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R4B
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Financial
Management
Work
Group
|
Maturity Level : 0 | Trial Use | Security Category : Patient | Compartments : Device , Patient , Practitioner , RelatedPerson |
Invoice containing collected ChargeItems from an Account with calculated individual and total price for Billing purpose.
Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. An invoice is a financial document issued by a healthcare provider to a patient or a payer indicating the goods and services (ChargeItems) performed with their quantities and prices.
Example implementations:
The existing Claim resource is constricted to use cases where Claims are sent to insurances for reimbursement, in a message-like style. It neither references ChargeItems nor Accounts.
Competing invoicing standards such as EDIFACT or X12 are aiming at inter-organizational exchange and do not offer human readable representations or traceable links to services rendered which is a requirement for invoicing towards patients. This resource is used where existing ChargeItems in an Account are collected to create an Invoice to be sent out to Individuals or Organizations in a structured way. The invoice is the hospital's view, whereas the Claim is the payer's view on the performed services.
Since the individual ChargeItem resources that make up the line items of the Invoice do not carry any pricing information, ChargeItemDefinitions will have to be applied to the ChargeItems in order to calculate the price components for the Invoice depending on the context of the ChargeItem
No resources refer to this resource directly.
This resource does not implement any patterns.
Structure
| Name | Flags | Card. | Type |
Description
&
Constraints
|
|---|---|---|---|---|
|
TU | DomainResource |
Invoice
containing
ChargeItems
from
an
Account
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension |
|
|
Σ | 0..* | Identifier |
Business
Identifier
for
item
|
|
?! Σ | 1..1 | code |
draft
|
issued
|
balanced
|
cancelled
|
entered-in-error
InvoiceStatus ( Required ) |
|
0..1 | string | Reason for cancellation of this Invoice | |
|
Σ | 0..1 | CodeableConcept | Type of Invoice |
|
Σ | 0..1 | Reference ( Patient | Group ) | Recipient(s) of goods and services |
|
Σ | 0..1 | Reference ( Organization | Patient | RelatedPerson ) | Recipient of this invoice |
|
Σ | 0..1 | dateTime | Invoice date / posting date |
|
0..* | BackboneElement |
Participant
in
creation
of
this
Invoice
|
|
|
0..1 | CodeableConcept | Type of involvement in creation of this Invoice | |
|
1..1 | Reference ( Practitioner | Organization | Patient | PractitionerRole | Device | RelatedPerson ) | Individual who was involved | |
|
0..1 | Reference ( Organization ) | Issuing Organization of Invoice | |
|
0..1 | Reference ( Account ) | Account that is being balanced | |
|
0..* | BackboneElement |
Line
items
of
this
Invoice
|
|
|
0..1 | positiveInt | Sequence number of line item | |
|
1..1 | Reference to ChargeItem containing details of this line item or an inline billing code | ||
|
Reference ( ChargeItem ) | |||
|
CodeableConcept | |||
|
0..* | BackboneElement |
Components
of
total
line
item
price
|
|
|
1..1 | code |
base
|
surcharge
|
deduction
|
discount
|
tax
|
informational
InvoicePriceComponentType ( Required ) |
|
|
0..1 | CodeableConcept | Code identifying the specific component | |
|
0..1 | decimal | Factor used for calculating this component | |
|
0..1 | Money | Monetary amount associated with this component | |
|
0..* | see priceComponent |
Components
of
Invoice
total
|
|
|
Σ | 0..1 | Money | Net total of this Invoice |
|
Σ | 0..1 | Money | Gross total of this Invoice |
|
0..1 | markdown | Payment details | |
|
0..* | Annotation |
Comments
made
about
the
invoice
|
|
Documentation
for
this
format
|
||||
UML Diagram ( Legend )
XML Template
<Invoice xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Business Identifier for item --></identifier> <status value="[code]"/><!-- 1..1 draft | issued | balanced | cancelled | entered-in-error --> <cancelledReason value="[string]"/><!-- 0..1 Reason for cancellation of this Invoice --> <type><!-- 0..1 CodeableConcept Type of Invoice --></type>
<</subject><subject><!-- 0..1 Reference(Group|Patient) Recipient(s) of goods and services --></subject> <recipient><!-- 0..1 Reference(Organization|Patient|RelatedPerson) Recipient of this invoice --></recipient> <date value="[dateTime]"/><!-- 0..1 Invoice date / posting date --> <participant> <!-- 0..* Participant in creation of this Invoice --> <role><!-- 0..1 CodeableConcept Type of involvement in creation of this Invoice --></role><| </actor><actor><!-- 1..1 Reference(Device|Organization|Patient|Practitioner| PractitionerRole|RelatedPerson) Individual who was involved --></actor> </participant> <issuer><!-- 0..1 Reference(Organization) Issuing Organization of Invoice --></issuer> <account><!-- 0..1 Reference(Account) Account that is being balanced --></account> <lineItem> <!-- 0..* Line items of this Invoice --> <sequence value="[positiveInt]"/><!-- 0..1 Sequence number of line item --> <chargeItem[x]><!-- 1..1 Reference(ChargeItem)|CodeableConcept Reference to ChargeItem containing details of this line item or an inline billing code --></chargeItem[x]> <priceComponent> <!-- 0..* Components of total line item price --> <type value="[code]"/><!-- 1..1 base | surcharge | deduction | discount | tax | informational --> <code><!-- 0..1 CodeableConcept Code identifying the specific component --></code> <factor value="[decimal]"/><!-- 0..1 Factor used for calculating this component --> <amount><!-- 0..1 Money Monetary amount associated with this component --></amount> </priceComponent> </lineItem> <totalPriceComponent><!-- 0..* Content as for Invoice.lineItem.priceComponent Components of Invoice total --></totalPriceComponent> <totalNet><!-- 0..1 Money Net total of this Invoice --></totalNet> <totalGross><!-- 0..1 Money Gross total of this Invoice --></totalGross> <paymentTerms value="[markdown]"/><!-- 0..1 Payment details --> <note><!-- 0..* Annotation Comments made about the invoice --></note> </Invoice>
JSON Template
{
"resourceType" : "Invoice",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Business Identifier for item
"status" : "<code>", // R! draft | issued | balanced | cancelled | entered-in-error
"cancelledReason" : "<string>", // Reason for cancellation of this Invoice
"type" : { CodeableConcept }, // Type of Invoice
"
"subject" : { Reference(Group|Patient) }, // Recipient(s) of goods and services
"recipient" : { Reference(Organization|Patient|RelatedPerson) }, // Recipient of this invoice
"date" : "<dateTime>", // Invoice date / posting date
"participant" : [{ // Participant in creation of this Invoice
"role" : { CodeableConcept }, // Type of involvement in creation of this Invoice
"|
"actor" : { Reference(Device|Organization|Patient|Practitioner|
PractitionerRole|RelatedPerson) } // R! Individual who was involved
}],
"issuer" : { Reference(Organization) }, // Issuing Organization of Invoice
"account" : { Reference(Account) }, // Account that is being balanced
"lineItem" : [{ // Line items of this Invoice
"sequence" : "<positiveInt>", // Sequence number of line item
// chargeItem[x]:
Reference to ChargeItem containing details of this line item or an inline billing code. One of these 2:
"chargeItemReference" : { Reference(ChargeItem) },
"chargeItemCodeableConcept" : { CodeableConcept },
"priceComponent" : [{ // Components of total line item price
"type" : "<code>", // R! base | surcharge | deduction | discount | tax | informational
"code" : { CodeableConcept }, // Code identifying the specific component
"factor" : <decimal>, // Factor used for calculating this component
"amount" : { Money } // Monetary amount associated with this component
}]
}],
"totalPriceComponent" : [{ Content as for Invoice.lineItem.priceComponent }], // Components of Invoice total
"totalNet" : { Money }, // Net total of this Invoice
"totalGross" : { Money }, // Gross total of this Invoice
"paymentTerms" : "<markdown>", // Payment details
"note" : [{ Annotation }] // Comments made about the invoice
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .[ a fhir:Invoice; 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:Invoice.identifier [ Identifier ], ... ; # 0..* Business Identifier for item fhir:Invoice.status [ code ]; # 1..1 draft | issued | balanced | cancelled | entered-in-error fhir:Invoice.cancelledReason [ string ]; # 0..1 Reason for cancellation of this Invoice fhir:Invoice.type [ CodeableConcept ]; # 0..1 Type of Invoice
fhir:fhir:Invoice.subject [ Reference(Group|Patient) ]; # 0..1 Recipient(s) of goods and services fhir:Invoice.recipient [ Reference(Organization|Patient|RelatedPerson) ]; # 0..1 Recipient of this invoice fhir:Invoice.date [ dateTime ]; # 0..1 Invoice date / posting date fhir:Invoice.participant [ # 0..* Participant in creation of this Invoice fhir:Invoice.participant.role [ CodeableConcept ]; # 0..1 Type of involvement in creation of this Invoicefhir:fhir:Invoice.participant.actor [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 1..1 Individual who was involved ], ...; fhir:Invoice.issuer [ Reference(Organization) ]; # 0..1 Issuing Organization of Invoice fhir:Invoice.account [ Reference(Account) ]; # 0..1 Account that is being balanced fhir:Invoice.lineItem [ # 0..* Line items of this Invoice fhir:Invoice.lineItem.sequence [ positiveInt ]; # 0..1 Sequence number of line item # Invoice.lineItem.chargeItem[x] : 1..1 Reference to ChargeItem containing details of this line item or an inline billing code. One of these 2 fhir:Invoice.lineItem.chargeItemReference [ Reference(ChargeItem) ] fhir:Invoice.lineItem.chargeItemCodeableConcept [ CodeableConcept ] fhir:Invoice.lineItem.priceComponent [ # 0..* Components of total line item price fhir:Invoice.lineItem.priceComponent.type [ code ]; # 1..1 base | surcharge | deduction | discount | tax | informational fhir:Invoice.lineItem.priceComponent.code [ CodeableConcept ]; # 0..1 Code identifying the specific component fhir:Invoice.lineItem.priceComponent.factor [ decimal ]; # 0..1 Factor used for calculating this component fhir:Invoice.lineItem.priceComponent.amount [ Money ]; # 0..1 Monetary amount associated with this component ], ...; ], ...; fhir:Invoice.totalPriceComponent [ See Invoice.lineItem.priceComponent ], ... ; # 0..* Components of Invoice total fhir:Invoice.totalNet [ Money ]; # 0..1 Net total of this Invoice fhir:Invoice.totalGross [ Money ]; # 0..1 Gross total of this Invoice fhir:Invoice.paymentTerms [ markdown ]; # 0..1 Payment details fhir:Invoice.note [ Annotation ], ... ; # 0..* Comments made about the invoice ]
Changes since R3
| Invoice | |
| Invoice.status |
|
| Invoice.lineItem.priceComponent.type |
|
This
resource
did
not
exist
in
Release
2
See
the
Full
Difference
for
further
information
Structure
| Name | Flags | Card. | Type |
Description
&
Constraints
|
|---|---|---|---|---|
|
TU | DomainResource |
Invoice
containing
ChargeItems
from
an
Account
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension |
|
|
Σ | 0..* | Identifier |
Business
Identifier
for
item
|
|
?! Σ | 1..1 | code |
draft
|
issued
|
balanced
|
cancelled
|
entered-in-error
InvoiceStatus ( Required ) |
|
0..1 | string | Reason for cancellation of this Invoice | |
|
Σ | 0..1 | CodeableConcept | Type of Invoice |
|
Σ | 0..1 | Reference ( Patient | Group ) | Recipient(s) of goods and services |
|
Σ | 0..1 | Reference ( Organization | Patient | RelatedPerson ) | Recipient of this invoice |
|
Σ | 0..1 | dateTime | Invoice date / posting date |
|
0..* | BackboneElement |
Participant
in
creation
of
this
Invoice
|
|
|
0..1 | CodeableConcept | Type of involvement in creation of this Invoice | |
|
1..1 | Reference ( Practitioner | Organization | Patient | PractitionerRole | Device | RelatedPerson ) | Individual who was involved | |
|
0..1 | Reference ( Organization ) | Issuing Organization of Invoice | |
|
0..1 | Reference ( Account ) | Account that is being balanced | |
|
0..* | BackboneElement |
Line
items
of
this
Invoice
|
|
|
0..1 | positiveInt | Sequence number of line item | |
|
1..1 | Reference to ChargeItem containing details of this line item or an inline billing code | ||
|
Reference ( ChargeItem ) | |||
|
CodeableConcept | |||
|
0..* | BackboneElement |
Components
of
total
line
item
price
|
|
|
1..1 | code |
base
|
surcharge
|
deduction
|
discount
|
tax
|
informational
InvoicePriceComponentType ( Required ) |
|
|
0..1 | CodeableConcept | Code identifying the specific component | |
|
0..1 | decimal | Factor used for calculating this component | |
|
0..1 | Money | Monetary amount associated with this component | |
|
0..* | see priceComponent |
Components
of
Invoice
total
|
|
|
Σ | 0..1 | Money | Net total of this Invoice |
|
Σ | 0..1 | Money | Gross total of this Invoice |
|
0..1 | markdown | Payment details | |
|
0..* | Annotation |
Comments
made
about
the
invoice
|
|
Documentation
for
this
format
|
||||
XML Template
<Invoice xmlns="http://hl7.org/fhir"><!-- from Resource: id, meta, implicitRules, and language --> <!-- from DomainResource: text, contained, extension, and modifierExtension --> <identifier><!-- 0..* Identifier Business Identifier for item --></identifier> <status value="[code]"/><!-- 1..1 draft | issued | balanced | cancelled | entered-in-error --> <cancelledReason value="[string]"/><!-- 0..1 Reason for cancellation of this Invoice --> <type><!-- 0..1 CodeableConcept Type of Invoice --></type>
<</subject><subject><!-- 0..1 Reference(Group|Patient) Recipient(s) of goods and services --></subject> <recipient><!-- 0..1 Reference(Organization|Patient|RelatedPerson) Recipient of this invoice --></recipient> <date value="[dateTime]"/><!-- 0..1 Invoice date / posting date --> <participant> <!-- 0..* Participant in creation of this Invoice --> <role><!-- 0..1 CodeableConcept Type of involvement in creation of this Invoice --></role><| </actor><actor><!-- 1..1 Reference(Device|Organization|Patient|Practitioner| PractitionerRole|RelatedPerson) Individual who was involved --></actor> </participant> <issuer><!-- 0..1 Reference(Organization) Issuing Organization of Invoice --></issuer> <account><!-- 0..1 Reference(Account) Account that is being balanced --></account> <lineItem> <!-- 0..* Line items of this Invoice --> <sequence value="[positiveInt]"/><!-- 0..1 Sequence number of line item --> <chargeItem[x]><!-- 1..1 Reference(ChargeItem)|CodeableConcept Reference to ChargeItem containing details of this line item or an inline billing code --></chargeItem[x]> <priceComponent> <!-- 0..* Components of total line item price --> <type value="[code]"/><!-- 1..1 base | surcharge | deduction | discount | tax | informational --> <code><!-- 0..1 CodeableConcept Code identifying the specific component --></code> <factor value="[decimal]"/><!-- 0..1 Factor used for calculating this component --> <amount><!-- 0..1 Money Monetary amount associated with this component --></amount> </priceComponent> </lineItem> <totalPriceComponent><!-- 0..* Content as for Invoice.lineItem.priceComponent Components of Invoice total --></totalPriceComponent> <totalNet><!-- 0..1 Money Net total of this Invoice --></totalNet> <totalGross><!-- 0..1 Money Gross total of this Invoice --></totalGross> <paymentTerms value="[markdown]"/><!-- 0..1 Payment details --> <note><!-- 0..* Annotation Comments made about the invoice --></note> </Invoice>
JSON Template
{
"resourceType" : "Invoice",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"identifier" : [{ Identifier }], // Business Identifier for item
"status" : "<code>", // R! draft | issued | balanced | cancelled | entered-in-error
"cancelledReason" : "<string>", // Reason for cancellation of this Invoice
"type" : { CodeableConcept }, // Type of Invoice
"
"subject" : { Reference(Group|Patient) }, // Recipient(s) of goods and services
"recipient" : { Reference(Organization|Patient|RelatedPerson) }, // Recipient of this invoice
"date" : "<dateTime>", // Invoice date / posting date
"participant" : [{ // Participant in creation of this Invoice
"role" : { CodeableConcept }, // Type of involvement in creation of this Invoice
"|
"actor" : { Reference(Device|Organization|Patient|Practitioner|
PractitionerRole|RelatedPerson) } // R! Individual who was involved
}],
"issuer" : { Reference(Organization) }, // Issuing Organization of Invoice
"account" : { Reference(Account) }, // Account that is being balanced
"lineItem" : [{ // Line items of this Invoice
"sequence" : "<positiveInt>", // Sequence number of line item
// chargeItem[x]:
Reference to ChargeItem containing details of this line item or an inline billing code. One of these 2:
"chargeItemReference" : { Reference(ChargeItem) },
"chargeItemCodeableConcept" : { CodeableConcept },
"priceComponent" : [{ // Components of total line item price
"type" : "<code>", // R! base | surcharge | deduction | discount | tax | informational
"code" : { CodeableConcept }, // Code identifying the specific component
"factor" : <decimal>, // Factor used for calculating this component
"amount" : { Money } // Monetary amount associated with this component
}]
}],
"totalPriceComponent" : [{ Content as for Invoice.lineItem.priceComponent }], // Components of Invoice total
"totalNet" : { Money }, // Net total of this Invoice
"totalGross" : { Money }, // Gross total of this Invoice
"paymentTerms" : "<markdown>", // Payment details
"note" : [{ Annotation }] // Comments made about the invoice
}
Turtle Template
@prefix fhir: <http://hl7.org/fhir/> .[ a fhir:Invoice; 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:Invoice.identifier [ Identifier ], ... ; # 0..* Business Identifier for item fhir:Invoice.status [ code ]; # 1..1 draft | issued | balanced | cancelled | entered-in-error fhir:Invoice.cancelledReason [ string ]; # 0..1 Reason for cancellation of this Invoice fhir:Invoice.type [ CodeableConcept ]; # 0..1 Type of Invoice
fhir:fhir:Invoice.subject [ Reference(Group|Patient) ]; # 0..1 Recipient(s) of goods and services fhir:Invoice.recipient [ Reference(Organization|Patient|RelatedPerson) ]; # 0..1 Recipient of this invoice fhir:Invoice.date [ dateTime ]; # 0..1 Invoice date / posting date fhir:Invoice.participant [ # 0..* Participant in creation of this Invoice fhir:Invoice.participant.role [ CodeableConcept ]; # 0..1 Type of involvement in creation of this Invoicefhir:fhir:Invoice.participant.actor [ Reference(Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 1..1 Individual who was involved ], ...; fhir:Invoice.issuer [ Reference(Organization) ]; # 0..1 Issuing Organization of Invoice fhir:Invoice.account [ Reference(Account) ]; # 0..1 Account that is being balanced fhir:Invoice.lineItem [ # 0..* Line items of this Invoice fhir:Invoice.lineItem.sequence [ positiveInt ]; # 0..1 Sequence number of line item # Invoice.lineItem.chargeItem[x] : 1..1 Reference to ChargeItem containing details of this line item or an inline billing code. One of these 2 fhir:Invoice.lineItem.chargeItemReference [ Reference(ChargeItem) ] fhir:Invoice.lineItem.chargeItemCodeableConcept [ CodeableConcept ] fhir:Invoice.lineItem.priceComponent [ # 0..* Components of total line item price fhir:Invoice.lineItem.priceComponent.type [ code ]; # 1..1 base | surcharge | deduction | discount | tax | informational fhir:Invoice.lineItem.priceComponent.code [ CodeableConcept ]; # 0..1 Code identifying the specific component fhir:Invoice.lineItem.priceComponent.factor [ decimal ]; # 0..1 Factor used for calculating this component fhir:Invoice.lineItem.priceComponent.amount [ Money ]; # 0..1 Monetary amount associated with this component ], ...; ], ...; fhir:Invoice.totalPriceComponent [ See Invoice.lineItem.priceComponent ], ... ; # 0..* Components of Invoice total fhir:Invoice.totalNet [ Money ]; # 0..1 Net total of this Invoice fhir:Invoice.totalGross [ Money ]; # 0..1 Gross total of this Invoice fhir:Invoice.paymentTerms [ markdown ]; # 0..1 Payment details fhir:Invoice.note [ Annotation ], ... ; # 0..* Comments made about the invoice ]
Changes since Release 3
| Invoice | |
| Invoice.status |
|
| Invoice.lineItem.priceComponent.type |
|
This
resource
did
not
exist
in
Release
2
See
the
Full
Difference
for
further
information
See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a
| Path | Definition | Type | Reference |
|---|---|---|---|
| Invoice.status |
|
Required | InvoiceStatus |
| Invoice.lineItem.priceComponent.type |
|
Required | InvoicePriceComponentType |
Search parameters for 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 |
| account | reference | Account that is being balanced |
Invoice.account
( Account ) |
|
| date N | date | Invoice date / posting date | Invoice.date | |
| identifier | token | Business Identifier for item | Invoice.identifier | |
| issuer | reference | Issuing Organization of Invoice |
Invoice.issuer
( Organization ) |
|
| participant | reference | Individual who was involved |
Invoice.participant.actor
( Practitioner , Organization , Device , Patient , PractitionerRole , RelatedPerson ) |
|
| participant-role | token | Type of involvement in creation of this Invoice | Invoice.participant.role | |
| patient | reference | Recipient(s) of goods and services |
Invoice.subject.where(resolve()
is
Patient)
( Group , Patient ) |
|
| recipient | reference | Recipient of this invoice |
Invoice.recipient
( Organization , Patient , RelatedPerson ) |
|
| status N | token | draft | issued | balanced | cancelled | entered-in-error | Invoice.status | |
| subject | reference | Recipient(s) of goods and services |
Invoice.subject
( Group , Patient ) |
|
| totalgross | quantity | Gross total of this Invoice | Invoice.totalGross | |
| totalnet | quantity | Net total of this Invoice | Invoice.totalNet | |
| type | token | Type of Invoice | Invoice.type |