Release 4B Snapshot 3: Connectathon 32 Base

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

13.9 Resource PaymentReconciliation - Content

Financial Management icon Work Group Maturity Level : 2   Trial Use Security Category : Patient Compartments : Practitioner

This resource provides the details including amount of a payment and allocates the payment items being paid.

13.9.1 Scope and Usage

The PaymentReconciliation resource provides the bulk payment details associated with a payment by the payor for receivable amounts, such as for goods and services rendered by a provider to patients covered by insurance plans offered by that payor. These are the payment reconciliation details which may align to the individual payment amounts indicated on discrete ClaimResponses or Invoices for example.

Bulk payments need to provide a means to associate the amounts paid against specific Claims, Invoices, and other financial exchanges and adjustments, to the bulk payment itself in order to reconcile accounts receivable.

The PaymentReconciliation resource is a "event" resource from a FHIR workflow perspective - see Workflow Event.

13.9.1.1 Additional Information

Additional information regarding electronic payment notice content and usage may be found at:

13.9.2 Boundaries and Relationships

The PaymentReconciliation resource serves to correlate a payment amount to the adjudicated claim amounts appearing on one or more ClaimResponses . PaymentReconciliation provides the bulk payment details associated with a payment by the payor for goods and services rendered by a provider to patients covered by insurance plans offered by that payor.

The PaymentNotice resource is used to indicate that a payment has, or is about to occur. The resource is used commonly when tracking of payment occurences is required for regulatory or business purposes.

The ClaimResponse resource is an insurer's adjudication and/or authorization of a set of healthcare-related goods and services for a patient against the patient's insurance coverages and does not indicate that payment has occured.

For reporting out to patients or transferring data to patient centered applications, such as patient health Record (PHR) application, the ExplanationOfBenefit should be used instead.

The eClaim domain includes a number of related resources

PaymentReconciliation Provides the bulk payment details associated with a payment by the payor for goods and services rendered by a provider to patients covered by insurance plans offered by that payor.
ClaimResponse A payor's adjudication and/or authorization response to the suite of services provided in a Claim. Typically the ClaimResponse references the Claim but does not duplicate the clinical or financial information provided in the claim.
ExplanationOfBenefit This resource combines the information from the Claim and the ClaimResponse, stripping out any provider or payor proprietary information, into a unified information model suitable for use for: patient reporting; transferring information to a Patient Health Record system; and, supporting complete claim and adjudication information exchange with regulatory and analytics organizations and other parts of the provider's organization.
PaymentNotice An indication that a payment has occured, is about to occur, or has been cancelled.

13.9.3 References to this Resource

This resource is referenced by PaymentNotice . This resource implements the

13.9.4 Resource Content

Structure

Category
Name icon Flags icon Card. icon Type icon Description & Constraints icon doco icon
. . PaymentReconciliation TU DomainResource PaymentReconciliation resource

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier Business Identifier for a payment reconciliation

. . . type Σ 1..1 CodeableConcept Category of payment
Payment Type Codes ( Extensible )
... status ?! Σ 1..1 code active | cancelled | draft | entered-in-error
Financial Resource Status Codes ( Required )
. . . kind 0..1 CodeableConcept Workflow originating payment
Payment Kind ( Extensible )
. . . period Σ 0..1 Period Period covered
. . . created Σ 1..1 dateTime Creation date
. . . enterer 0..1 Reference ( Practitioner | PractitionerRole | Organization ) Who entered the payment
... issuerType 0..1 CodeableConcept Nature of the source
Payment Issuer Type ( Extensible )
. . . paymentIssuer Σ 0..1 Reference ( Organization | Patient | Person | RelatedPerson ) Party generating payment
. . . request 0..1 Reference ( Task ) Reference to requesting resource
. . . requestor 0..1 Reference ( Practitioner | PractitionerRole | Organization ) Responsible practitioner
. . . outcome 0..1 code queued | complete | error | partial
RemittanceOutcome PaymentOutcome ( Required )
. . . disposition 0..1 string Disposition message
. . . paymentDate date Σ 1..1 date When payment issued
. . . location 0..1 Reference ( Location ) Where payment collected
... method 0..1 CodeableConcept Payment instrument
hl7VS-paymentMethodCode icon ( Extensible )
... cardBrand 0..1 string Type of card
... accountNumber 0..1 string Digits for verification
... expirationDate 0..1 date Expiration year-month
... processor 0..1 string Processor name
... referenceNumber 0..1 string Check number or payment reference
... authorization 0..1 string Authorization number
. . . paymentAmount tenderedAmount 0..1 Money Amount offered by the issuer
... returnedAmount 0..1 Money Amount returned by the receiver
... amount Σ 1..1 Money Total amount of Payment
. . . paymentIdentifier 0..1 Identifier Business identifier for the payment
. . . detail allocation 0..* BackboneElement Settlement particulars

. . . . identifier 0..1 Identifier Business identifier of the payment detail
. . . . predecessor 0..1 Identifier Business identifier of the prior payment detail
. . . type . target 0..1 1..1 Reference ( Claim | Account | Invoice | ChargeItem | Encounter | Contract ) Subject of the payment
CodeableConcept
. . . . targetItem[x] 0..1 Sub-element of payment the subject
Payment Type Codes
. . . . . targetItemString string ( Example
. . . . . targetItemIdentifier Identifier )
. . . . . targetItemPositiveInt positiveInt
. . . . request encounter 0..1 Reference ( Encounter ) Applied-to encounter
.... account 0..1 Reference ( Any Account ) Applied-to account
.... type Request giving rise to the 0..1 CodeableConcept Category of payment
Payment Type Codes ( Extensible )
. . . . submitter 0..1 Reference ( Practitioner | PractitionerRole | Organization ) Submitter of the request
. . . . response 0..1 Reference ( Any ClaimResponse ) Response committing to a payment
. . . . date 0..1 date Date of commitment to pay
. . . . responsible 0..1 Reference ( PractitionerRole ) Contact for the response
. . . . payee 0..1 Reference ( Practitioner | PractitionerRole | Organization ) Recipient of the payment
. . . . amount 0..1 Money Amount allocated to this payable
. . . formCode 0..1 CodeableConcept Printed form identifier
Forms Form Codes ( Example )
. . . processNote 0..* BackboneElement Note concerning processing

. . . . type 0..1 code display | print | printoper
NoteType ( Required )
. . . . text 0..1 string Note explanatory text

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

PaymentReconciliation ( DomainResource ) A unique identifier assigned to this payment reconciliation identifier : Identifier [0..*] Code to indicate the nature of the payment such as payment, adjustment type : CodeableConcept [1..1] « null (Strength=Extensible) PaymentTypeCodes + » The status of the resource instance (this element modifies the meaning of other elements) status : code [1..1] « null (Strength=Required) FinancialResourceStatusCodes ! » The workflow or activity which gave rise to or during which the payment ocurred such as a kiosk, deposit on account, periodic payment etc kind : CodeableConcept [0..1] « null (Strength=Extensible) PaymentKind + » The period of time for which payments have been gathered into this bulk payment for settlement period : Period [0..1] The date when the resource was created created : dateTime [1..1] Payment enterer if not the actual payment issuer enterer : Reference [0..1] « Practitioner | PractitionerRole | Organization » The type of the source such as patient or insurance issuerType : CodeableConcept [0..1] « null (Strength=Extensible) PaymentIssuerType + » The party who generated the payment paymentIssuer : Reference [0..1] « Organization | Patient | Person | RelatedPerson » Original request resource reference request : Reference [0..1] « Task » The practitioner who is responsible for the services rendered to the patient requestor : Reference [0..1] « Practitioner | PractitionerRole | Organization » The outcome of a request for a reconciliation outcome : code [0..1] « null (Strength=Required) RemittanceOutcome PaymentOutcome ! » A human readable description of the status of the request for the reconciliation disposition : string [0..1] The date of payment as indicated on the financial instrument paymentDate date : date [1..1] The location of the site or device for electronic transfers or physical location for cash payments location : Reference [0..1] « Location » The means of payment such as check, card cash, or electronic funds transfer method : CodeableConcept [0..1] « null (Strength=Extensible) Hl7VSPaymentMethodCode + » The card brand such as debit, Visa, Amex etc. used if a card is the method of payment cardBrand : string [0..1] A portion of the account number, often the last 4 digits, used for verification not charging purposes accountNumber : string [0..1] The year and month (YYYY-MM) when the instrument, typically card, expires expirationDate : date [0..1] The name of the card processor, etf processor, bank for checks processor : string [0..1] The check number, eft reference, car processor reference referenceNumber : string [0..1] An alphanumeric issued by the processor to confirm the successful issuance of payment authorization : string [0..1] 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 tenderedAmount : Money [0..1] The amount returned by the receiver which is excess to the amount payable, often referred to as 'change' returnedAmount : Money [0..1] Total payment amount as indicated on the financial instrument paymentAmount amount : Money [1..1] Issuer's unique identifier for the payment instrument paymentIdentifier : Identifier [0..1] A code for the form to be used for printing the content formCode : CodeableConcept [0..1] « null (Strength=Example) Form FormCodes ?? » Details Allocation Unique identifier for the current payment item for the referenced payable identifier : Identifier [0..1] Unique identifier for the prior payment item for the referenced payable predecessor : Identifier [0..1] Code Specific resource to indicate which the nature of payment/adjustment/advance applies target : Reference [0..1] « Claim | Account | Invoice | ChargeItem | Encounter | Contract » 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 type targetItem[x] : CodeableConcept DataType [1..1] [0..1] « string | Identifier | positiveInt » null (Strength=Example) The Encounter to which this payment applies, may be completed by the receiver, used for search PaymentTypeCodes encounter : Reference [0..1] « Encounter ?? » A resource, such as a Claim, the evaluation of which could lead The Account to which this payment applies, may be completed by the receiver, used for search request account : Reference [0..1] « Any Account » Code to indicate the nature of the payment type : CodeableConcept [0..1] « null (Strength=Extensible) PaymentTypeCodes + » The party which submitted the claim or financial transaction submitter : Reference [0..1] « Practitioner | PractitionerRole | Organization » A resource, such as a ClaimResponse, which contains a commitment to payment response : Reference [0..1] « Any ClaimResponse » The date from the response resource containing a commitment to pay date : date [0..1] A reference to the individual who is responsible for inquiries regarding the response and its payment responsible : Reference [0..1] « PractitionerRole » The party which is receiving the payment payee : Reference [0..1] « Practitioner | PractitionerRole | Organization » The monetary amount allocated from the total payment to the payable amount : Money [0..1] Notes The business purpose of the note text type : code [0..1] « null (Strength=Required) NoteType ! » The explanation or description associated with the processing text : string [0..1] Distribution of the payment amount for a previously acknowledged payable detail allocation [0..*] A note that describes or explains the processing in a human readable form processNote [0..*]

XML Template 

<PaymentReconciliation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for a payment reconciliation --></identifier>
 <type><!-- 1..1 CodeableConcept Category of payment --></type>

 <status value="[code]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <kind><!-- 0..1 CodeableConcept Workflow originating payment --></kind>

 <period><!-- 0..1 Period Period covered --></period>
 <created value="[dateTime]"/><!-- 1..1 Creation date -->
 <</paymentIssuer>

 <enterer><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Who entered the payment --></enterer>
 <issuerType><!-- 0..1 CodeableConcept Nature of the source --></issuerType>
 <paymentIssuer><!-- 0..1 Reference(Organization|Patient|Person|RelatedPerson) Party generating payment --></paymentIssuer>

 <request><!-- 0..1 Reference(Task) Reference to requesting resource --></request>
 <requestor><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Responsible practitioner --></requestor>
 <

 <outcome value="[code]"/><!-- 0..1 queued | complete | error | partial -->

 <disposition value="[string]"/><!-- 0..1 Disposition message -->
 <
 <</paymentAmount>

 <date value="[date]"/><!-- 1..1 When payment issued -->
 <location><!-- 0..1 Reference(Location) Where payment collected --></location>
 <method><!-- 0..1 CodeableConcept Payment instrument icon --></method>
 <cardBrand value="[string]"/><!-- 0..1 Type of card -->
 <accountNumber value="[string]"/><!-- 0..1 Digits for verification -->
 <expirationDate value="[date]"/><!-- 0..1 Expiration year-month -->
 <processor value="[string]"/><!-- 0..1 Processor name -->
 <referenceNumber value="[string]"/><!-- 0..1 Check number or payment reference -->
 <authorization value="[string]"/><!-- 0..1 Authorization number -->
 <tenderedAmount><!-- 0..1 Money Amount offered by the issuer --></tenderedAmount>
 <returnedAmount><!-- 0..1 Money Amount returned by the receiver --></returnedAmount>
 <amount><!-- 1..1 Money Total amount of Payment --></amount>

 <paymentIdentifier><!-- 0..1 Identifier Business identifier for the payment --></paymentIdentifier>
 <
  <</identifier>
  <</predecessor>
  <</type>
  <</request>
  <</submitter>
  <</response>
  <
  <</responsible>
  <</payee>
  <</amount>
 </detail>

 <allocation>  <!-- 0..* Settlement particulars -->
  <identifier><!-- 0..1 Identifier Business identifier of the payment detail --></identifier>
  <predecessor><!-- 0..1 Identifier Business identifier of the prior payment detail --></predecessor>
  <target><!-- 0..1 Reference(Account|ChargeItem|Claim|Contract|Encounter|Invoice) Subject of the payment --></target>
  <targetItem[x]><!-- 0..1 string|Identifier|positiveInt Sub-element of the subject --></targetItem[x]>
  <encounter><!-- 0..1 Reference(Encounter) Applied-to encounter --></encounter>
  <account><!-- 0..1 Reference(Account) Applied-to account --></account>
  <type><!-- 0..1 CodeableConcept Category of payment --></type>
  <submitter><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Submitter of the request --></submitter>
  <response><!-- 0..1 Reference(ClaimResponse) Response committing to a payment --></response>
  <date value="[date]"/><!-- 0..1 Date of commitment to pay -->
  <responsible><!-- 0..1 Reference(PractitionerRole) Contact for the response --></responsible>
  <payee><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Recipient of the payment --></payee>
  <amount><!-- 0..1 Money Amount allocated to this payable --></amount>
 </allocation>

 <formCode><!-- 0..1 CodeableConcept Printed form identifier --></formCode>
 <processNote>  <!-- 0..* Note concerning processing -->
  <type value="[code]"/><!-- 0..1 display | print | printoper -->
  <text value="[string]"/><!-- 0..1 Note explanatory text -->
 </processNote>
</PaymentReconciliation>

JSON Template 

{doco
  "resourceType" : "PaymentReconciliation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for a payment reconciliation
  "type" : { CodeableConcept }, // R!  Category of payment

  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "kind" : { CodeableConcept }, // Workflow originating payment

  "period" : { Period }, // Period covered
  "created" : "<dateTime>", // R!  Creation date
  "

  "enterer" : { Reference(Organization|Practitioner|PractitionerRole) }, // Who entered the payment
  "issuerType" : { CodeableConcept }, // Nature of the source
  "paymentIssuer" : { Reference(Organization|Patient|Person|RelatedPerson) }, // Party generating payment

  "request" : { Reference(Task) }, // Reference to requesting resource
  "requestor" : { Reference(Organization|Practitioner|PractitionerRole) }, // Responsible practitioner
  "

  "outcome" : "<code>", // queued | complete | error | partial

  "disposition" : "<string>", // Disposition message
  "
  "

  "date" : "<date>", // R!  When payment issued
  "location" : { Reference(Location) }, // Where payment collected
  "method" : { CodeableConcept }, // Payment instrument icon
  "cardBrand" : "<string>", // Type of card
  "accountNumber" : "<string>", // Digits for verification
  "expirationDate" : "<date>", // Expiration year-month
  "processor" : "<string>", // Processor name
  "referenceNumber" : "<string>", // Check number or payment reference
  "authorization" : "<string>", // Authorization number
  "tenderedAmount" : { Money }, // Amount offered by the issuer
  "returnedAmount" : { Money }, // Amount returned by the receiver
  "amount" : { Money }, // R!  Total amount of Payment

  "paymentIdentifier" : { Identifier }, // Business identifier for the payment
  "
    "
    "
    "
    "
    "
    "
    "
    "
    "
    "

  "allocation" : [{ // Settlement particulars
    "identifier" : { Identifier }, // Business identifier of the payment detail
    "predecessor" : { Identifier }, // Business identifier of the prior payment detail
    "target" : { Reference(Account|ChargeItem|Claim|Contract|Encounter|Invoice) }, // Subject of the payment
    // targetItem[x]: Sub-element of the subject. One of these 3:

    "targetItemString" : "<string>",
    "targetItemIdentifier" : { Identifier },
    "targetItemPositiveInt" : "<positiveInt>",
    "encounter" : { Reference(Encounter) }, // Applied-to encounter
    "account" : { Reference(Account) }, // Applied-to account
    "type" : { CodeableConcept }, // Category of payment
    "submitter" : { Reference(Organization|Practitioner|PractitionerRole) }, // Submitter of the request
    "response" : { Reference(ClaimResponse) }, // Response committing to a payment
    "date" : "<date>", // Date of commitment to pay
    "responsible" : { Reference(PractitionerRole) }, // Contact for the response
    "payee" : { Reference(Organization|Practitioner|PractitionerRole) }, // Recipient of the payment
    "amount" : { Money } // Amount allocated to this payable

  }],
  "formCode" : { CodeableConcept }, // Printed form identifier
  "processNote" : [{ // Note concerning processing
    "type" : "<code>", // display | print | printoper
    "text" : "<string>" // Note explanatory text
  }]
}

Turtle Template 

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


[ a fhir:PaymentReconciliation;
  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:PaymentReconciliation.identifier [ Identifier ], ... ; # 0..* Business Identifier for a payment reconciliation
  fhir:PaymentReconciliation.type [ CodeableConcept ]; # 1..1 Category of payment

  fhir:PaymentReconciliation.status [ code ]; # 1..1 active | cancelled | draft | entered-in-error
  fhir:PaymentReconciliation.kind [ CodeableConcept ]; # 0..1 Workflow originating payment

  fhir:PaymentReconciliation.period [ Period ]; # 0..1 Period covered
  fhir:PaymentReconciliation.created [ dateTime ]; # 1..1 Creation date
  fhir:

  fhir:PaymentReconciliation.enterer [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Who entered the payment
  fhir:PaymentReconciliation.issuerType [ CodeableConcept ]; # 0..1 Nature of the source
  fhir:PaymentReconciliation.paymentIssuer [ Reference(Organization|Patient|Person|RelatedPerson) ]; # 0..1 Party generating payment

  fhir:PaymentReconciliation.request [ Reference(Task) ]; # 0..1 Reference to requesting resource
  fhir:PaymentReconciliation.requestor [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Responsible practitioner
  fhir:PaymentReconciliation.outcome [ code ]; # 0..1 queued | complete | error | partial
  fhir:PaymentReconciliation.disposition [ string ]; # 0..1 Disposition message
  fhir:
  fhir:

  fhir:PaymentReconciliation.date [ date ]; # 1..1 When payment issued
  fhir:PaymentReconciliation.location [ Reference(Location) ]; # 0..1 Where payment collected
  fhir:PaymentReconciliation.method [ CodeableConcept ]; # 0..1 Payment instrument
  fhir:PaymentReconciliation.cardBrand [ string ]; # 0..1 Type of card
  fhir:PaymentReconciliation.accountNumber [ string ]; # 0..1 Digits for verification
  fhir:PaymentReconciliation.expirationDate [ date ]; # 0..1 Expiration year-month
  fhir:PaymentReconciliation.processor [ string ]; # 0..1 Processor name
  fhir:PaymentReconciliation.referenceNumber [ string ]; # 0..1 Check number or payment reference
  fhir:PaymentReconciliation.authorization [ string ]; # 0..1 Authorization number
  fhir:PaymentReconciliation.tenderedAmount [ Money ]; # 0..1 Amount offered by the issuer
  fhir:PaymentReconciliation.returnedAmount [ Money ]; # 0..1 Amount returned by the receiver
  fhir:PaymentReconciliation.amount [ Money ]; # 1..1 Total amount of Payment

  fhir:PaymentReconciliation.paymentIdentifier [ Identifier ]; # 0..1 Business identifier for the payment
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:

  fhir:PaymentReconciliation.allocation [ # 0..* Settlement particulars
    fhir:PaymentReconciliation.allocation.identifier [ Identifier ]; # 0..1 Business identifier of the payment detail
    fhir:PaymentReconciliation.allocation.predecessor [ Identifier ]; # 0..1 Business identifier of the prior payment detail
    fhir:PaymentReconciliation.allocation.target [ Reference(Account|ChargeItem|Claim|Contract|Encounter|Invoice) ]; # 0..1 Subject of the payment
    # PaymentReconciliation.allocation.targetItem[x] : 0..1 Sub-element of the subject. One of these 3
      fhir:PaymentReconciliation.allocation.targetItemString [ string ]
      fhir:PaymentReconciliation.allocation.targetItemIdentifier [ Identifier ]
      fhir:PaymentReconciliation.allocation.targetItemPositiveInt [ positiveInt ]
    fhir:PaymentReconciliation.allocation.encounter [ Reference(Encounter) ]; # 0..1 Applied-to encounter
    fhir:PaymentReconciliation.allocation.account [ Reference(Account) ]; # 0..1 Applied-to account
    fhir:PaymentReconciliation.allocation.type [ CodeableConcept ]; # 0..1 Category of payment
    fhir:PaymentReconciliation.allocation.submitter [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Submitter of the request
    fhir:PaymentReconciliation.allocation.response [ Reference(ClaimResponse) ]; # 0..1 Response committing to a payment
    fhir:PaymentReconciliation.allocation.date [ date ]; # 0..1 Date of commitment to pay
    fhir:PaymentReconciliation.allocation.responsible [ Reference(PractitionerRole) ]; # 0..1 Contact for the response
    fhir:PaymentReconciliation.allocation.payee [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Recipient of the payment
    fhir:PaymentReconciliation.allocation.amount [ Money ]; # 0..1 Amount allocated to this payable

  ], ...;
  fhir:PaymentReconciliation.formCode [ CodeableConcept ]; # 0..1 Printed form identifier
  fhir:PaymentReconciliation.processNote [ # 0..* Note concerning processing
    fhir:PaymentReconciliation.processNote.type [ code ]; # 0..1 display | print | printoper
    fhir:PaymentReconciliation.processNote.text [ string ]; # 0..1 Note explanatory text
  ], ...;
]

Changes since R4

PaymentReconciliation
PaymentReconciliation.type
  • No Changes Added Mandatory Element
PaymentReconciliation.kind
  • Added Element
PaymentReconciliation.enterer
  • Added Element
PaymentReconciliation.issuerType
  • Added Element
PaymentReconciliation.paymentIssuer
  • Type Reference: Added Target Types Patient, Person, RelatedPerson
  • Type Reference: Added Target Types Patient, Person, RelatedPerson
PaymentReconciliation.outcome
  • Change value set from http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.0 to http://hl7.org/fhir/ValueSet/payment-outcome|5.0.0-snapshot3
  • Change value set from http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.0 to http://hl7.org/fhir/ValueSet/payment-outcome|5.0.0-snapshot3
PaymentReconciliation.date
  • Added Mandatory Element
PaymentReconciliation.location
  • Added Element
PaymentReconciliation.method
  • Added Element
PaymentReconciliation.cardBrand
  • Added Element
PaymentReconciliation.accountNumber
  • Added Element
PaymentReconciliation.expirationDate
  • Added Element
PaymentReconciliation.processor
  • Added Element
PaymentReconciliation.referenceNumber
  • Added Element
PaymentReconciliation.authorization
  • Added Element
PaymentReconciliation.tenderedAmount
  • Added Element
PaymentReconciliation.returnedAmount
  • Added Element
PaymentReconciliation.amount
  • Added Mandatory Element
PaymentReconciliation.allocation
  • Added Element
PaymentReconciliation.allocation.identifier
  • Added Element
PaymentReconciliation.allocation.predecessor
  • Added Element
PaymentReconciliation.allocation.target
  • Added Element
PaymentReconciliation.allocation.targetItem[x]
  • Added Element
PaymentReconciliation.allocation.encounter
  • Added Element
PaymentReconciliation.allocation.account
  • Added Element
PaymentReconciliation.allocation.type
  • Added Element
PaymentReconciliation.allocation.submitter
  • Added Element
PaymentReconciliation.allocation.response
  • Added Element
PaymentReconciliation.allocation.date
  • Added Element
PaymentReconciliation.allocation.responsible
  • Added Element
PaymentReconciliation.allocation.payee
  • Added Element
PaymentReconciliation.allocation.amount
  • Added Element
PaymentReconciliation.paymentDate
  • deleted
PaymentReconciliation.paymentAmount
  • deleted
PaymentReconciliation.detail
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4 See R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. 1 fail round-trip testing and 1 r3 resources are invalid (0 errors). )

Structure

Category
Name icon Flags icon Card. icon Type icon Description & Constraints icon doco icon
. . PaymentReconciliation TU DomainResource PaymentReconciliation resource

Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier 0..* Identifier Business Identifier for a payment reconciliation

. . . type Σ 1..1 CodeableConcept Category of payment
Payment Type Codes ( Extensible )
... status ?! Σ 1..1 code active | cancelled | draft | entered-in-error
Financial Resource Status Codes ( Required )
. . . kind 0..1 CodeableConcept Workflow originating payment
Payment Kind ( Extensible )
. . . period Σ 0..1 Period Period covered
. . . created Σ 1..1 dateTime Creation date
. . . enterer 0..1 Reference ( Practitioner | PractitionerRole | Organization ) Who entered the payment
... issuerType 0..1 CodeableConcept Nature of the source
Payment Issuer Type ( Extensible )
. . . paymentIssuer Σ 0..1 Reference ( Organization | Patient | Person | RelatedPerson ) Party generating payment
. . . request 0..1 Reference ( Task ) Reference to requesting resource
. . . requestor 0..1 Reference ( Practitioner | PractitionerRole | Organization ) Responsible practitioner
. . . outcome 0..1 code queued | complete | error | partial
RemittanceOutcome PaymentOutcome ( Required )
. . . disposition 0..1 string Disposition message
. . . paymentDate date Σ 1..1 date When payment issued
. . . location 0..1 Reference ( Location ) Where payment collected
... method 0..1 CodeableConcept Payment instrument
hl7VS-paymentMethodCode icon ( Extensible )
... cardBrand 0..1 string Type of card
... accountNumber 0..1 string Digits for verification
... expirationDate 0..1 date Expiration year-month
... processor 0..1 string Processor name
... referenceNumber 0..1 string Check number or payment reference
... authorization 0..1 string Authorization number
. . . paymentAmount tenderedAmount 0..1 Money Amount offered by the issuer
... returnedAmount 0..1 Money Amount returned by the receiver
... amount Σ 1..1 Money Total amount of Payment
. . . paymentIdentifier 0..1 Identifier Business identifier for the payment
. . . detail allocation 0..* BackboneElement Settlement particulars

. . . . identifier 0..1 Identifier Business identifier of the payment detail
. . . . predecessor 0..1 Identifier Business identifier of the prior payment detail
. . . type . target 0..1 1..1 Reference ( Claim | Account | Invoice | ChargeItem | Encounter | Contract ) Subject of the payment
CodeableConcept
. . . . targetItem[x] 0..1 Sub-element of payment the subject
Payment Type Codes
. . . . . targetItemString string ( Example
. . . . . targetItemIdentifier Identifier )
. . . . . targetItemPositiveInt positiveInt
. . . . request encounter 0..1 Reference ( Encounter ) Applied-to encounter
.... account 0..1 Reference ( Any Account ) Applied-to account
.... type Request giving rise to the 0..1 CodeableConcept Category of payment
Payment Type Codes ( Extensible )
. . . . submitter 0..1 Reference ( Practitioner | PractitionerRole | Organization ) Submitter of the request
. . . . response 0..1 Reference ( Any ClaimResponse ) Response committing to a payment
. . . . date 0..1 date Date of commitment to pay
. . . . responsible 0..1 Reference ( PractitionerRole ) Contact for the response
. . . . payee 0..1 Reference ( Practitioner | PractitionerRole | Organization ) Recipient of the payment
. . . . amount 0..1 Money Amount allocated to this payable
. . . formCode 0..1 CodeableConcept Printed form identifier
Forms Form Codes ( Example )
. . . processNote 0..* BackboneElement Note concerning processing

. . . . type 0..1 code display | print | printoper
NoteType ( Required )
. . . . text 0..1 string Note explanatory text

doco Documentation for this format icon

See the Extensions for this resource

UML Diagram ( Legend )

PaymentReconciliation ( DomainResource ) A unique identifier assigned to this payment reconciliation identifier : Identifier [0..*] Code to indicate the nature of the payment such as payment, adjustment type : CodeableConcept [1..1] « null (Strength=Extensible) PaymentTypeCodes + » The status of the resource instance (this element modifies the meaning of other elements) status : code [1..1] « null (Strength=Required) FinancialResourceStatusCodes ! » The workflow or activity which gave rise to or during which the payment ocurred such as a kiosk, deposit on account, periodic payment etc kind : CodeableConcept [0..1] « null (Strength=Extensible) PaymentKind + » The period of time for which payments have been gathered into this bulk payment for settlement period : Period [0..1] The date when the resource was created created : dateTime [1..1] Payment enterer if not the actual payment issuer enterer : Reference [0..1] « Practitioner | PractitionerRole | Organization » The type of the source such as patient or insurance issuerType : CodeableConcept [0..1] « null (Strength=Extensible) PaymentIssuerType + » The party who generated the payment paymentIssuer : Reference [0..1] « Organization | Patient | Person | RelatedPerson » Original request resource reference request : Reference [0..1] « Task » The practitioner who is responsible for the services rendered to the patient requestor : Reference [0..1] « Practitioner | PractitionerRole | Organization » The outcome of a request for a reconciliation outcome : code [0..1] « null (Strength=Required) RemittanceOutcome PaymentOutcome ! » A human readable description of the status of the request for the reconciliation disposition : string [0..1] The date of payment as indicated on the financial instrument paymentDate date : date [1..1] The location of the site or device for electronic transfers or physical location for cash payments location : Reference [0..1] « Location » The means of payment such as check, card cash, or electronic funds transfer method : CodeableConcept [0..1] « null (Strength=Extensible) Hl7VSPaymentMethodCode + » The card brand such as debit, Visa, Amex etc. used if a card is the method of payment cardBrand : string [0..1] A portion of the account number, often the last 4 digits, used for verification not charging purposes accountNumber : string [0..1] The year and month (YYYY-MM) when the instrument, typically card, expires expirationDate : date [0..1] The name of the card processor, etf processor, bank for checks processor : string [0..1] The check number, eft reference, car processor reference referenceNumber : string [0..1] An alphanumeric issued by the processor to confirm the successful issuance of payment authorization : string [0..1] 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 tenderedAmount : Money [0..1] The amount returned by the receiver which is excess to the amount payable, often referred to as 'change' returnedAmount : Money [0..1] Total payment amount as indicated on the financial instrument paymentAmount amount : Money [1..1] Issuer's unique identifier for the payment instrument paymentIdentifier : Identifier [0..1] A code for the form to be used for printing the content formCode : CodeableConcept [0..1] « null (Strength=Example) Form FormCodes ?? » Details Allocation Unique identifier for the current payment item for the referenced payable identifier : Identifier [0..1] Unique identifier for the prior payment item for the referenced payable predecessor : Identifier [0..1] Code Specific resource to indicate which the nature of payment/adjustment/advance applies target : Reference [0..1] « Claim | Account | Invoice | ChargeItem | Encounter | Contract » 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 type targetItem[x] : CodeableConcept DataType [1..1] [0..1] « string | Identifier | positiveInt » null (Strength=Example) The Encounter to which this payment applies, may be completed by the receiver, used for search PaymentTypeCodes encounter : Reference [0..1] « Encounter ?? » A resource, such as a Claim, the evaluation of which could lead The Account to which this payment applies, may be completed by the receiver, used for search request account : Reference [0..1] « Any Account » Code to indicate the nature of the payment type : CodeableConcept [0..1] « null (Strength=Extensible) PaymentTypeCodes + » The party which submitted the claim or financial transaction submitter : Reference [0..1] « Practitioner | PractitionerRole | Organization » A resource, such as a ClaimResponse, which contains a commitment to payment response : Reference [0..1] « Any ClaimResponse » The date from the response resource containing a commitment to pay date : date [0..1] A reference to the individual who is responsible for inquiries regarding the response and its payment responsible : Reference [0..1] « PractitionerRole » The party which is receiving the payment payee : Reference [0..1] « Practitioner | PractitionerRole | Organization » The monetary amount allocated from the total payment to the payable amount : Money [0..1] Notes The business purpose of the note text type : code [0..1] « null (Strength=Required) NoteType ! » The explanation or description associated with the processing text : string [0..1] Distribution of the payment amount for a previously acknowledged payable detail allocation [0..*] A note that describes or explains the processing in a human readable form processNote [0..*]

XML Template 

<PaymentReconciliation xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <identifier><!-- 0..* Identifier Business Identifier for a payment reconciliation --></identifier>
 <type><!-- 1..1 CodeableConcept Category of payment --></type>

 <status value="[code]"/><!-- 1..1 active | cancelled | draft | entered-in-error -->
 <kind><!-- 0..1 CodeableConcept Workflow originating payment --></kind>

 <period><!-- 0..1 Period Period covered --></period>
 <created value="[dateTime]"/><!-- 1..1 Creation date -->
 <</paymentIssuer>

 <enterer><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Who entered the payment --></enterer>
 <issuerType><!-- 0..1 CodeableConcept Nature of the source --></issuerType>
 <paymentIssuer><!-- 0..1 Reference(Organization|Patient|Person|RelatedPerson) Party generating payment --></paymentIssuer>

 <request><!-- 0..1 Reference(Task) Reference to requesting resource --></request>
 <requestor><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Responsible practitioner --></requestor>
 <

 <outcome value="[code]"/><!-- 0..1 queued | complete | error | partial -->

 <disposition value="[string]"/><!-- 0..1 Disposition message -->
 <
 <</paymentAmount>

 <date value="[date]"/><!-- 1..1 When payment issued -->
 <location><!-- 0..1 Reference(Location) Where payment collected --></location>
 <method><!-- 0..1 CodeableConcept Payment instrument icon --></method>
 <cardBrand value="[string]"/><!-- 0..1 Type of card -->
 <accountNumber value="[string]"/><!-- 0..1 Digits for verification -->
 <expirationDate value="[date]"/><!-- 0..1 Expiration year-month -->
 <processor value="[string]"/><!-- 0..1 Processor name -->
 <referenceNumber value="[string]"/><!-- 0..1 Check number or payment reference -->
 <authorization value="[string]"/><!-- 0..1 Authorization number -->
 <tenderedAmount><!-- 0..1 Money Amount offered by the issuer --></tenderedAmount>
 <returnedAmount><!-- 0..1 Money Amount returned by the receiver --></returnedAmount>
 <amount><!-- 1..1 Money Total amount of Payment --></amount>

 <paymentIdentifier><!-- 0..1 Identifier Business identifier for the payment --></paymentIdentifier>
 <
  <</identifier>
  <</predecessor>
  <</type>
  <</request>
  <</submitter>
  <</response>
  <
  <</responsible>
  <</payee>
  <</amount>
 </detail>

 <allocation>  <!-- 0..* Settlement particulars -->
  <identifier><!-- 0..1 Identifier Business identifier of the payment detail --></identifier>
  <predecessor><!-- 0..1 Identifier Business identifier of the prior payment detail --></predecessor>
  <target><!-- 0..1 Reference(Account|ChargeItem|Claim|Contract|Encounter|Invoice) Subject of the payment --></target>
  <targetItem[x]><!-- 0..1 string|Identifier|positiveInt Sub-element of the subject --></targetItem[x]>
  <encounter><!-- 0..1 Reference(Encounter) Applied-to encounter --></encounter>
  <account><!-- 0..1 Reference(Account) Applied-to account --></account>
  <type><!-- 0..1 CodeableConcept Category of payment --></type>
  <submitter><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Submitter of the request --></submitter>
  <response><!-- 0..1 Reference(ClaimResponse) Response committing to a payment --></response>
  <date value="[date]"/><!-- 0..1 Date of commitment to pay -->
  <responsible><!-- 0..1 Reference(PractitionerRole) Contact for the response --></responsible>
  <payee><!-- 0..1 Reference(Organization|Practitioner|PractitionerRole) Recipient of the payment --></payee>
  <amount><!-- 0..1 Money Amount allocated to this payable --></amount>
 </allocation>

 <formCode><!-- 0..1 CodeableConcept Printed form identifier --></formCode>
 <processNote>  <!-- 0..* Note concerning processing -->
  <type value="[code]"/><!-- 0..1 display | print | printoper -->
  <text value="[string]"/><!-- 0..1 Note explanatory text -->
 </processNote>
</PaymentReconciliation>

JSON Template 

{doco
  "resourceType" : "PaymentReconciliation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for a payment reconciliation
  "type" : { CodeableConcept }, // R!  Category of payment

  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "kind" : { CodeableConcept }, // Workflow originating payment

  "period" : { Period }, // Period covered
  "created" : "<dateTime>", // R!  Creation date
  "

  "enterer" : { Reference(Organization|Practitioner|PractitionerRole) }, // Who entered the payment
  "issuerType" : { CodeableConcept }, // Nature of the source
  "paymentIssuer" : { Reference(Organization|Patient|Person|RelatedPerson) }, // Party generating payment

  "request" : { Reference(Task) }, // Reference to requesting resource
  "requestor" : { Reference(Organization|Practitioner|PractitionerRole) }, // Responsible practitioner
  "

  "outcome" : "<code>", // queued | complete | error | partial

  "disposition" : "<string>", // Disposition message
  "
  "

  "date" : "<date>", // R!  When payment issued
  "location" : { Reference(Location) }, // Where payment collected
  "method" : { CodeableConcept }, // Payment instrument icon
  "cardBrand" : "<string>", // Type of card
  "accountNumber" : "<string>", // Digits for verification
  "expirationDate" : "<date>", // Expiration year-month
  "processor" : "<string>", // Processor name
  "referenceNumber" : "<string>", // Check number or payment reference
  "authorization" : "<string>", // Authorization number
  "tenderedAmount" : { Money }, // Amount offered by the issuer
  "returnedAmount" : { Money }, // Amount returned by the receiver
  "amount" : { Money }, // R!  Total amount of Payment

  "paymentIdentifier" : { Identifier }, // Business identifier for the payment
  "
    "
    "
    "
    "
    "
    "
    "
    "
    "
    "

  "allocation" : [{ // Settlement particulars
    "identifier" : { Identifier }, // Business identifier of the payment detail
    "predecessor" : { Identifier }, // Business identifier of the prior payment detail
    "target" : { Reference(Account|ChargeItem|Claim|Contract|Encounter|Invoice) }, // Subject of the payment
    // targetItem[x]: Sub-element of the subject. One of these 3:

    "targetItemString" : "<string>",
    "targetItemIdentifier" : { Identifier },
    "targetItemPositiveInt" : "<positiveInt>",
    "encounter" : { Reference(Encounter) }, // Applied-to encounter
    "account" : { Reference(Account) }, // Applied-to account
    "type" : { CodeableConcept }, // Category of payment
    "submitter" : { Reference(Organization|Practitioner|PractitionerRole) }, // Submitter of the request
    "response" : { Reference(ClaimResponse) }, // Response committing to a payment
    "date" : "<date>", // Date of commitment to pay
    "responsible" : { Reference(PractitionerRole) }, // Contact for the response
    "payee" : { Reference(Organization|Practitioner|PractitionerRole) }, // Recipient of the payment
    "amount" : { Money } // Amount allocated to this payable

  }],
  "formCode" : { CodeableConcept }, // Printed form identifier
  "processNote" : [{ // Note concerning processing
    "type" : "<code>", // display | print | printoper
    "text" : "<string>" // Note explanatory text
  }]
}

Turtle Template 

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


[ a fhir:PaymentReconciliation;
  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:PaymentReconciliation.identifier [ Identifier ], ... ; # 0..* Business Identifier for a payment reconciliation
  fhir:PaymentReconciliation.type [ CodeableConcept ]; # 1..1 Category of payment

  fhir:PaymentReconciliation.status [ code ]; # 1..1 active | cancelled | draft | entered-in-error
  fhir:PaymentReconciliation.kind [ CodeableConcept ]; # 0..1 Workflow originating payment

  fhir:PaymentReconciliation.period [ Period ]; # 0..1 Period covered
  fhir:PaymentReconciliation.created [ dateTime ]; # 1..1 Creation date
  fhir:

  fhir:PaymentReconciliation.enterer [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Who entered the payment
  fhir:PaymentReconciliation.issuerType [ CodeableConcept ]; # 0..1 Nature of the source
  fhir:PaymentReconciliation.paymentIssuer [ Reference(Organization|Patient|Person|RelatedPerson) ]; # 0..1 Party generating payment

  fhir:PaymentReconciliation.request [ Reference(Task) ]; # 0..1 Reference to requesting resource
  fhir:PaymentReconciliation.requestor [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Responsible practitioner
  fhir:PaymentReconciliation.outcome [ code ]; # 0..1 queued | complete | error | partial
  fhir:PaymentReconciliation.disposition [ string ]; # 0..1 Disposition message
  fhir:
  fhir:

  fhir:PaymentReconciliation.date [ date ]; # 1..1 When payment issued
  fhir:PaymentReconciliation.location [ Reference(Location) ]; # 0..1 Where payment collected
  fhir:PaymentReconciliation.method [ CodeableConcept ]; # 0..1 Payment instrument
  fhir:PaymentReconciliation.cardBrand [ string ]; # 0..1 Type of card
  fhir:PaymentReconciliation.accountNumber [ string ]; # 0..1 Digits for verification
  fhir:PaymentReconciliation.expirationDate [ date ]; # 0..1 Expiration year-month
  fhir:PaymentReconciliation.processor [ string ]; # 0..1 Processor name
  fhir:PaymentReconciliation.referenceNumber [ string ]; # 0..1 Check number or payment reference
  fhir:PaymentReconciliation.authorization [ string ]; # 0..1 Authorization number
  fhir:PaymentReconciliation.tenderedAmount [ Money ]; # 0..1 Amount offered by the issuer
  fhir:PaymentReconciliation.returnedAmount [ Money ]; # 0..1 Amount returned by the receiver
  fhir:PaymentReconciliation.amount [ Money ]; # 1..1 Total amount of Payment

  fhir:PaymentReconciliation.paymentIdentifier [ Identifier ]; # 0..1 Business identifier for the payment
  fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:
    fhir:

  fhir:PaymentReconciliation.allocation [ # 0..* Settlement particulars
    fhir:PaymentReconciliation.allocation.identifier [ Identifier ]; # 0..1 Business identifier of the payment detail
    fhir:PaymentReconciliation.allocation.predecessor [ Identifier ]; # 0..1 Business identifier of the prior payment detail
    fhir:PaymentReconciliation.allocation.target [ Reference(Account|ChargeItem|Claim|Contract|Encounter|Invoice) ]; # 0..1 Subject of the payment
    # PaymentReconciliation.allocation.targetItem[x] : 0..1 Sub-element of the subject. One of these 3
      fhir:PaymentReconciliation.allocation.targetItemString [ string ]
      fhir:PaymentReconciliation.allocation.targetItemIdentifier [ Identifier ]
      fhir:PaymentReconciliation.allocation.targetItemPositiveInt [ positiveInt ]
    fhir:PaymentReconciliation.allocation.encounter [ Reference(Encounter) ]; # 0..1 Applied-to encounter
    fhir:PaymentReconciliation.allocation.account [ Reference(Account) ]; # 0..1 Applied-to account
    fhir:PaymentReconciliation.allocation.type [ CodeableConcept ]; # 0..1 Category of payment
    fhir:PaymentReconciliation.allocation.submitter [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Submitter of the request
    fhir:PaymentReconciliation.allocation.response [ Reference(ClaimResponse) ]; # 0..1 Response committing to a payment
    fhir:PaymentReconciliation.allocation.date [ date ]; # 0..1 Date of commitment to pay
    fhir:PaymentReconciliation.allocation.responsible [ Reference(PractitionerRole) ]; # 0..1 Contact for the response
    fhir:PaymentReconciliation.allocation.payee [ Reference(Organization|Practitioner|PractitionerRole) ]; # 0..1 Recipient of the payment
    fhir:PaymentReconciliation.allocation.amount [ Money ]; # 0..1 Amount allocated to this payable

  ], ...;
  fhir:PaymentReconciliation.formCode [ CodeableConcept ]; # 0..1 Printed form identifier
  fhir:PaymentReconciliation.processNote [ # 0..* Note concerning processing
    fhir:PaymentReconciliation.processNote.type [ code ]; # 0..1 display | print | printoper
    fhir:PaymentReconciliation.processNote.text [ string ]; # 0..1 Note explanatory text
  ], ...;
]

Changes since Release 4

PaymentReconciliation
PaymentReconciliation.type
  • No Changes Added Mandatory Element
PaymentReconciliation.kind
  • Added Element
PaymentReconciliation.enterer
  • Added Element
PaymentReconciliation.issuerType
  • Added Element
PaymentReconciliation.paymentIssuer
  • Type Reference: Added Target Types Patient, Person, RelatedPerson
  • Type Reference: Added Target Types Patient, Person, RelatedPerson
PaymentReconciliation.outcome
  • Change value set from http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.0 to http://hl7.org/fhir/ValueSet/payment-outcome|5.0.0-snapshot3
  • Change value set from http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.0 to http://hl7.org/fhir/ValueSet/payment-outcome|5.0.0-snapshot3
PaymentReconciliation.date
  • Added Mandatory Element
PaymentReconciliation.location
  • Added Element
PaymentReconciliation.method
  • Added Element
PaymentReconciliation.cardBrand
  • Added Element
PaymentReconciliation.accountNumber
  • Added Element
PaymentReconciliation.expirationDate
  • Added Element
PaymentReconciliation.processor
  • Added Element
PaymentReconciliation.referenceNumber
  • Added Element
PaymentReconciliation.authorization
  • Added Element
PaymentReconciliation.tenderedAmount
  • Added Element
PaymentReconciliation.returnedAmount
  • Added Element
PaymentReconciliation.amount
  • Added Mandatory Element
PaymentReconciliation.allocation
  • Added Element
PaymentReconciliation.allocation.identifier
  • Added Element
PaymentReconciliation.allocation.predecessor
  • Added Element
PaymentReconciliation.allocation.target
  • Added Element
PaymentReconciliation.allocation.targetItem[x]
  • Added Element
PaymentReconciliation.allocation.encounter
  • Added Element
PaymentReconciliation.allocation.account
  • Added Element
PaymentReconciliation.allocation.type
  • Added Element
PaymentReconciliation.allocation.submitter
  • Added Element
PaymentReconciliation.allocation.response
  • Added Element
PaymentReconciliation.allocation.date
  • Added Element
PaymentReconciliation.allocation.responsible
  • Added Element
PaymentReconciliation.allocation.payee
  • Added Element
PaymentReconciliation.allocation.amount
  • Added Element
PaymentReconciliation.paymentDate
  • deleted
PaymentReconciliation.paymentAmount
  • deleted
PaymentReconciliation.detail
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

Conversions between R3 and R4 See R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. 1 fail round-trip testing and 1 r3 resources are invalid (0 errors). )

 

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

13.9.4.1 Terminology Bindings

Path Definition Type Reference
PaymentReconciliation.type

This value set includes sample Payment Type codes.

Extensible PaymentTypeCodes
PaymentReconciliation.status

This value set includes Status codes.

Required FinancialResourceStatusCodes
PaymentReconciliation.kind

The type of workflow from which this payment arose.

Extensible PaymentKind (a valid code from Payment Kind Codes )
PaymentReconciliation.issuerType

The type of payment issuer.

Extensible PaymentIssuerType (a valid code from Payment Issuer Type Codes )
PaymentReconciliation.outcome

The outcome of the processing.

Required RemittanceOutcome PaymentOutcome (a valid code from Claim Processing Codes )
PaymentReconciliation.method

Value Set of codes used to specify the method for the movement of payment.

Extensible Hl7VSPaymentMethodCode icon (a valid code from paymentMethod icon )
PaymentReconciliation.detail.type PaymentReconciliation.allocation.type

This value set includes sample Payment Type codes.

Example Extensible PaymentTypeCodes
PaymentReconciliation.formCode

This value set includes a sample set of Forms codes.

Example Form Codes FormCodes
PaymentReconciliation.processNote.type

The presentation types of notes.

Required NoteType

13.9.5 Search Parameters

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
allocation-account reference The account to which payment or adjustment was applied. PaymentReconciliation.allocation.account
( Account )
allocation-encounter reference The encounter to which payment or adjustment was applied. PaymentReconciliation.allocation.encounter
( Encounter )
created date The creation date PaymentReconciliation.created
disposition string The contents of the disposition message PaymentReconciliation.disposition
identifier token The business identifier of the ExplanationOfBenefit PaymentReconciliation.identifier
outcome token The processing outcome PaymentReconciliation.outcome
payment-issuer reference The organization which generated this resource PaymentReconciliation.paymentIssuer
( Organization , Patient , Person , RelatedPerson )
request reference The reference to the claim PaymentReconciliation.request
( Task )
requestor reference The reference to the provider who submitted the claim PaymentReconciliation.requestor
( Practitioner , Organization , PractitionerRole )
status token The status of the payment reconciliation PaymentReconciliation.status