DSTU2

This page is part of the FHIR Specification (v1.0.2: DSTU 2). 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

7.10.5 Resource PaymentReconciliation - Detailed Descriptions

Detailed Descriptions for the elements in the PaymentReconciliation resource.

PaymentReconciliation
Definition

This resource provides payment details and claim references supporting a bulk payment.

Control1..1
Summarytrue
PaymentReconciliation.identifier
Definition

The Response business identifier.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
PaymentReconciliation.request
Definition

Original request resource reference.

Control0..1
TypeReference(ProcessRequest)
Summarytrue
PaymentReconciliation.outcome
Definition

Transaction status: error, complete.

Control0..1
BindingRemittanceOutcome: The outcome of the processing. (Required)
Typecode
Summarytrue
PaymentReconciliation.disposition
Definition

A description of the status of the adjudication.

Control0..1
Typestring
Summarytrue
PaymentReconciliation.ruleset
Definition

The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources.

Control0..1
BindingRuleset Codes: The static and dynamic model to which contents conform, which may be business version or standard/version. (Example)
TypeCoding
Summarytrue
PaymentReconciliation.originalRuleset
Definition

The style (standard) and version of the original material which was converted into this resource.

Control0..1
BindingRuleset Codes: The static and dynamic model to which contents conform, which may be business version or standard/version. (Example)
TypeCoding
Requirements

Knowledge of the original version can inform the processing of this instance so that information which is processable by the originating system may be generated.

Summarytrue
PaymentReconciliation.created
Definition

The date when the enclosed suite of services were performed or completed.

Control0..1
TypedateTime
Summarytrue
PaymentReconciliation.period
Definition

The period of time for which payments have been gathered into this bulk payment for settlement.

Control0..1
TypePeriod
Summarytrue
PaymentReconciliation.organization
Definition

The Insurer who produced this adjudicated response.

Control0..1
TypeReference(Organization)
Summarytrue
PaymentReconciliation.requestProvider
Definition

The practitioner who is responsible for the services rendered to the patient.

Control0..1
TypeReference(Practitioner)
Summarytrue
PaymentReconciliation.requestOrganization
Definition

The organization which is responsible for the services rendered to the patient.

Control0..1
TypeReference(Organization)
Summarytrue
PaymentReconciliation.detail
Definition

List of individual settlement amounts and the corresponding transaction.

Control0..*
Summarytrue
PaymentReconciliation.detail.type
Definition

Code to indicate the nature of the payment, adjustment, funds advance, etc.

Control1..1
BindingPayment Type Codes: The reason for the amount: payment, adjustment, advance. (Example)
TypeCoding
Summarytrue
PaymentReconciliation.detail.request
Definition

The claim or financial resource.

Control0..1
TypeReference(Any)
Summarytrue
PaymentReconciliation.detail.responce
Definition

The claim response resource.

Control0..1
TypeReference(Any)
Summarytrue
PaymentReconciliation.detail.submitter
Definition

The Organization which submitted the invoice or financial transaction.

Control0..1
TypeReference(Organization)
Summarytrue
PaymentReconciliation.detail.payee
Definition

The organization which is receiving the payment.

Control0..1
TypeReference(Organization)
Summarytrue
PaymentReconciliation.detail.date
Definition

The date of the invoice or financial resource.

Control0..1
Typedate
Summarytrue
PaymentReconciliation.detail.amount
Definition

Amount paid for this detail.

Control0..1
TypeMoney
Summarytrue
PaymentReconciliation.form
Definition

The form to be used for printing the content.

Control0..1
BindingForm Codes: The forms codes. (Required)
TypeCoding
Summarytrue
PaymentReconciliation.total
Definition

Total payment amount.

Control1..1
TypeMoney
Summarytrue
PaymentReconciliation.note
Definition

Suite of notes.

Control0..*
Summarytrue
PaymentReconciliation.note.type
Definition

The note purpose: Print/Display.

Control0..1
BindingNoteType: The presentation types of notes. (Required)
TypeCoding
Summarytrue
PaymentReconciliation.note.text
Definition

The note text.

Control0..1
Typestring
Summarytrue