FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 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

Financial Management Work GroupMaturity Level: 2 Trial UseCompartments: Practitioner

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
PaymentReconciliation.identifier
Definition

The Response business identifier.

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

The status of the resource instance.

Control0..1
Terminology BindingFinancial Resource Status Codes (Required)
Typecode
Is Modifiertrue
Summarytrue
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

PaymentReconciliation.period
Definition

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

Control0..1
TypePeriod
PaymentReconciliation.created
Definition

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

Control0..1
TypedateTime
PaymentReconciliation.organization
Definition

The Insurer who produced this adjudicated response.

Control0..1
TypeReference(Organization)
PaymentReconciliation.request
Definition

Original request resource reference.

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

Transaction status: error, complete.

Control0..1
Terminology BindingRemittanceOutcome (Required)
TypeCodeableConcept
PaymentReconciliation.disposition
Definition

A description of the status of the adjudication.

Control0..1
Typestring
PaymentReconciliation.requestProvider
Definition

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

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

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

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

List of individual settlement amounts and the corresponding transaction.

Control0..*
PaymentReconciliation.detail.type
Definition

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

Control1..1
Terminology BindingPayment Type Codes (Example)
TypeCodeableConcept
PaymentReconciliation.detail.request
Definition

The claim or financial resource.

Control0..1
TypeReference(Any)
PaymentReconciliation.detail.response
Definition

The claim response resource.

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

The Organization which submitted the claim or financial transaction.

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

The organization which is receiving the payment.

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

The date of the invoice or financial resource.

Control0..1
Typedate
PaymentReconciliation.detail.amount
Definition

Amount paid for this detail.

Control0..1
TypeMoney
PaymentReconciliation.form
Definition

The form to be used for printing the content.

Control0..1
Terminology BindingForm Codes (Example)
TypeCodeableConcept
PaymentReconciliation.total
Definition

Total payment amount.

Control0..1
TypeMoney
PaymentReconciliation.processNote
Definition

Suite of notes.

Control0..*
PaymentReconciliation.processNote.type
Definition

The note purpose: Print/Display.

Control0..1
Terminology BindingNoteType (Required)
TypeCodeableConcept
PaymentReconciliation.processNote.text
Definition

The note text.

Control0..1
Typestring