Release 4 5 Preview #2
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Financial Management Work Group Maturity Level : 2   Trial Use Security Category : Patient Compartments : Practitioner

Detailed Descriptions for the elements in the PaymentReconciliation resource.

PaymentReconciliation
Element Id PaymentReconciliation
Definition

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

Cardinality 0..*
Type DomainResource
PaymentReconciliation.identifier
Element Id PaymentReconciliation.identifier
Definition

A unique identifier assigned to this payment reconciliation.

Note This is a business identifier, not a resource identifier (see discussion )
Cardinality 0..*
Type Identifier
Requirements

Allows payment reconciliations to be distinguished and referenced.

PaymentReconciliation.status
Element Id PaymentReconciliation.status
Definition

The status of the resource instance.

Cardinality 1..1
Terminology Binding Financial Resource Status Codes ( Required )
Type code
Is Modifier true (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Requirements

Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.

Summary true
Comments

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

PaymentReconciliation.period
Element Id PaymentReconciliation.period
Definition

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

Cardinality 0..1
Type Period
Requirements

Needed to allow receivers to monitor and reconcile payment issuer schedules.

Summary true
PaymentReconciliation.created
Element Id PaymentReconciliation.created
Definition

The date when the resource was created.

Cardinality 1..1
Type dateTime
Requirements

Need to record a timestamp for use by both the recipient and the issuer.

Summary true
PaymentReconciliation.paymentIssuer
Element Id PaymentReconciliation.paymentIssuer
Definition

The party who generated the payment.

Cardinality 0..1
Type Reference ( Organization )
Requirements

Need to identify the party resonsible for the payment and this resource.

Summary true
Comments

This party is also responsible for the reconciliation.

PaymentReconciliation.request
Element Id PaymentReconciliation.request
Definition

Original request resource reference.

Cardinality 0..1
Type Reference ( Task )
Requirements

Needed to allow the response to be linked to the request.

PaymentReconciliation.requestor
Element Id PaymentReconciliation.requestor
Definition

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

Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole | Organization )
Patterns Reference(Practitioner,PractitionerRole,Organization): Common patterns = Participant
Requirements

Need to identify the party responsible for the request.

PaymentReconciliation.outcome
Element Id PaymentReconciliation.outcome
Definition

The outcome of a request for a reconciliation.

Cardinality 0..1
Terminology Binding RemittanceOutcome ( Required )
Type code
Requirements

To advise the requestor of an overall processing outcome.

Comments

The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).

PaymentReconciliation.disposition
Element Id PaymentReconciliation.disposition
Definition

A human readable description of the status of the request for the reconciliation.

Cardinality 0..1
Type string
Requirements

Provided for user display.

PaymentReconciliation.paymentDate
Element Id PaymentReconciliation.paymentDate
Definition

The date of payment as indicated on the financial instrument.

Cardinality 1..1
Type date
Requirements

To advise the payee when payment can be expected.

Summary true
PaymentReconciliation.paymentAmount
Element Id PaymentReconciliation.paymentAmount
Definition

Total payment amount as indicated on the financial instrument.

Cardinality 1..1
Type Money
Requirements

Needed to provide the actual payment amount.

Summary true
PaymentReconciliation.paymentIdentifier
Element Id PaymentReconciliation.paymentIdentifier
Definition

Issuer's unique identifier for the payment instrument.

Cardinality 0..1
Type Identifier
Requirements

Enable the receiver to reconcile when payment is received.

Comments

For example: EFT number or check number.

PaymentReconciliation.detail
Element Id PaymentReconciliation.detail
Definition

Distribution of the payment amount for a previously acknowledged payable.

Cardinality 0..*
Requirements

Needed to show how the payment amount is distributed across the payables.

PaymentReconciliation.detail.identifier
Element Id PaymentReconciliation.detail.identifier
Definition

Unique identifier for the current payment item for the referenced payable.

Note This is a business identifier, not a resource identifier (see discussion )
Cardinality 0..1
Type Identifier
Requirements

Needed for reconciliation of payments.

PaymentReconciliation.detail.predecessor
Element Id PaymentReconciliation.detail.predecessor
Definition

Unique identifier for the prior payment item for the referenced payable.

Cardinality 0..1
Type Identifier
Requirements

Needed for reconciliation of payments.

PaymentReconciliation.detail.type
Element Id PaymentReconciliation.detail.type
Definition

Code to indicate the nature of the payment.

Cardinality 1..1
Terminology Binding Payment Type Codes ( Example )
Type CodeableConcept
Requirements

Needed to provide context for the amount.

Comments

For example: payment, adjustment, funds advance, etc.

PaymentReconciliation.detail.request
Element Id PaymentReconciliation.detail.request
Definition

A resource, such as a Claim, the evaluation of which could lead to payment.

Cardinality 0..1
Type Reference ( Any )
Requirements

Needed to provide a linkage to the original request.

PaymentReconciliation.detail.submitter
Element Id PaymentReconciliation.detail.submitter
Definition

The party which submitted the claim or financial transaction.

Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole | Organization )
Patterns Reference(Practitioner,PractitionerRole,Organization): Common patterns = Participant
Requirements

Needed for audit and validation.

PaymentReconciliation.detail.response
Element Id PaymentReconciliation.detail.response
Definition

A resource, such as a ClaimResponse, which contains a commitment to payment.

Cardinality 0..1
Type Reference ( Any )
Requirements

Needed to provide a linkage to the payment commitment.

PaymentReconciliation.detail.date
Element Id PaymentReconciliation.detail.date
Definition

The date from the response resource containing a commitment to pay.

Cardinality 0..1
Type date
Requirements

Needed for audit and validation.

PaymentReconciliation.detail.responsible
Element Id PaymentReconciliation.detail.responsible
Definition

A reference to the individual who is responsible for inquiries regarding the response and its payment.

Cardinality 0..1
Type Reference ( PractitionerRole )
Requirements

To provide contact information.

PaymentReconciliation.detail.payee
Element Id PaymentReconciliation.detail.payee
Definition

The party which is receiving the payment.

Cardinality 0..1
Type Reference ( Practitioner | PractitionerRole | Organization )
Patterns Reference(Practitioner,PractitionerRole,Organization): Common patterns = Participant
Requirements

Needed for audit and validation.

PaymentReconciliation.detail.amount
Element Id PaymentReconciliation.detail.amount
Definition

The monetary amount allocated from the total payment to the payable.

Cardinality 0..1
Type Money
Requirements

Needed to explain the distribution of the payment to the payables.

PaymentReconciliation.formCode
Element Id PaymentReconciliation.formCode
Definition

A code for the form to be used for printing the content.

Cardinality 0..1
Terminology Binding Forms ( Example )
Type CodeableConcept
Requirements

Needed to specify the specific form used for producing output for this response.

Comments

May be needed to identify specific jurisdictional forms.

PaymentReconciliation.processNote
Element Id PaymentReconciliation.processNote
Definition

A note that describes or explains the processing in a human readable form.

Cardinality 0..*
Requirements

Provides the specific textual explanations associated with the processing.

PaymentReconciliation.processNote.type
Element Id PaymentReconciliation.processNote.type
Definition

The business purpose of the note text.

Cardinality 0..1
Terminology Binding NoteType ( Required )
Type code
Requirements

To convey the expectation for when the text is used.

PaymentReconciliation.processNote.text
Element Id PaymentReconciliation.processNote.text
Definition

The explanation or description associated with the processing.

Cardinality 0..1
Type string
Requirements

Required to provide human readable explanation.