Release 4 R5 Final QA

This page is part of the FHIR Specification (v4.0.1: R4 (v5.0.0-draft-final: Final QA Preview for R5 - Mixed Normative and STU see ballot notes ) in it's permanent home (it will always be available at this URL). ). 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

Medicationexample0310.xml

8.13 Resource Account - Content

Pharmacy Patient Administration icon Work Group Maturity Level : N/A 2   Trial Use Standards Status : Informative Security Category : Patient Compartments : Not linked to any defined compartments Device , Patient , Practitioner

Raw XML ( canonical form

A financial tool for tracking value accrued for a particular purpose. In the healthcare field, used to track charges for a patient, cost centers, etc.

+ also see XML Format Specification

8.13.1 Scope and Usage )

The Account resource acts as a central record against which charges, payments, and adjustments are applied. It contains information about which parties are responsible for payment of the account.

While the Account does conceptually have a balance, expressing that balance directly as a resource property is challenging due to the complexity of pricing contracts. An operation to retrieve the current balance of an account is in consideration as future work.

8.13.2 Boundaries and Relationships Jump past Narrative

The Account itself does not include information about the charges, payments or adjustments, but rather those resources, such as ChargeItem point to the account to which they apply. Payment and adjustment resources have not yet been developed.

8.13.3 Background and Context

Generic Formulation - Oxycodone (id = "med0310") The Account resource can be considered a "bucket" to which ChargeItem resources are linked. These charges are processed by a billing system, which determines the responsible parties for the balance of the account. The billing system then submits claims or sends statements to the appropriate parties. Once payment is received, an adjustment is applied to the Account. The internal calculation of balances and allocation of responsibility is expected to be internal to the billing systems. Only the inputs and outputs of the billing process is communicated in the relevant financial FHIR resources.

<?xml version="1.0" encoding="UTF-8"?> (Details : {SNOMED CT code '430127000' = 'Oral form oxycodone', given as 'Oral Form Oxycodone (product)'})(Details : {SNOMED CT code '385055001' = 'Tablet', given as 'Tablet dose form (qualifier value)'})

8.13.4 References to this Resource

8.13.5 Resource Content

Structure </ Medication

Name > Flags Card. Type Description & Constraints doco
. . Account TU DomainResource Tracks balance, charges, for patient or cost center

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
... identifier Σ 0..* Identifier Account number

... status ?! Σ 1..1 code active | inactive | entered-in-error | on-hold | unknown
Binding: Account Status ( Required )
... billingStatus Σ 0..1 CodeableConcept Tracks the lifecycle of the account through the billing process
Binding: Example Account Billing Statuses ( Example )
... name Σ 0..1 string Human-readable label
... subject Σ 0..* Reference ( Patient | Device | Practitioner | PractitionerRole | Location | HealthcareService | Organization ) The entity that caused the expenses

... servicePeriod Σ 0..1 Period Transaction window
... coverage Σ 0..* BackboneElement The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account

.... coverage Σ 1..1 Reference ( Coverage ) The party(s), such as insurances, that may contribute to the payment of this account
.... priority Σ 0..1 positiveInt The priority of the coverage in the context of this account
... owner Σ 0..1 Reference ( Organization ) Entity managing the Account
... description Σ 0..1 markdown Explanation of purpose/use
... guarantor 0..* BackboneElement The parties ultimately responsible for balancing the Account

.... party 1..1 Reference ( Patient | RelatedPerson | Organization ) Responsible entity
.... onHold 0..1 boolean Credit or other hold applied
.... period 0..1 Period Guarantee account during
... diagnosis Σ C TU 0..* BackboneElement The list of diagnoses relevant to this account
+ Rule: The dateOfDiagnosis is not valid when using a reference to a diagnosis

.... sequence 0..1 positiveInt Ranking of the diagnosis (for each type)
.... condition Σ C 1..1 CodeableReference ( Condition ) The diagnosis relevant to the account
Binding: Condition/Problem/Diagnosis Codes ( Example )
.... dateOfDiagnosis C 0..1 dateTime Date of the diagnosis (when coded diagnosis)
.... type 0..* CodeableConcept Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …)
Binding: Encounter Diagnosis Use ( Preferred )

.... onAdmission 0..1 boolean Diagnosis present on Admission
.... packageCode 0..* CodeableConcept Package Code specific for billing
Binding: diagnosis-package-code ( Example )

... procedure Σ C TU 0..* BackboneElement The list of procedures relevant to this account
+ Rule: The dateOfService is not valid when using a reference to a procedure

.... sequence 0..1 positiveInt Ranking of the procedure (for each type)
.... code Σ C 1..1 CodeableReference ( Procedure ) The procedure relevant to the account
Binding: Procedure Codes (SNOMED CT) ( Example )
.... dateOfService C 0..1 dateTime Date of the procedure (when coded procedure)
.... type 0..* CodeableConcept How this procedure value should be used in charging the account
Binding: procedure-type ( Example )

.... packageCode 0..* CodeableConcept Package Code specific for billing
Binding: procedure-package-code ( Example )

.... device Σ 0..* Reference ( Device ) Any devices that were associated with the procedure

... relatedAccount 0..* BackboneElement Other associated accounts related to this account

.... relationship 0..1 CodeableConcept Relationship of the associated Account
Binding: Account Relationship ( Example )
.... account 1..1 Reference ( Account ) Reference to an associated Account
... currency 0..1 CodeableConcept The base or default currency
Binding: Currencies ( Required )
... balance 0..* BackboneElement Calculated account balance(s)

.... aggregate 0..1 CodeableConcept Who is expected to pay this part of the balance
Binding: Account Aggregate ( Extensible )
.... term 0..1 CodeableConcept current | 30 | 60 | 90 | 120
Binding: Account Balance Term ( Extensible )
.... estimate 0..1 boolean Estimated balance
.... amount 1..1 Money Calculated amount
... calculatedAt 0..1 instant Time the balance amount was calculated

doco Documentation for this format icon

See the Extensions for this resource

Usage note: every effort UML Diagram ( Legend )

Account ( DomainResource ) Unique identifier used to reference the account. Might or might not be intended for human use (e.g. credit card number) identifier : Identifier [0..*] Indicates whether the account is presently used/usable or not (this element modifies the meaning of other elements) status : code [1..1] « null (Strength=Required) AccountStatus ! » The BillingStatus tracks the lifecycle of the account through the billing process. It indicates how transactions are treated when they are allocated to the account billingStatus : CodeableConcept [0..1] « null (Strength=Example) AccountBillingStatus ?? » Categorizes the account for reporting and searching purposes type : CodeableConcept [0..1] « null (Strength=Example) AccountTypes ?? » Name used for the account when displaying it to humans in reports, etc name : string [0..1] Identifies the entity which incurs the expenses. While the immediate recipients of services or goods might be entities related to the subject, the expenses were ultimately incurred by the subject of the Account subject : Reference [0..*] « Patient | Device | Practitioner | PractitionerRole | Location | HealthcareService | Organization » The date range of services associated with this account servicePeriod : Period [0..1] Indicates the service area, hospital, department, etc. with responsibility for managing the Account owner : Reference [0..1] « Organization » Provides additional information about what the account tracks and how it is used description : markdown [0..1] The default currency for the account currency : CodeableConcept [0..1] « null (Strength=Required) Currencies ! » Time the balance amount was calculated calculatedAt : instant [0..1] Coverage The party(s) that contribute to payment (or part of) of the charges applied to this account (including self-pay). A coverage may only be responsible for specific types of charges, and the sequence of the coverages in the account could be important when processing billing coverage : Reference [1..1] « Coverage » The priority of the coverage in the context of this account priority : positiveInt [0..1] Guarantor The entity who is responsible party : Reference [1..1] « Patient | RelatedPerson | Organization » A guarantor may be placed on credit hold or otherwise have their role temporarily suspended onHold : boolean [0..1] The timeframe during which the guarantor accepts responsibility for the account period : Period [0..1] Diagnosis Ranking of the diagnosis (for each type) sequence : positiveInt [0..1] The diagnosis relevant to the account condition : CodeableReference [1..1] « Condition ; null (Strength=Example) ConditionProblemDiagnosisCodes ?? » « This element has been made or is affected by some invariants C » Ranking of the diagnosis (for each type) dateOfDiagnosis : dateTime [0..1] « This element has or is affected by some invariants C » Type that this diagnosis has relevant to ensure the account (e.g. admission, billing, discharge …) type : CodeableConcept [0..*] « null (Strength=Preferred) EncounterDiagnosisUse ? » Was the Diagnosis present on Admission in the related Encounter onAdmission : boolean [0..1] The package code can be used to group diagnoses that may be priced or delivered as a single product. Such as DRGs packageCode : CodeableConcept [0..*] « null (Strength=Example) diagnosis-package-code?? » Procedure Ranking of the examples procedure (for each type) sequence : positiveInt [0..1] The procedure relevant to the account code : CodeableReference [1..1] « Procedure ; null (Strength=Example) ProcedureCodesSNOMEDCT ?? » « This element has or is affected by some invariants C » Date of the procedure when using a coded procedure. If using a reference to a procedure, then the date on the procedure should be used dateOfService : dateTime [0..1] « This element has or is affected by some invariants C » How this procedure value should be used in charging the account type : CodeableConcept [0..*] « null (Strength=Example) procedure-type?? » The package code can be used to group procedures that may be priced or delivered as a single product. Such as DRGs packageCode : CodeableConcept [0..*] « null (Strength=Example) procedure-package-code?? » Any devices that were associated with the procedure relevant to the account device : Reference [0..*] « Device » RelatedAccount Relationship of the associated Account relationship : CodeableConcept [0..1] « null (Strength=Example) AccountRelationship ?? » Reference to an associated Account account : Reference [1..1] « Account » Balance Who is expected to pay this part of the balance aggregate : CodeableConcept [0..1] « null (Strength=Extensible) AccountAggregate + » The term of the account balances - The balance value is the amount that was outstanding for this age term : CodeableConcept [0..1] « null (Strength=Extensible) AccountBalanceTerm + » The amount is only an estimated value - this is likely common for `current` term balances, but not with known terms (that were generated by a backend process) estimate : boolean [0..1] The actual balance value calculated for the age defined in the term property amount : Money [1..1] The party(s) that are correct responsible for covering the payment of this account, and useful, but what order should they be applied to the account coverage [0..*] The parties responsible for balancing the account if other payment options fall short guarantor [0..*] When using an account for billing a specific Encounter the set of diagnoses that are not relevant for billing are stored here on the account where they are able to be sequenced appropriately prior to processing to produce claim(s) diagnosis [0..*] When using an account for billing a normative part specific Encounter the set of procedures that are relevant for billing are stored here on the specification. account where they are able to be sequenced appropriately prior to processing to produce claim(s) procedure [0..*] Other associated accounts related to this account relatedAccount [0..*] The calculated account balances - these are calculated and processed by the finance system. The balances with a `term` that is not current are usually generated/updated by an invoicing or similar process balance [0..*]

XML Template 


<Account xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Account number --></identifier>
 <status value="[code]"/><!-- 1..1 active | inactive | entered-in-error | on-hold | unknown -->
 <billingStatus><!-- 0..1 CodeableConcept Tracks the lifecycle of the account through the billing process --></billingStatus>
 <type><!-- 0..1 CodeableConcept E.g. patient, expense, depreciation --></type>
 <name value="[string]"/><!-- 0..1 Human-readable label -->
 <subject><!-- 0..* Reference(Device|HealthcareService|Location|Organization|
   Patient|Practitioner|PractitionerRole) The entity that caused the expenses --></subject>

 <servicePeriod><!-- 0..1 Period Transaction window --></servicePeriod>
 <coverage>  <!-- 0..* The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account -->
  <coverage><!-- 1..1 Reference(Coverage) The party(s), such as insurances, that may contribute to the payment of this account --></coverage>
  <priority value="[positiveInt]"/><!-- 0..1 The priority of the coverage in the context of this account -->
 </coverage>
 <owner><!-- 0..1 Reference(Organization) Entity managing the Account --></owner>
 <description value="[markdown]"/><!-- 0..1 Explanation of purpose/use -->
 <guarantor>  <!-- 0..* The parties ultimately responsible for balancing the Account -->
  <party><!-- 1..1 Reference(Organization|Patient|RelatedPerson) Responsible entity --></party>
  <onHold value="[boolean]"/><!-- 0..1 Credit or other hold applied -->
  <period><!-- 0..1 Period Guarantee account during --></period>
 </guarantor>
 <diagnosis>  <!-- 0..* The list of diagnoses relevant to this account -->
  <sequence value="[positiveInt]"/><!-- 0..1 Ranking of the diagnosis (for each type) -->
  <condition><!-- I 1..1 CodeableReference(Condition) The diagnosis relevant to the account --></condition>
  <dateOfDiagnosis value="[dateTime]"/><!-- I 0..1 Date of the diagnosis (when coded diagnosis) -->
  <type><!-- 0..* CodeableConcept Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …) --></type>
  <onAdmission value="[boolean]"/><!-- 0..1 Diagnosis present on Admission -->
  <packageCode><!-- 0..* CodeableConcept Package Code specific for billing --></packageCode>
 </diagnosis>
 <procedure>  <!-- 0..* The list of procedures relevant to this account -->
  <sequence value="[positiveInt]"/><!-- 0..1 Ranking of the procedure (for each type) -->
  <code><!-- I 1..1 CodeableReference(Procedure) The procedure relevant to the account --></code>
  <dateOfService value="[dateTime]"/><!-- I 0..1 Date of the procedure (when coded procedure) -->
  <type><!-- 0..* CodeableConcept How this procedure value should be used in charging the account --></type>
  <packageCode><!-- 0..* CodeableConcept Package Code specific for billing --></packageCode>
  <device><!-- 0..* Reference(Device) Any devices that were associated with the procedure --></device>
 </procedure>
 <relatedAccount>  <!-- 0..* Other associated accounts related to this account -->
  <relationship><!-- 0..1 CodeableConcept Relationship of the associated Account --></relationship>
  <account><!-- 1..1 Reference(Account) Reference to an associated Account --></account>
 </relatedAccount>
 <currency><!-- 0..1 CodeableConcept The base or default currency --></currency>
 <balance>  <!-- 0..* Calculated account balance(s) -->
  <aggregate><!-- 0..1 CodeableConcept Who is expected to pay this part of the balance --></aggregate>
  <term><!-- 0..1 CodeableConcept current | 30 | 60 | 90 | 120 --></term>
  <estimate value="[boolean]"/><!-- 0..1 Estimated balance -->
  <amount><!-- 1..1 Money Calculated amount --></amount>
 </balance>
 <calculatedAt value="[instant]"/><!-- 0..1 Time the balance amount was calculated -->
</Account>

JSON Template 


{doco
  "resourceType" : "Account",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Account number
  "status" : "<code>", // R!  active | inactive | entered-in-error | on-hold | unknown
  "billingStatus" : { CodeableConcept }, // Tracks the lifecycle of the account through the billing process
  "type" : { CodeableConcept }, // E.g. patient, expense, depreciation
  "name" : "<string>", // Human-readable label
  "subject" : [{ Reference(Device|HealthcareService|Location|Organization|
   Patient|Practitioner|PractitionerRole) }], // The entity that caused the expenses

  "servicePeriod" : { Period }, // Transaction window
  "coverage" : [{ // The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account
    "coverage" : { Reference(Coverage) }, // R!  The party(s), such as insurances, that may contribute to the payment of this account
    "priority" : "<positiveInt>" // The priority of the coverage in the context of this account
  }],
  "owner" : { Reference(Organization) }, // Entity managing the Account
  "description" : "<markdown>", // Explanation of purpose/use
  "guarantor" : [{ // The parties ultimately responsible for balancing the Account
    "party" : { Reference(Organization|Patient|RelatedPerson) }, // R!  Responsible entity
    "onHold" : <boolean>, // Credit or other hold applied
    "period" : { Period } // Guarantee account during
  }],
  "diagnosis" : [{ // The list of diagnoses relevant to this account
    "sequence" : "<positiveInt>", // Ranking of the diagnosis (for each type)
    "condition" : { CodeableReference(Condition) }, // I R!  The diagnosis relevant to the account
    "dateOfDiagnosis" : "<dateTime>", // I Date of the diagnosis (when coded diagnosis)
    "type" : [{ CodeableConcept }], // Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …)
    "onAdmission" : <boolean>, // Diagnosis present on Admission
    "packageCode" : [{ CodeableConcept }] // Package Code specific for billing
  }],
  "procedure" : [{ // The list of procedures relevant to this account
    "sequence" : "<positiveInt>", // Ranking of the procedure (for each type)
    "code" : { CodeableReference(Procedure) }, // I R!  The procedure relevant to the account
    "dateOfService" : "<dateTime>", // I Date of the procedure (when coded procedure)
    "type" : [{ CodeableConcept }], // How this procedure value should be used in charging the account
    "packageCode" : [{ CodeableConcept }], // Package Code specific for billing
    "device" : [{ Reference(Device) }] // Any devices that were associated with the procedure
  }],
  "relatedAccount" : [{ // Other associated accounts related to this account
    "relationship" : { CodeableConcept }, // Relationship of the associated Account
    "account" : { Reference(Account) } // R!  Reference to an associated Account
  }],
  "currency" : { CodeableConcept }, // The base or default currency
  "balance" : [{ // Calculated account balance(s)
    "aggregate" : { CodeableConcept }, // Who is expected to pay this part of the balance
    "term" : { CodeableConcept }, // current | 30 | 60 | 90 | 120
    "estimate" : <boolean>, // Estimated balance
    "amount" : { Money } // R!  Calculated amount
  }],
  "calculatedAt" : "<instant>" // Time the balance amount was calculated
}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Account;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Account number
  fhir:status [ code ] ; # 1..1 active | inactive | entered-in-error | on-hold | unknown
  fhir:billingStatus [ CodeableConcept ] ; # 0..1 Tracks the lifecycle of the account through the billing process
  fhir:type [ CodeableConcept ] ; # 0..1 E.g. patient, expense, depreciation
  fhir:name [ string ] ; # 0..1 Human-readable label
  fhir:subject  ( [ Reference(Device|HealthcareService|Location|Organization|Patient|Practitioner|
  PractitionerRole) ] ... ) ; # 0..* The entity that caused the expenses

  fhir:servicePeriod [ Period ] ; # 0..1 Transaction window
  fhir:coverage ( [ # 0..* The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account
    fhir:coverage [ Reference(Coverage) ] ; # 1..1 The party(s), such as insurances, that may contribute to the payment of this account
    fhir:priority [ positiveInt ] ; # 0..1 The priority of the coverage in the context of this account
  ] ... ) ;
  fhir:owner [ Reference(Organization) ] ; # 0..1 Entity managing the Account
  fhir:description [ markdown ] ; # 0..1 Explanation of purpose/use
  fhir:guarantor ( [ # 0..* The parties ultimately responsible for balancing the Account
    fhir:party [ Reference(Organization|Patient|RelatedPerson) ] ; # 1..1 Responsible entity
    fhir:onHold [ boolean ] ; # 0..1 Credit or other hold applied
    fhir:period [ Period ] ; # 0..1 Guarantee account during
  ] ... ) ;
  fhir:diagnosis ( [ # 0..* The list of diagnoses relevant to this account
    fhir:sequence [ positiveInt ] ; # 0..1 Ranking of the diagnosis (for each type)
    fhir:condition [ CodeableReference(Condition) ] ; # 1..1 I The diagnosis relevant to the account
    fhir:dateOfDiagnosis [ dateTime ] ; # 0..1 I Date of the diagnosis (when coded diagnosis)
    fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …)
    fhir:onAdmission [ boolean ] ; # 0..1 Diagnosis present on Admission
    fhir:packageCode  ( [ CodeableConcept ] ... ) ; # 0..* Package Code specific for billing
  ] ... ) ;
  fhir:procedure ( [ # 0..* The list of procedures relevant to this account
    fhir:sequence [ positiveInt ] ; # 0..1 Ranking of the procedure (for each type)
    fhir:code [ CodeableReference(Procedure) ] ; # 1..1 I The procedure relevant to the account
    fhir:dateOfService [ dateTime ] ; # 0..1 I Date of the procedure (when coded procedure)
    fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* How this procedure value should be used in charging the account
    fhir:packageCode  ( [ CodeableConcept ] ... ) ; # 0..* Package Code specific for billing
    fhir:device  ( [ Reference(Device) ] ... ) ; # 0..* Any devices that were associated with the procedure
  ] ... ) ;
  fhir:relatedAccount ( [ # 0..* Other associated accounts related to this account
    fhir:relationship [ CodeableConcept ] ; # 0..1 Relationship of the associated Account
    fhir:account [ Reference(Account) ] ; # 1..1 Reference to an associated Account
  ] ... ) ;
  fhir:currency [ CodeableConcept ] ; # 0..1 The base or default currency
  fhir:balance ( [ # 0..* Calculated account balance(s)
    fhir:aggregate [ CodeableConcept ] ; # 0..1 Who is expected to pay this part of the balance
    fhir:term [ CodeableConcept ] ; # 0..1 current | 30 | 60 | 90 | 120
    fhir:estimate [ boolean ] ; # 0..1 Estimated balance
    fhir:amount [ Money ] ; # 1..1 Calculated amount
  ] ... ) ;
  fhir:calculatedAt [ instant ] ; # 0..1 Time the balance amount was calculated
]

Changes since R4

Account
Account.billingStatus
  • Added Element
Account.description
  • Type changed from string to markdown
Account.diagnosis
  • Added Element
Account.diagnosis.sequence
  • Added Element
Account.diagnosis.condition
  • Added Mandatory Element
Account.diagnosis.dateOfDiagnosis
  • Added Element
Account.diagnosis.type
  • Added Element
Account.diagnosis.onAdmission
  • Added Element
Account.diagnosis.packageCode
  • Added Element
Account.procedure
  • Added Element
Account.procedure.sequence
  • Added Element
Account.procedure.code
  • Added Mandatory Element
Account.procedure.dateOfService
  • Added Element
Account.procedure.type
  • Added Element
Account.procedure.packageCode
  • Added Element
Account.procedure.device
  • Added Element
Account.relatedAccount
  • Added Element
Account.relatedAccount.relationship
  • Added Element
Account.relatedAccount.account
  • Added Mandatory Element
Account.currency
  • Added Element
Account.balance
  • Added Element
Account.balance.aggregate
  • Added Element
Account.balance.term
  • Added Element
Account.balance.estimate
  • Added Element
Account.balance.amount
  • Added Mandatory Element
Account.calculatedAt
  • Added Element
Account.partOf
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. 2 fail round-trip testing and all r3 resources are valid.)

®© HL7.org 2011+. FHIR Release 4 (Technical Correction #1) (v4.0.1) generated on Fri, Nov 1, 2019 09:35+1100. QA Page Structure

Name Flags Card. Type Description & Constraints doco
.. Account TU DomainResource Tracks balance, charges, for patient or cost center
Links: Search
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
... identifier Σ 0..* Identifier Account number

... status ?! Σ 1..1 code active | Version History inactive | entered-in-error | on-hold | unknown
Binding: Account Status ( Required )
... billingStatus Σ 0..1 CodeableConcept Tracks the lifecycle of the account through the billing process
Binding: Example Account Billing Statuses ( Example )
... name Σ 0..1 string Human-readable label
... subject Σ 0..* Reference ( Patient | Table Device | Practitioner | PractitionerRole | Location | HealthcareService | Organization ) The entity that caused the expenses

... servicePeriod Σ 0..1 Period Transaction window
... coverage Σ 0..* BackboneElement The party(s) that are responsible for covering the payment of Contents this account, and what order should they be applied to the account

.... coverage Σ 1..1 Reference ( Coverage ) The party(s), such as insurances, that may contribute to the payment of this account
.... priority Σ 0..1 positiveInt The priority of the coverage in the context of this account
... owner Σ 0..1 Reference ( Organization ) Entity managing the Account
... description Σ 0..1 markdown Explanation of purpose/use
... guarantor 0..* BackboneElement The parties ultimately responsible for balancing the Account

.... party 1..1 Reference ( Patient | Credits RelatedPerson | Compare Organization ) Responsible entity
.... onHold 0..1 boolean Credit or other hold applied
.... period 0..1 Period Guarantee account during
... diagnosis Σ C TU 0..* BackboneElement The list of diagnoses relevant to R3 this account
+ Rule: The dateOfDiagnosis is not valid when using a reference to a diagnosis

.... sequence 0..1 positiveInt Ranking of the diagnosis (for each type)
.... condition Σ C 1..1 CodeableReference ( Condition ) The diagnosis relevant to the account
Binding: Condition/Problem/Diagnosis Codes ( Example )
.... dateOfDiagnosis C 0..1 dateTime Date of the diagnosis (when coded diagnosis)
.... type 0..* CodeableConcept Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …)
Binding: Encounter Diagnosis Use ( Preferred )

.... onAdmission 0..1 boolean Diagnosis present on Admission
.... packageCode 0..* CodeableConcept Package Code specific for billing
Binding: diagnosis-package-code ( Example )

... procedure Σ C TU 0..* BackboneElement The list of procedures relevant to this account
+ Rule: The dateOfService is not valid when using a reference to a procedure

.... sequence 0..1 positiveInt Ranking of the procedure (for each type)
.... code Σ C 1..1 CodeableReference ( Procedure ) The procedure relevant to the account
Binding: Procedure Codes (SNOMED CT) ( Example )
.... dateOfService C 0..1 dateTime Date of the procedure (when coded procedure)
.... type 0..* CodeableConcept How this procedure value should be used in charging the account
Binding: procedure-type ( Example )

.... packageCode 0..* CodeableConcept Package Code specific for billing
Binding: procedure-package-code ( Example )

.... device Σ 0..* Reference ( Device ) Any devices that were associated with the procedure

... relatedAccount 0..* BackboneElement Other associated accounts related to this account

.... relationship 0..1 CodeableConcept Relationship of the associated Account
Binding: Account Relationship ( Example )
.... account 1..1 Reference ( Account ) Reference to an associated Account
... currency 0..1 CodeableConcept The base or default currency
Binding: Currencies ( Required )
... balance 0..* BackboneElement Calculated account balance(s)

.... aggregate 0..1 CodeableConcept Who is expected to pay this part of the balance
Binding: Account Aggregate ( Extensible )
.... term 0..1 CodeableConcept current | 30 | 60 | 90 | 120
Binding: Account Balance Term ( Extensible )
. . . . estimate 0..1 boolean Estimated balance
.... amount 1..1 Money Calculated amount
... calculatedAt 0..1 instant Time the balance amount was calculated

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

Account ( DomainResource ) Unique identifier used to reference the account. Might or might not be intended for human use (e.g. credit card number) identifier : Identifier [0..*] Indicates whether the account is presently used/usable or not (this element modifies the meaning of other elements) status : code [1..1] « null (Strength=Required) AccountStatus ! » The BillingStatus tracks the lifecycle of the account through the billing process. It indicates how transactions are treated when they are allocated to the account billingStatus : CodeableConcept [0..1] « null (Strength=Example) AccountBillingStatus ?? » Categorizes the account for reporting and searching purposes type : CodeableConcept [0..1] « null (Strength=Example) AccountTypes ?? » Name used for the account when displaying it to humans in reports, etc name : string [0..1] Identifies the entity which incurs the expenses. While the immediate recipients of services or goods might be entities related to the subject, the expenses were ultimately incurred by the subject of the Account subject : Reference [0..*] « Patient | Propose Device | Practitioner | PractitionerRole | Location | HealthcareService | Organization » The date range of services associated with this account servicePeriod : Period [0..1] Indicates the service area, hospital, department, etc. with responsibility for managing the Account owner : Reference [0..1] « Organization » Provides additional information about what the account tracks and how it is used description : markdown [0..1] The default currency for the account currency : CodeableConcept [0..1] « null (Strength=Required) Currencies ! » Time the balance amount was calculated calculatedAt : instant [0..1] Coverage The party(s) that contribute to payment (or part of) of the charges applied to this account (including self-pay). A coverage may only be responsible for specific types of charges, and the sequence of the coverages in the account could be important when processing billing coverage : Reference [1..1] « Coverage » The priority of the coverage in the context of this account priority : positiveInt [0..1] Guarantor The entity who is responsible party : Reference [1..1] « Patient | RelatedPerson | Organization » A guarantor may be placed on credit hold or otherwise have their role temporarily suspended onHold : boolean [0..1] The timeframe during which the guarantor accepts responsibility for the account period : Period [0..1] Diagnosis Ranking of the diagnosis (for each type) sequence : positiveInt [0..1] The diagnosis relevant to the account condition : CodeableReference [1..1] « Condition ; null (Strength=Example) ConditionProblemDiagnosisCodes ?? » « This element has or is affected by some invariants C » Ranking of the diagnosis (for each type) dateOfDiagnosis : dateTime [0..1] « This element has or is affected by some invariants C » Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …) type : CodeableConcept [0..*] « null (Strength=Preferred) EncounterDiagnosisUse ? » Was the Diagnosis present on Admission in the related Encounter onAdmission : boolean [0..1] The package code can be used to group diagnoses that may be priced or delivered as a change single product. Such as DRGs packageCode : CodeableConcept [0..*] « null (Strength=Example) diagnosis-package-code?? » Procedure Ranking of the procedure (for each type) sequence : positiveInt [0..1] The procedure relevant to the account code : CodeableReference [1..1] « Procedure ; null (Strength=Example) ProcedureCodesSNOMEDCT ?? » « This element has or is affected by some invariants C » Date of the procedure when using a coded procedure. If using a reference to a procedure, then the date on the procedure should be used dateOfService : dateTime [0..1] « This element has or is affected by some invariants C » How this procedure value should be used in charging the account type : CodeableConcept [0..*] « null (Strength=Example) procedure-type?? » The package code can be used to group procedures that may be priced or delivered as a single product. Such as DRGs packageCode : CodeableConcept [0..*] « null (Strength=Example) procedure-package-code?? » Any devices that were associated with the procedure relevant to the account device : Reference [0..*] « Device » RelatedAccount Relationship of the associated Account relationship : CodeableConcept [0..1] « null (Strength=Example) AccountRelationship ?? » Reference to an associated Account account : Reference [1..1] « Account » Balance Who is expected to pay this part of the balance aggregate : CodeableConcept [0..1] « null (Strength=Extensible) AccountAggregate + » The term of the account balances - The balance value is the amount that was outstanding for this age term : CodeableConcept [0..1] « null (Strength=Extensible) AccountBalanceTerm + » The amount is only an estimated value - this is likely common for `current` term balances, but not with known terms (that were generated by a backend process) estimate : boolean [0..1] The actual balance value calculated for the age defined in the term property amount : Money [1..1] The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account coverage [0..*] The parties responsible for balancing the account if other payment options fall short guarantor [0..*] When using an account for billing a specific Encounter the set of diagnoses that are relevant for billing are stored here on the account where they are able to be sequenced appropriately prior to processing to produce claim(s) diagnosis [0..*] When using an account for billing a specific Encounter the set of procedures that are relevant for billing are stored here on the account where they are able to be sequenced appropriately prior to processing to produce claim(s) procedure [0..*] Other associated accounts related to this account relatedAccount [0..*] The calculated account balances - these are calculated and processed by the finance system. The balances with a `term` that is not current are usually generated/updated by an invoicing or similar process balance [0..*]

XML Template 


<Account xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Account number --></identifier>
 <status value="[code]"/><!-- 1..1 active | inactive | entered-in-error | on-hold | unknown -->
 <billingStatus><!-- 0..1 CodeableConcept Tracks the lifecycle of the account through the billing process --></billingStatus>
 <type><!-- 0..1 CodeableConcept E.g. patient, expense, depreciation --></type>
 <name value="[string]"/><!-- 0..1 Human-readable label -->
 <subject><!-- 0..* Reference(Device|HealthcareService|Location|Organization|
   Patient|Practitioner|PractitionerRole) The entity that caused the expenses --></subject>

 <servicePeriod><!-- 0..1 Period Transaction window --></servicePeriod>
 <coverage>  <!-- 0..* The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account -->
  <coverage><!-- 1..1 Reference(Coverage) The party(s), such as insurances, that may contribute to the payment of this account --></coverage>
  <priority value="[positiveInt]"/><!-- 0..1 The priority of the coverage in the context of this account -->
 </coverage>
 <owner><!-- 0..1 Reference(Organization) Entity managing the Account --></owner>
 <description value="[markdown]"/><!-- 0..1 Explanation of purpose/use -->
 <guarantor>  <!-- 0..* The parties ultimately responsible for balancing the Account -->
  <party><!-- 1..1 Reference(Organization|Patient|RelatedPerson) Responsible entity --></party>
  <onHold value="[boolean]"/><!-- 0..1 Credit or other hold applied -->
  <period><!-- 0..1 Period Guarantee account during --></period>
 </guarantor>
 <diagnosis>  <!-- 0..* The list of diagnoses relevant to this account -->
  <sequence value="[positiveInt]"/><!-- 0..1 Ranking of the diagnosis (for each type) -->
  <condition><!-- I 1..1 CodeableReference(Condition) The diagnosis relevant to the account --></condition>
  <dateOfDiagnosis value="[dateTime]"/><!-- I 0..1 Date of the diagnosis (when coded diagnosis) -->
  <type><!-- 0..* CodeableConcept Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …) --></type>
  <onAdmission value="[boolean]"/><!-- 0..1 Diagnosis present on Admission -->
  <packageCode><!-- 0..* CodeableConcept Package Code specific for billing --></packageCode>
 </diagnosis>
 <procedure>  <!-- 0..* The list of procedures relevant to this account -->
  <sequence value="[positiveInt]"/><!-- 0..1 Ranking of the procedure (for each type) -->
  <code><!-- I 1..1 CodeableReference(Procedure) The procedure relevant to the account --></code>
  <dateOfService value="[dateTime]"/><!-- I 0..1 Date of the procedure (when coded procedure) -->
  <type><!-- 0..* CodeableConcept How this procedure value should be used in charging the account --></type>
  <packageCode><!-- 0..* CodeableConcept Package Code specific for billing --></packageCode>
  <device><!-- 0..* Reference(Device) Any devices that were associated with the procedure --></device>
 </procedure>
 <relatedAccount>  <!-- 0..* Other associated accounts related to this account -->
  <relationship><!-- 0..1 CodeableConcept Relationship of the associated Account --></relationship>
  <account><!-- 1..1 Reference(Account) Reference to an associated Account --></account>
 </relatedAccount>
 <currency><!-- 0..1 CodeableConcept The base or default currency --></currency>
 <balance>  <!-- 0..* Calculated account balance(s) -->
  <aggregate><!-- 0..1 CodeableConcept Who is expected to pay this part of the balance --></aggregate>
  <term><!-- 0..1 CodeableConcept current | 30 | 60 | 90 | 120 --></term>
  <estimate value="[boolean]"/><!-- 0..1 Estimated balance -->
  <amount><!-- 1..1 Money Calculated amount --></amount>
 </balance>
 <calculatedAt value="[instant]"/><!-- 0..1 Time the balance amount was calculated -->
</Account>

JSON Template 


{doco
  "resourceType" : "Account",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Account number
  "status" : "<code>", // R!  active | inactive | entered-in-error | on-hold | unknown
  "billingStatus" : { CodeableConcept }, // Tracks the lifecycle of the account through the billing process
  "type" : { CodeableConcept }, // E.g. patient, expense, depreciation
  "name" : "<string>", // Human-readable label
  "subject" : [{ Reference(Device|HealthcareService|Location|Organization|
   Patient|Practitioner|PractitionerRole) }], // The entity that caused the expenses

  "servicePeriod" : { Period }, // Transaction window
  "coverage" : [{ // The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account
    "coverage" : { Reference(Coverage) }, // R!  The party(s), such as insurances, that may contribute to the payment of this account
    "priority" : "<positiveInt>" // The priority of the coverage in the context of this account
  }],
  "owner" : { Reference(Organization) }, // Entity managing the Account
  "description" : "<markdown>", // Explanation of purpose/use
  "guarantor" : [{ // The parties ultimately responsible for balancing the Account
    "party" : { Reference(Organization|Patient|RelatedPerson) }, // R!  Responsible entity
    "onHold" : <boolean>, // Credit or other hold applied
    "period" : { Period } // Guarantee account during
  }],
  "diagnosis" : [{ // The list of diagnoses relevant to this account
    "sequence" : "<positiveInt>", // Ranking of the diagnosis (for each type)
    "condition" : { CodeableReference(Condition) }, // I R!  The diagnosis relevant to the account
    "dateOfDiagnosis" : "<dateTime>", // I Date of the diagnosis (when coded diagnosis)
    "type" : [{ CodeableConcept }], // Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …)
    "onAdmission" : <boolean>, // Diagnosis present on Admission
    "packageCode" : [{ CodeableConcept }] // Package Code specific for billing
  }],
  "procedure" : [{ // The list of procedures relevant to this account
    "sequence" : "<positiveInt>", // Ranking of the procedure (for each type)
    "code" : { CodeableReference(Procedure) }, // I R!  The procedure relevant to the account
    "dateOfService" : "<dateTime>", // I Date of the procedure (when coded procedure)
    "type" : [{ CodeableConcept }], // How this procedure value should be used in charging the account
    "packageCode" : [{ CodeableConcept }], // Package Code specific for billing
    "device" : [{ Reference(Device) }] // Any devices that were associated with the procedure
  }],
  "relatedAccount" : [{ // Other associated accounts related to this account
    "relationship" : { CodeableConcept }, // Relationship of the associated Account
    "account" : { Reference(Account) } // R!  Reference to an associated Account
  }],
  "currency" : { CodeableConcept }, // The base or default currency
  "balance" : [{ // Calculated account balance(s)
    "aggregate" : { CodeableConcept }, // Who is expected to pay this part of the balance
    "term" : { CodeableConcept }, // current | 30 | 60 | 90 | 120
    "estimate" : <boolean>, // Estimated balance
    "amount" : { Money } // R!  Calculated amount
  }],
  "calculatedAt" : "<instant>" // Time the balance amount was calculated
}

Turtle Template 


@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Account;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:identifier  ( [ Identifier ] ... ) ; # 0..* Account number
  fhir:status [ code ] ; # 1..1 active | inactive | entered-in-error | on-hold | unknown
  fhir:billingStatus [ CodeableConcept ] ; # 0..1 Tracks the lifecycle of the account through the billing process
  fhir:type [ CodeableConcept ] ; # 0..1 E.g. patient, expense, depreciation
  fhir:name [ string ] ; # 0..1 Human-readable label
  fhir:subject  ( [ Reference(Device|HealthcareService|Location|Organization|Patient|Practitioner|
  PractitionerRole) ] ... ) ; # 0..* The entity that caused the expenses

  fhir:servicePeriod [ Period ] ; # 0..1 Transaction window
  fhir:coverage ( [ # 0..* The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account
    fhir:coverage [ Reference(Coverage) ] ; # 1..1 The party(s), such as insurances, that may contribute to the payment of this account
    fhir:priority [ positiveInt ] ; # 0..1 The priority of the coverage in the context of this account
  ] ... ) ;
  fhir:owner [ Reference(Organization) ] ; # 0..1 Entity managing the Account
  fhir:description [ markdown ] ; # 0..1 Explanation of purpose/use
  fhir:guarantor ( [ # 0..* The parties ultimately responsible for balancing the Account
    fhir:party [ Reference(Organization|Patient|RelatedPerson) ] ; # 1..1 Responsible entity
    fhir:onHold [ boolean ] ; # 0..1 Credit or other hold applied
    fhir:period [ Period ] ; # 0..1 Guarantee account during
  ] ... ) ;
  fhir:diagnosis ( [ # 0..* The list of diagnoses relevant to this account
    fhir:sequence [ positiveInt ] ; # 0..1 Ranking of the diagnosis (for each type)
    fhir:condition [ CodeableReference(Condition) ] ; # 1..1 I The diagnosis relevant to the account
    fhir:dateOfDiagnosis [ dateTime ] ; # 0..1 I Date of the diagnosis (when coded diagnosis)
    fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …)
    fhir:onAdmission [ boolean ] ; # 0..1 Diagnosis present on Admission
    fhir:packageCode  ( [ CodeableConcept ] ... ) ; # 0..* Package Code specific for billing
  ] ... ) ;
  fhir:procedure ( [ # 0..* The list of procedures relevant to this account
    fhir:sequence [ positiveInt ] ; # 0..1 Ranking of the procedure (for each type)
    fhir:code [ CodeableReference(Procedure) ] ; # 1..1 I The procedure relevant to the account
    fhir:dateOfService [ dateTime ] ; # 0..1 I Date of the procedure (when coded procedure)
    fhir:type  ( [ CodeableConcept ] ... ) ; # 0..* How this procedure value should be used in charging the account
    fhir:packageCode  ( [ CodeableConcept ] ... ) ; # 0..* Package Code specific for billing
    fhir:device  ( [ Reference(Device) ] ... ) ; # 0..* Any devices that were associated with the procedure
  ] ... ) ;
  fhir:relatedAccount ( [ # 0..* Other associated accounts related to this account
    fhir:relationship [ CodeableConcept ] ; # 0..1 Relationship of the associated Account
    fhir:account [ Reference(Account) ] ; # 1..1 Reference to an associated Account
  ] ... ) ;
  fhir:currency [ CodeableConcept ] ; # 0..1 The base or default currency
  fhir:balance ( [ # 0..* Calculated account balance(s)
    fhir:aggregate [ CodeableConcept ] ; # 0..1 Who is expected to pay this part of the balance
    fhir:term [ CodeableConcept ] ; # 0..1 current | 30 | 60 | 90 | 120
    fhir:estimate [ boolean ] ; # 0..1 Estimated balance
    fhir:amount [ Money ] ; # 1..1 Calculated amount
  ] ... ) ;
  fhir:calculatedAt [ instant ] ; # 0..1 Time the balance amount was calculated
]

Changes since Release 4

Account
Account.billingStatus
  • Added Element
Account.description
  • Type changed from string to markdown
Account.diagnosis
  • Added Element
Account.diagnosis.sequence
  • Added Element
Account.diagnosis.condition
  • Added Mandatory Element
Account.diagnosis.dateOfDiagnosis
  • Added Element
Account.diagnosis.type
  • Added Element
Account.diagnosis.onAdmission
  • Added Element
Account.diagnosis.packageCode
  • Added Element
Account.procedure
  • Added Element
Account.procedure.sequence
  • Added Element
Account.procedure.code
  • Added Mandatory Element
Account.procedure.dateOfService
  • Added Element
Account.procedure.type
  • Added Element
Account.procedure.packageCode
  • Added Element
Account.procedure.device
  • Added Element
Account.relatedAccount
  • Added Element
Account.relatedAccount.relationship
  • Added Element
Account.relatedAccount.account
  • Added Mandatory Element
Account.currency
  • Added Element
Account.balance
  • Added Element
Account.balance.aggregate
  • Added Element
Account.balance.term
  • Added Element
Account.balance.estimate
  • Added Element
Account.balance.amount
  • Added Mandatory Element
Account.calculatedAt
  • Added Element
Account.partOf
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 2 tests that all execute ok. 2 fail round-trip testing and all r3 resources are valid.)

 

Additional definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis

8.13.5.1 Terminology Bindings

Path ValueSet Type Documentation
Account.status AccountStatus Required

Indicates whether the account is available to be used.

Account.billingStatus AccountBillingStatus (a valid code from Example Account Billing Statuses ) Example

Indicates whether the account is available to be used for billing purposes.

Account.type AccountTypes Example

This examples value set defines the set of codes that can be used to represent the type of an account.

Account.diagnosis.condition ConditionProblemDiagnosisCodes Example

Example value set for Condition/Problem/Diagnosis codes.

Account.diagnosis.type EncounterDiagnosisUse Preferred

What a specific Encounter/EpisodeOfCare diagnosis.condition is to be used for.

Account.diagnosis.packageCode ?? Example
Account.procedure.code ProcedureCodesSNOMEDCT Example

Procedure Code: All SNOMED CT procedure codes.

Account.procedure.type ?? Example
Account.procedure.packageCode ?? Example
Account.relatedAccount.relationship AccountRelationship Example

Relationship between accounts

Currencies (a valid code from urn:iso:std:iso:4217 ) Required

Currency codes from ISO 4217 (see https://www.iso.org/iso-4217-currency-codes.html)

Account.balance.aggregate AccountAggregate Extensible

Indicates who is expected to pay a part of the account balance.

Account.balance.term AccountBalanceTerm Extensible

Indicates the account balance's age.

8.13.5.2 Constraints

UniqueKey Level Location Description Expression
img  act-1 Rule Account.diagnosis The dateOfDiagnosis is not valid when using a reference to a diagnosis condition.reference.empty().not() implies dateOfDiagnosis.empty()
img  act-2 Rule Account.procedure The dateOfService is not valid when using a reference to a procedure code.reference.empty().not() implies dateOfService.empty()

8.13.6 Search Parameters

Search parameters for this resource. See also the full list of search parameters for this resource , and check the Extensions registry for search parameters on extensions related to this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
guarantor reference The parties ultimately responsible for balancing the Account Account.guarantor.party
( Organization , Patient , RelatedPerson )
identifier token Account number Account.identifier 65 Resources
name string Human-readable label Account.name
owner reference Entity managing the Account Account.owner
( Organization )
patient reference The entity that caused the expenses Account.subject.where(resolve() is Patient)
( Patient ) 		66 Resources
period date Transaction window Account.servicePeriod
relatedaccount reference Parent and other related accounts Account.relatedAccount.account
( Account )
status token active | inactive | entered-in-error | on-hold | unknown Account.status
subject reference The entity that caused the expenses Account.subject
( Practitioner , Organization , Device , Patient , HealthcareService , PractitionerRole , Location )
type token E.g. patient, expense, depreciation Account.type 11 Resources