STU3 Candidate

This page is part of the FHIR Specification (v1.8.0: STU 3 Draft). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Detailed Descriptions for the elements in the PaymentReconciliation resource.

PaymentReconciliation
Definition

This resource provides payment details and claim references supporting a bulk payment.

Control 1..1
PaymentReconciliation.identifier
Definition

The Response business identifier.

Note This is a business identifer, not a resource identifier (see discussion )
Control 0..*
Type Identifier
PaymentReconciliation.status
Definition

The status of the resource instance.

Control 0..1
Terminology Binding Financial Resource Status Codes ( Required )
Type code
Is Modifier true
Summary true
To Do The category of claim this is.
PaymentReconciliation.period
Definition

The period of time for which payments have been gathered into this bulk payment for settlement.

Control 0..1
Type Period
PaymentReconciliation.created
Definition

The date when the enclosed suite of services were performed or completed.

Control 0..1
Type dateTime
PaymentReconciliation.organization
Definition

The Insurer who produced this adjudicated response.

Control 0..1
Type Reference ( Organization )
PaymentReconciliation.request
Definition

Original request resource reference.

Control 0..1
Type Reference ( ProcessRequest )
PaymentReconciliation.outcome
Definition

Transaction status: error, complete.

Control 0..1
Terminology Binding RemittanceOutcome ( Required )
Type CodeableConcept
PaymentReconciliation.disposition
Definition

A description of the status of the adjudication.

Control 0..1
Type string
PaymentReconciliation.requestProvider
Definition

The practitioner who is responsible for the services rendered to the patient.

Control 0..1
Type Reference ( Practitioner )
PaymentReconciliation.requestOrganization
Definition

The organization which is responsible for the services rendered to the patient.

Control 0..1
Type Reference ( Organization )
PaymentReconciliation.detail
Definition

List of individual settlement amounts and the corresponding transaction.

Control 0..*
PaymentReconciliation.detail.type
Definition

Code to indicate the nature of the payment, adjustment, funds advance, etc.

Control 1..1
Terminology Binding Payment Type Codes ( Example )
Type CodeableConcept
PaymentReconciliation.detail.request
Definition

The claim or financial resource.

Control 0..1
Type Reference ( Any )
PaymentReconciliation.detail.response
Definition

The claim response resource.

Control 0..1
Type Reference ( Any )
PaymentReconciliation.detail.submitter
Definition

The Organization which submitted the invoice or financial transaction.

Control 0..1
Type Reference ( Organization )
PaymentReconciliation.detail.payee
Definition

The organization which is receiving the payment.

Control 0..1
Type Reference ( Organization )
PaymentReconciliation.detail.date
Definition

The date of the invoice or financial resource.

Control 0..1
Type date
PaymentReconciliation.detail.amount
Definition

Amount paid for this detail.

Control 0..1
Type Money
PaymentReconciliation.form
Definition

The form to be used for printing the content.

Control 0..1
Terminology Binding Form Codes ( Required )
Type CodeableConcept
PaymentReconciliation.total
Definition

Total payment amount.

Control 0..1
Type Money
PaymentReconciliation.note
Definition

Suite of notes.

Control 0..*
PaymentReconciliation.note.type
Definition

The note purpose: Print/Display.

Control 0..1
Terminology Binding NoteType ( Required )
Type CodeableConcept
PaymentReconciliation.note.text
Definition

The note text.

Control 0..1
Type string