Release 4B Snapshot 3: Connectathon 32 Base

This page is part of the Snapshot #3 for FHIR Specification (v4.3.0: R4B - STU ). The current version which supercedes this version is 5.0.0 R5 , released to support Connectathon 32 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Paymentreconciliation-example.ttl

Example PaymentReconciliation/ER2500 (Turtle)

Financial Management Work Group Maturity Level : N/A Standards Status : Informative Compartments : Practitioner

Raw Turtle (+ also see Turtle/RDF Format Specification )

General Payment Reconciliation Example 

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/PaymentReconciliation/ER2500> a fhir:PaymentReconciliation;

[a fhir:PaymentReconciliation;

  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "ER2500"];

  fhir:Resource.id [ fhir:value "ER2500"]; # 

  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the PaymentReconciliation</div>"
  ];

  ]; # 

  fhir:PaymentReconciliation.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/fhir/enrollmentresponse" ];
     fhir:Identifier.value [ fhir:value "781234" ]
  ];
  fhir:PaymentReconciliation.status [ fhir:value "active"];

  ]; # 
  fhir:PaymentReconciliation.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/payment-type" ];
       fhir:Coding.code [ fhir:value "payment" ]
     ]
  ]; # 
  fhir:PaymentReconciliation.status [ fhir:value "active"]; # 

  fhir:PaymentReconciliation.period [
     fhir:Period.start [ fhir:value "2014-08-16"^^xsd:date ];
     fhir:Period.end [ fhir:value "2014-08-31"^^xsd:date ]
  ];
  fhir:PaymentReconciliation.created [ fhir:value "2014-08-16"^^xsd:date];

  ]; # 
  fhir:PaymentReconciliation.created [ fhir:value "2014-08-16"^^xsd:date]; # 

  fhir:PaymentReconciliation.paymentIssuer [
     fhir:link <http://hl7.org/fhir/Organization/2>;

     fhir:Reference.reference [ fhir:value "Organization/2" ]
  ];

  ]; # 

  fhir:PaymentReconciliation.request [
     fhir:link <http://www.BenefitsInc.com/fhir/eligibility/225476332402>;
     fhir:Reference.reference [ fhir:value "http://www.BenefitsInc.com/fhir/eligibility/225476332402" ]
  ];

  ]; # 

  fhir:PaymentReconciliation.requestor [
     fhir:link <http://hl7.org/fhir/Organization/1>;

     fhir:Reference.reference [ fhir:value "Organization/1" ]
  ];
  fhir:PaymentReconciliation.outcome [ fhir:value "complete"];
  fhir:PaymentReconciliation.disposition [ fhir:value "2014 August mid-month settlement."];
  fhir:PaymentReconciliation.paymentDate [ fhir:value "2014-08-01"^^xsd:date];
  fhir:PaymentReconciliation.paymentAmount [

  ]; # 
  fhir:PaymentReconciliation.outcome [ fhir:value "complete"]; # 
  fhir:PaymentReconciliation.disposition [ fhir:value "2014 August mid-month settlement."]; # 
  fhir:PaymentReconciliation.date [ fhir:value "2014-08-01"^^xsd:date]; # 
  fhir:PaymentReconciliation.amount [

     fhir:Money.value [ fhir:value "7000.00"^^xsd:decimal ];
     fhir:Money.currency [ fhir:value "USD" ]
  ];

  ]; # 

  fhir:PaymentReconciliation.paymentIdentifier [
     fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/payment/2018" ];
     fhir:Identifier.value [ fhir:value "10-12345" ]
  ];
  fhir:PaymentReconciliation.detail [

  ]; # 
  fhir:PaymentReconciliation.allocation [

     fhir:index 0;
     fhir:PaymentReconciliation.detail.identifier [

     fhir:PaymentReconciliation.allocation.identifier [

       fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/payment/2018/detail" ];
       fhir:Identifier.value [ fhir:value "10-12345-001" ]
     ];
     fhir:PaymentReconciliation.detail.type [

     fhir:PaymentReconciliation.allocation.target [
       fhir:Reference.identifier [
         fhir:Identifier.system [ fhir:value "http://happyvalleyclinic.com/claim" ];
         fhir:Identifier.value [ fhir:value "AB12345" ]
       ]
     ];
     fhir:PaymentReconciliation.allocation.type [

       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/payment-type" ];
         fhir:Coding.code [ fhir:value "payment" ]
       ]
     ];
     fhir:PaymentReconciliation.detail.request [
       fhir:Reference.identifier [
         fhir:Identifier.system [ fhir:value "http://happyvalleyclinic.com/claim" ];
         fhir:Identifier.value [ fhir:value "AB12345" ]
       ]
     ];
     fhir:PaymentReconciliation.detail.submitter [
       fhir:link <http://hl7.org/fhir/Organization/1>;

     fhir:PaymentReconciliation.allocation.submitter [

       fhir:Reference.reference [ fhir:value "Organization/1" ]
     ];
     fhir:PaymentReconciliation.detail.response [

     fhir:PaymentReconciliation.allocation.response [

       fhir:Reference.identifier [
         fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/fhir/claimresponse" ];
         fhir:Identifier.value [ fhir:value "CR20140815-AB12345" ]
       ]
     ];
     fhir:PaymentReconciliation.detail.date [ fhir:value "2014-08-16"^^xsd:date ];
     fhir:PaymentReconciliation.detail.payee [
       fhir:link <http://hl7.org/fhir/Organization/1>;

     fhir:PaymentReconciliation.allocation.date [ fhir:value "2014-08-16"^^xsd:date ];
     fhir:PaymentReconciliation.allocation.payee [

       fhir:Reference.reference [ fhir:value "Organization/1" ]
     ];
     fhir:PaymentReconciliation.detail.amount [

     fhir:PaymentReconciliation.allocation.amount [

       fhir:Money.value [ fhir:value "3500.00"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]
     ]
  ], [
     fhir:index 1;
     fhir:PaymentReconciliation.detail.identifier [

     fhir:PaymentReconciliation.allocation.identifier [

       fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/payment/2018/detail" ];
       fhir:Identifier.value [ fhir:value "10-12345-002" ]
     ];
     fhir:PaymentReconciliation.detail.type [

     fhir:PaymentReconciliation.allocation.target [
       fhir:link <http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699>;
       fhir:Reference.reference [ fhir:value "http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699" ]
     ];
     fhir:PaymentReconciliation.allocation.type [

       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/payment-type" ];
         fhir:Coding.code [ fhir:value "payment" ]
       ]
     ];
     fhir:PaymentReconciliation.detail.request [
       fhir:link <http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699>;
       fhir:Reference.reference [ fhir:value "http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699" ]
     ];
     fhir:PaymentReconciliation.detail.date [ fhir:value "2014-08-12"^^xsd:date ];
     fhir:PaymentReconciliation.detail.amount [

     fhir:PaymentReconciliation.allocation.date [ fhir:value "2014-08-12"^^xsd:date ];
     fhir:PaymentReconciliation.allocation.amount [

       fhir:Money.value [ fhir:value "4000.00"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]
     ]
  ], [
     fhir:index 2;
     fhir:PaymentReconciliation.detail.identifier [

     fhir:PaymentReconciliation.allocation.identifier [

       fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/payment/2018/detail" ];
       fhir:Identifier.value [ fhir:value "10-12345-003" ]
     ];
     fhir:PaymentReconciliation.detail.type [

     fhir:PaymentReconciliation.allocation.type [

       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/payment-type" ];
         fhir:Coding.code [ fhir:value "advance" ]
       ]
     ];
     fhir:PaymentReconciliation.detail.date [ fhir:value "2014-08-16"^^xsd:date ];
     fhir:PaymentReconciliation.detail.amount [

     fhir:PaymentReconciliation.allocation.date [ fhir:value "2014-08-16"^^xsd:date ];
     fhir:PaymentReconciliation.allocation.amount [

       fhir:Money.value [ fhir:value "-1500.00"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]
     ]
  ];

  ]; # 

  fhir:PaymentReconciliation.formCode [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://ncforms.org/formid" ];
       fhir:Coding.code [ fhir:value "PAYREC/2016/01B" ]
     ]
  ];

  ]; # 

  fhir:PaymentReconciliation.processNote [
     fhir:index 0;
     fhir:PaymentReconciliation.processNote.type [ fhir:value "display" ];
     fhir:PaymentReconciliation.processNote.text [ fhir:value "Due to the year end holiday the cutoff for submissions for December will be the 28th." ]
  ] .

<http://hl7.org/fhir/Organization/2> a fhir:Organization .

<http://hl7.org/fhir/Organization/1> a fhir:Organization .

  ]] . # 


# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/PaymentReconciliation/ER2500.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://build.fhir.org/PaymentReconciliation/ER2500.ttl> .

[a owl:Ontology;
  owl:imports fhir:fhir.ttl] .


# -------------------------------------------------------------------------------------

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.