This
page
is
part
of
the
FHIR
Specification
(v4.3.0:
R4B
-
STU
(v5.0.0-snapshot3:
R5
Snapshot
#3,
to
support
Connectathon
32
).
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
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. |
| Short Display | PaymentReconciliation resource |
| Cardinality | 0..* |
| Type | DomainResource |
| Summary | false |
| PaymentReconciliation.identifier | |
| Element Id | PaymentReconciliation.identifier |
| Definition |
A unique identifier assigned to this payment reconciliation. |
| Short Display | Business Identifier for a 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. |
| Summary | false |
| PaymentReconciliation.type | |
| Element Id | PaymentReconciliation.type |
| Definition | Code to indicate the nature of the payment such as payment, adjustment. |
| Short Display | Category of payment |
| Cardinality | 1..1 |
| Terminology Binding | Payment Type Codes ( Extensible ) |
| Type | CodeableConcept |
| Summary | true |
| PaymentReconciliation.status | |
| Element Id | PaymentReconciliation.status |
| Definition |
The status of the resource instance. |
| Short Display | active | cancelled | draft | entered-in-error |
| 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.kind | |
| Element Id | PaymentReconciliation.kind |
| Definition | The workflow or activity which gave rise to or during which the payment ocurred such as a kiosk, deposit on account, periodic payment etc. |
| Short Display | Workflow originating payment |
| Cardinality | 0..1 |
| Terminology Binding | Payment Kind ( Extensible ) |
| Type | CodeableConcept |
| Summary | false |
| PaymentReconciliation.period | |
| Element Id | PaymentReconciliation.period |
| Definition |
The period of time for which payments have been gathered into this bulk payment for settlement. |
| Short Display | Period covered |
| 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. |
| Short Display | Creation date |
| Cardinality | 1..1 |
| Type | dateTime |
| Requirements |
Need to record a timestamp for use by both the recipient and the issuer. |
| Summary | true |
| PaymentReconciliation.enterer | |
| Element Id | PaymentReconciliation.enterer |
| Definition | Payment enterer if not the actual payment issuer. |
| Short Display | Who entered the payment |
| Cardinality | 0..1 |
| Type | Reference ( Practitioner | PractitionerRole | Organization ) |
| Summary | false |
| PaymentReconciliation.issuerType | |
| Element Id | PaymentReconciliation.issuerType |
| Definition | The type of the source such as patient or insurance. |
| Short Display | Nature of the source |
| Cardinality | 0..1 |
| Terminology Binding | Payment Issuer Type ( Extensible ) |
| Type | CodeableConcept |
| Requirements | Providers may need to identify the source to know to which sub-ledger to apply the payment. |
| Summary | false |
| PaymentReconciliation.paymentIssuer | |
| Element Id | PaymentReconciliation.paymentIssuer |
| Definition |
The party who generated the payment. |
| Short Display | Party generating payment |
| Cardinality | 0..1 |
| Type | Reference ( Organization | Patient | Person | RelatedPerson ) |
| 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. |
| Short Display | Reference to requesting resource |
| Cardinality | 0..1 |
| Type | Reference ( Task ) |
| Requirements |
Needed to allow the response to be linked to the request. |
| Summary | false |
| PaymentReconciliation.requestor | |
| Element Id | PaymentReconciliation.requestor |
| Definition |
The practitioner who is responsible for the services rendered to the patient. |
| Short Display | Responsible practitioner |
| Cardinality | 0..1 |
| Type | Reference ( Practitioner | PractitionerRole | Organization ) |
| Requirements |
Need to identify the party responsible for the request. |
| Summary | false |
| PaymentReconciliation.outcome | |
| Element Id | PaymentReconciliation.outcome |
| Definition |
The outcome of a request for a reconciliation. |
| Short Display | queued | complete | error | partial |
| Cardinality | 0..1 |
| Terminology Binding |
|
| Type | code |
| Requirements |
To advise the requestor of an overall processing outcome. |
| Summary | false |
| 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. |
| Short Display | Disposition message |
| Cardinality | 0..1 |
| Type | string |
| Requirements |
Provided for user display. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
The date of payment as indicated on the financial instrument. |
| Short Display | When payment issued |
| Cardinality | 1..1 |
| Type | date |
| Requirements |
To advise the payee when payment can be expected. |
| Summary | true |
|
|
|
| Element Id |
|
| Definition | The location of the site or device for electronic transfers or physical location for cash payments. |
| Short Display | Where payment collected |
| Cardinality | 0..1 |
| Type | Reference ( Location ) |
| Summary | false |
| PaymentReconciliation.method | |
| Element Id | PaymentReconciliation.method |
| Definition | The means of payment such as check, card cash, or electronic funds transfer. |
| Short Display | Payment instrument |
| Cardinality | 0..1 |
| Terminology Binding |
hl7VS-paymentMethodCode
(
Extensible
)
|
| Type | CodeableConcept |
| Summary | false |
| PaymentReconciliation.cardBrand | |
| Element Id | PaymentReconciliation.cardBrand |
| Definition | The card brand such as debit, Visa, Amex etc. used if a card is the method of payment. |
| Short Display | Type of card |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| PaymentReconciliation.accountNumber | |
| Element Id | PaymentReconciliation.accountNumber |
| Definition | A portion of the account number, often the last 4 digits, used for verification not charging purposes. |
| Short Display | Digits for verification |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| PaymentReconciliation.expirationDate | |
| Element Id | PaymentReconciliation.expirationDate |
| Definition | The year and month (YYYY-MM) when the instrument, typically card, expires. |
| Short Display | Expiration year-month |
| Cardinality | 0..1 |
| Type | date |
| Summary | false |
| PaymentReconciliation.processor | |
| Element Id | PaymentReconciliation.processor |
| Definition | The name of the card processor, etf processor, bank for checks. |
| Short Display | Processor name |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| PaymentReconciliation.referenceNumber | |
| Element Id | PaymentReconciliation.referenceNumber |
| Definition | The check number, eft reference, car processor reference. |
| Short Display | Check number or payment reference |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| PaymentReconciliation.authorization | |
| Element Id | PaymentReconciliation.authorization |
| Definition | An alphanumeric issued by the processor to confirm the successful issuance of payment. |
| Short Display | Authorization number |
| Cardinality | 0..1 |
| Type | string |
| Summary | false |
| PaymentReconciliation.tenderedAmount | |
| Element Id | PaymentReconciliation.tenderedAmount |
| Definition | The amount offered by the issuer, typically applies to cash when the issuer provides an amount in bank note denominations equal to or excess of the amount actually being paid. |
| Short Display | Amount offered by the issuer |
| Cardinality | 0..1 |
| Type | Money |
| Summary | false |
| PaymentReconciliation.returnedAmount | |
| Element Id | PaymentReconciliation.returnedAmount |
| Definition | The amount returned by the receiver which is excess to the amount payable, often referred to as 'change'. |
| Short Display | Amount returned by the receiver |
| Cardinality | 0..1 |
| Type | Money |
| Summary | false |
| PaymentReconciliation.amount | |
| Element Id | PaymentReconciliation.amount |
| Definition |
Total payment amount as indicated on the financial instrument. |
| Short Display | Total amount of Payment |
| 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. |
| Short Display | Business identifier for the payment |
| Cardinality | 0..1 |
| Type | Identifier |
| Requirements |
Enable the receiver to reconcile when payment is received. |
| Summary | false |
| Comments |
For example: EFT number or check number. |
|
|
|
| Element Id |
|
| Definition |
Distribution of the payment amount for a previously acknowledged payable. |
| Short Display | Settlement particulars |
| Cardinality | 0..* |
| Requirements |
Needed to show how the payment amount is distributed across the payables. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
Unique identifier for the current payment item for the referenced payable. |
| Short Display | Business identifier of the payment detail |
| Note | This is a business identifier, not a resource identifier (see discussion ) |
| Cardinality | 0..1 |
| Type | Identifier |
| Requirements |
Needed for reconciliation of payments. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
Unique identifier for the prior payment item for the referenced payable. |
| Short Display | Business identifier of the prior payment detail |
| Cardinality | 0..1 |
| Type | Identifier |
| Requirements |
Needed for reconciliation of payments. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
|
| Short Display |
Subject
of
the
|
| Cardinality |
|
|
|
|
| Summary | false |
| PaymentReconciliation.allocation.targetItem[x] | |
| Element Id | PaymentReconciliation.allocation.targetItem[x] |
| Definition | Identifies the claim line item, encounter or other sub-element being paid. Note payment may be partial, that is not match the then outstanding balance or amount incurred. |
| Short Display | Sub-element of the subject |
| Cardinality | 0..1 |
| Type |
|
|
| See Choice of Datatypes for further information about how to use [x] |
| Summary | false |
| PaymentReconciliation.allocation.encounter | |
| Element Id | PaymentReconciliation.allocation.encounter |
| Definition |
|
| Short Display | Applied-to encounter |
| Cardinality | 0..1 |
| Type | Reference ( Encounter ) |
| Summary | false |
| PaymentReconciliation.allocation.account | |
|
| PaymentReconciliation.allocation.account |
| Definition |
|
| Short Display | Applied-to account |
| Cardinality | 0..1 |
| Type | Reference ( Account ) |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
|
| Short Display | Category of payment |
| Cardinality | 0..1 |
|
|
|
| Type | CodeableConcept |
| Requirements |
Needed
to
provide
|
| Summary | false |
| Comments | For example: payment, adjustment, funds advance, etc. |
|
|
|
| Element Id |
|
| Definition |
The party which submitted the claim or financial transaction. |
| Short Display | Submitter of the request |
| Cardinality | 0..1 |
| Type | Reference ( Practitioner | PractitionerRole | Organization ) |
| Requirements |
Needed for audit and validation. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
A resource, such as a ClaimResponse, which contains a commitment to payment. |
| Short Display | Response committing to a payment |
| Cardinality | 0..1 |
| Type |
Reference
(
|
| Requirements |
Needed to provide a linkage to the payment commitment. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
The date from the response resource containing a commitment to pay. |
| Short Display | Date of commitment to pay |
| Cardinality | 0..1 |
| Type | date |
| Requirements |
Needed for audit and validation. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
A reference to the individual who is responsible for inquiries regarding the response and its payment. |
| Short Display | Contact for the response |
| Cardinality | 0..1 |
| Type | Reference ( PractitionerRole ) |
| Requirements |
To provide contact information. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
The party which is receiving the payment. |
| Short Display | Recipient of the payment |
| Cardinality | 0..1 |
| Type | Reference ( Practitioner | PractitionerRole | Organization ) |
| Requirements |
Needed for audit and validation. |
| Summary | false |
|
|
|
| Element Id |
|
| Definition |
The monetary amount allocated from the total payment to the payable. |
| Short Display | Amount allocated to this payable |
| Cardinality | 0..1 |
| Type | Money |
| Requirements |
Needed to explain the distribution of the payment to the payables. |
| Summary | false |
| PaymentReconciliation.formCode | |
| Element Id | PaymentReconciliation.formCode |
| Definition |
A code for the form to be used for printing the content. |
| Short Display | Printed form identifier |
| Cardinality | 0..1 |
| Terminology Binding |
|
| Type | CodeableConcept |
| Requirements |
Needed to specify the specific form used for producing output for this response. |
| Summary | false |
| 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. |
| Short Display | Note concerning processing |
| Cardinality | 0..* |
| Requirements |
Provides the specific textual explanations associated with the processing. |
| Summary | false |
| PaymentReconciliation.processNote.type | |
| Element Id | PaymentReconciliation.processNote.type |
| Definition |
The business purpose of the note text. |
| Short Display | display | print | printoper |
| Cardinality | 0..1 |
| Terminology Binding | NoteType ( Required ) |
| Type | code |
| Requirements |
To convey the expectation for when the text is used. |
| Summary | false |
| PaymentReconciliation.processNote.text | |
| Element Id | PaymentReconciliation.processNote.text |
| Definition |
The explanation or description associated with the processing. |
| Short Display | Note explanatory text |
| Cardinality | 0..1 |
| Type | string |
| Requirements |
Required to provide human readable explanation. |
| Summary | false |