DSTU2 FHIR Release 3 (STU)

This page is part of the FHIR Specification (v1.0.2: DSTU (v3.0.2: STU 2). 3). 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 R3 R2

Paymentnotice-example.xml

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

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Claim PaymentNotice Example (id = "77654") 


 

<PaymentNotice xmlns="http://hl7.org/fhir">
  <id value="77654"/> 

 
    
    
  

  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the PaymentNotice</div> 
  </text> 

  
  
  
  
 
  

  <identifier> 
    <system value="http://benefitsinc.com/paymentnotice"/> 
    <value value="776543"/> 
  </identifier> 

  
    
  
  
  
    
  

  <status value="active"/> 

  
    
    
  

  <request> 
    <reference value="http://benefitsinc.com/fhir/claim/12345"/> 
  </request> 

  <response> 
    <reference value="http://benefitsinc.com/fhir/claimresponse/CR12345"/> 
  </response> 


  <statusDate value="2014-08-15"/> 


  <created value="2014-08-16"/> 


  <target> 
    <identifier> 
      <system value="http://regulators.gov"/> 
      <value value="AB123"/> 
    </identifier> 
  </target> 


  <provider> 
    <identifier> 
      <system value="http://npid.org/provider"/> 
      <value value="PR957857"/> 
    </identifier> 
  </provider> 


  <organization> 
    <reference value="Organization/1"/> 
  </organization> 


  <paymentStatus> 
    <coding> 
      <system value="http://hl7.org/fhir/paymentstatus"/> 
      <code value="paid"/> 
    </coding> 
  </paymentStatus> 



</

PaymentNotice

>

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.