This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). 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
Detailed Descriptions for the elements in the PaymentReconciliation resource.
PaymentReconciliation | |
Definition | This resource provides payment details and claim references supporting a bulk payment. |
Control | 1..1 |
PaymentReconciliation.identifier | |
Definition | The Response business identifier. |
Note | This is a business identifer, not a resource identifier (see discussion) |
Control | 0..* |
Type | Identifier |
PaymentReconciliation.status | |
Definition | The status of the resource instance. |
Control | 1..1 |
Binding | PaymentReconciliationStatus: A code specifying the state of the resource instance. (Required) |
Type | code |
Is Modifier | true |
Summary | true |
To Do | The category of claim this is. |
PaymentReconciliation.request[x] | |
Definition | Original request resource reference. |
Control | 0..1 |
Type | Identifier|Reference(ProcessRequest) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
PaymentReconciliation.outcome | |
Definition | Transaction status: error, complete. |
Control | 0..1 |
Binding | RemittanceOutcome: The outcome of the processing. (Required) |
Type | code |
PaymentReconciliation.disposition | |
Definition | A description of the status of the adjudication. |
Control | 0..1 |
Type | string |
PaymentReconciliation.ruleset | |
Definition | The version of the style of resource contents. This should be mapped to the allowable profiles for this and supporting resources. |
Control | 0..1 |
Binding | Ruleset Codes: The static and dynamic model to which contents conform, which may be business version or standard/version. (Example) |
Type | Coding |
PaymentReconciliation.originalRuleset | |
Definition | The style (standard) and version of the original material which was converted into this resource. |
Control | 0..1 |
Binding | Ruleset Codes: The static and dynamic model to which contents conform, which may be business version or standard/version. (Example) |
Type | Coding |
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. |
PaymentReconciliation.created | |
Definition | The date when the enclosed suite of services were performed or completed. |
Control | 0..1 |
Type | dateTime |
PaymentReconciliation.period | |
Definition | The period of time for which payments have been gathered into this bulk payment for settlement. |
Control | 0..1 |
Type | Period |
PaymentReconciliation.organization[x] | |
Definition | The Insurer who produced this adjudicated response. |
Control | 0..1 |
Type | Identifier|Reference(Organization) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
PaymentReconciliation.requestProvider[x] | |
Definition | The practitioner who is responsible for the services rendered to the patient. |
Control | 0..1 |
Type | Identifier|Reference(Practitioner) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
PaymentReconciliation.requestOrganization[x] | |
Definition | The organization which is responsible for the services rendered to the patient. |
Control | 0..1 |
Type | Identifier|Reference(Organization) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
PaymentReconciliation.detail | |
Definition | List of individual settlement amounts and the corresponding transaction. |
Control | 0..* |
PaymentReconciliation.detail.type | |
Definition | Code to indicate the nature of the payment, adjustment, funds advance, etc. |
Control | 1..1 |
Binding | Payment Type Codes: The reason for the amount: payment, adjustment, advance. (Example) |
Type | Coding |
PaymentReconciliation.detail.request[x] | |
Definition | The claim or financial resource. |
Control | 0..1 |
Type | Identifier|Reference(Any) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
PaymentReconciliation.detail.response[x] | |
Definition | The claim response resource. |
Control | 0..1 |
Type | Identifier|Reference(Any) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
PaymentReconciliation.detail.submitter[x] | |
Definition | The Organization which submitted the invoice or financial transaction. |
Control | 0..1 |
Type | Identifier|Reference(Organization) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
PaymentReconciliation.detail.payee[x] | |
Definition | The organization which is receiving the payment. |
Control | 0..1 |
Type | Identifier|Reference(Organization) |
[x] Note | See Choice of Data Types for further information about how to use [x] |
PaymentReconciliation.detail.date | |
Definition | The date of the invoice or financial resource. |
Control | 0..1 |
Type | date |
PaymentReconciliation.detail.amount | |
Definition | Amount paid for this detail. |
Control | 0..1 |
Type | Money |
PaymentReconciliation.form | |
Definition | The form to be used for printing the content. |
Control | 0..1 |
Binding | Form Codes: The forms codes. (Required) |
Type | Coding |
PaymentReconciliation.total | |
Definition | Total payment amount. |
Control | 1..1 |
Type | Money |
PaymentReconciliation.note | |
Definition | Suite of notes. |
Control | 0..* |
PaymentReconciliation.note.type | |
Definition | The note purpose: Print/Display. |
Control | 0..1 |
Binding | NoteType: The presentation types of notes. (Required) |
Type | Coding |
PaymentReconciliation.note.text | |
Definition | The note text. |
Control | 0..1 |
Type | string |