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Financial
Management
Work
Group
|
Maturity Level : 2 | Trial Use | Security Category : Patient | Compartments : Practitioner |
Detailed Descriptions for the elements in the PaymentReconciliation resource.
| PaymentReconciliation | |
| Element Id | PaymentReconciliation |
| Definition |
This resource provides the details including amount of a payment and allocates the payment items being paid. |
| Cardinality | 0..* |
| Type | DomainResource |
| PaymentReconciliation.identifier | |
| Element Id | PaymentReconciliation.identifier |
| Definition |
A unique identifier assigned to this payment reconciliation. |
| Note | This is a business identifier, not a resource identifier (see discussion ) |
| Cardinality | 0..* |
| Type | Identifier |
| Requirements |
Allows payment reconciliations to be distinguished and referenced. |
| PaymentReconciliation.status | |
| Element Id | PaymentReconciliation.status |
| Definition |
The status of the resource instance. |
| Cardinality | 1..1 |
| Terminology Binding | Financial Resource Status Codes ( Required ) |
| Type | code |
| Is Modifier | true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid) |
| Requirements |
Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'. |
| Summary | true |
| Comments |
This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. |
| PaymentReconciliation.period | |
| Element Id | PaymentReconciliation.period |
| Definition |
The period of time for which payments have been gathered into this bulk payment for settlement. |
| Cardinality | 0..1 |
| Type | Period |
| Requirements |
Needed to allow receivers to monitor and reconcile payment issuer schedules. |
| Summary | true |
| PaymentReconciliation.created | |
| Element Id | PaymentReconciliation.created |
| Definition |
The date when the resource was created. |
| Cardinality | 1..1 |
| Type | dateTime |
| Requirements |
Need to record a timestamp for use by both the recipient and the issuer. |
| Summary | true |
| PaymentReconciliation.paymentIssuer | |
| Element Id | PaymentReconciliation.paymentIssuer |
| Definition |
The party who generated the payment. |
| Cardinality | 0..1 |
| Type | Reference ( Organization ) |
| Requirements |
Need to identify the party resonsible for the payment and this resource. |
| Summary | true |
| Comments |
This party is also responsible for the reconciliation. |
| PaymentReconciliation.request | |
| Element Id | PaymentReconciliation.request |
| Definition |
Original request resource reference. |
| Cardinality | 0..1 |
| Type | Reference ( Task ) |
| Requirements |
Needed to allow the response to be linked to the request. |
| PaymentReconciliation.requestor | |
| Element Id | PaymentReconciliation.requestor |
| Definition |
The practitioner who is responsible for the services rendered to the patient. |
| Cardinality | 0..1 |
| Type | Reference ( Practitioner | PractitionerRole | Organization ) |
| Patterns | Reference(Practitioner,PractitionerRole,Organization): Common patterns = Participant |
| Requirements |
Need to identify the party responsible for the request. |
| PaymentReconciliation.outcome | |
| Element Id | PaymentReconciliation.outcome |
| Definition |
The outcome of a request for a reconciliation. |
| Cardinality | 0..1 |
| Terminology Binding | RemittanceOutcome ( Required ) |
| Type | code |
| Requirements |
To advise the requestor of an overall processing outcome. |
| Comments |
The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete). |
| PaymentReconciliation.disposition | |
| Element Id | PaymentReconciliation.disposition |
| Definition |
A human readable description of the status of the request for the reconciliation. |
| Cardinality | 0..1 |
| Type | string |
| Requirements |
Provided for user display. |
| PaymentReconciliation.paymentDate | |
| Element Id | PaymentReconciliation.paymentDate |
| Definition |
The date of payment as indicated on the financial instrument. |
| Cardinality | 1..1 |
| Type | date |
| Requirements |
To advise the payee when payment can be expected. |
| Summary | true |
| PaymentReconciliation.paymentAmount | |
| Element Id | PaymentReconciliation.paymentAmount |
| Definition |
Total payment amount as indicated on the financial instrument. |
| Cardinality | 1..1 |
| Type | Money |
| Requirements |
Needed to provide the actual payment amount. |
| Summary | true |
| PaymentReconciliation.paymentIdentifier | |
| Element Id | PaymentReconciliation.paymentIdentifier |
| Definition |
Issuer's unique identifier for the payment instrument. |
| Cardinality | 0..1 |
| Type | Identifier |
| Requirements |
Enable the receiver to reconcile when payment is received. |
| Comments |
For example: EFT number or check number. |
| PaymentReconciliation.detail | |
| Element Id | PaymentReconciliation.detail |
| Definition |
Distribution of the payment amount for a previously acknowledged payable. |
| Cardinality | 0..* |
| Requirements |
Needed to show how the payment amount is distributed across the payables. |
| PaymentReconciliation.detail.identifier | |
| Element Id | PaymentReconciliation.detail.identifier |
| Definition |
Unique identifier for the current payment item for the referenced payable. |
| Note | This is a business identifier, not a resource identifier (see discussion ) |
| Cardinality | 0..1 |
| Type | Identifier |
| Requirements |
Needed for reconciliation of payments. |
| PaymentReconciliation.detail.predecessor | |
| Element Id | PaymentReconciliation.detail.predecessor |
| Definition |
Unique identifier for the prior payment item for the referenced payable. |
| Cardinality | 0..1 |
| Type | Identifier |
| Requirements |
Needed for reconciliation of payments. |
| PaymentReconciliation.detail.type | |
| Element Id | PaymentReconciliation.detail.type |
| Definition |
Code to indicate the nature of the payment. |
| Cardinality | 1..1 |
| Terminology Binding | Payment Type Codes ( Example ) |
| Type | CodeableConcept |
| Requirements |
Needed to provide context for the amount. |
| Comments |
For example: payment, adjustment, funds advance, etc. |
| PaymentReconciliation.detail.request | |
| Element Id | PaymentReconciliation.detail.request |
| Definition |
A resource, such as a Claim, the evaluation of which could lead to payment. |
| Cardinality | 0..1 |
| Type | Reference ( Any ) |
| Requirements |
Needed to provide a linkage to the original request. |
| PaymentReconciliation.detail.submitter | |
| Element Id | PaymentReconciliation.detail.submitter |
| Definition |
The party which submitted the claim or financial transaction. |
| Cardinality | 0..1 |
| Type | Reference ( Practitioner | PractitionerRole | Organization ) |
| Patterns | Reference(Practitioner,PractitionerRole,Organization): Common patterns = Participant |
| Requirements |
Needed for audit and validation. |
| PaymentReconciliation.detail.response | |
| Element Id | PaymentReconciliation.detail.response |
| Definition |
A resource, such as a ClaimResponse, which contains a commitment to payment. |
| Cardinality | 0..1 |
| Type | Reference ( Any ) |
| Requirements |
Needed to provide a linkage to the payment commitment. |
| PaymentReconciliation.detail.date | |
| Element Id | PaymentReconciliation.detail.date |
| Definition |
The date from the response resource containing a commitment to pay. |
| Cardinality | 0..1 |
| Type | date |
| Requirements |
Needed for audit and validation. |
| PaymentReconciliation.detail.responsible | |
| Element Id | PaymentReconciliation.detail.responsible |
| Definition |
A reference to the individual who is responsible for inquiries regarding the response and its payment. |
| Cardinality | 0..1 |
| Type | Reference ( PractitionerRole ) |
| Requirements |
To provide contact information. |
| PaymentReconciliation.detail.payee | |
| Element Id | PaymentReconciliation.detail.payee |
| Definition |
The party which is receiving the payment. |
| Cardinality | 0..1 |
| Type | Reference ( Practitioner | PractitionerRole | Organization ) |
| Patterns | Reference(Practitioner,PractitionerRole,Organization): Common patterns = Participant |
| Requirements |
Needed for audit and validation. |
| PaymentReconciliation.detail.amount | |
| Element Id | PaymentReconciliation.detail.amount |
| Definition |
The monetary amount allocated from the total payment to the payable. |
| Cardinality | 0..1 |
| Type | Money |
| Requirements |
Needed to explain the distribution of the payment to the payables. |
| PaymentReconciliation.formCode | |
| Element Id | PaymentReconciliation.formCode |
| Definition |
A code for the form to be used for printing the content. |
| Cardinality | 0..1 |
| Terminology Binding | Forms ( Example ) |
| Type | CodeableConcept |
| Requirements |
Needed to specify the specific form used for producing output for this response. |
| Comments |
May be needed to identify specific jurisdictional forms. |
| PaymentReconciliation.processNote | |
| Element Id | PaymentReconciliation.processNote |
| Definition |
A note that describes or explains the processing in a human readable form. |
| Cardinality | 0..* |
| Requirements |
Provides the specific textual explanations associated with the processing. |
| PaymentReconciliation.processNote.type | |
| Element Id | PaymentReconciliation.processNote.type |
| Definition |
The business purpose of the note text. |
| Cardinality | 0..1 |
| Terminology Binding | NoteType ( Required ) |
| Type | code |
| Requirements |
To convey the expectation for when the text is used. |
| PaymentReconciliation.processNote.text | |
| Element Id | PaymentReconciliation.processNote.text |
| Definition |
The explanation or description associated with the processing. |
| Cardinality | 0..1 |
| Type | string |
| Requirements |
Required to provide human readable explanation. |