccurs="1" name="PackageName" type="tns:ContractPackageName" />
                                </xs:sequence>
                            </xs:complexType>
                        </xs:element>
                    </xs:sequence>
                </xs:complexType>
            </xs:element>
        </xs:sequence>
    </xs:complexType>
</xs:element>
Collapse Child Elements:
Name Type Min Occurs Max Occurs
Header Header (1) (1)
Claim Claim 1 unbounded