R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). 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

Financial Management Work GroupMaturity Level: 0 Draft Compartments: Device, Patient, Practitioner, RelatedPerson

Detailed Descriptions for the elements in the Invoice resource.

Invoice
Definition

Invoice containing collected ChargeItems from an Account with calculated individual and total price for Billing purpose.

Control1..1
Invoice.identifier
Definition

Identifier of this Invoice, often used for reference in corresponcence about this invoice or for tracking of payments.

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

Allows Identification of this Invoice instance.

Summarytrue
Invoice.status
Definition

The current state of the Invoice.

Control1..1
Terminology BindingInvoiceStatus (Required)
Typecode
Is Modifiertrue
Summarytrue
Invoice.cancelledReason
Definition

In case of Invoice cancellation a reason must be given (entered in error, superseded by corrected invoice etc).

Control0..1
Typestring
Summaryfalse
Comments

Derived Profiles may chose to add invariants requiring this field to be populated if either priceOverride or factorOverride have been filled.

Invoice.type
Definition

Type of Invoice depending on domain, realm an usage (eg. internal/external, dental, preliminary).

Control0..1
TypeCodeableConcept
Alternate Namestype
Summarytrue
Invoice.subject
Definition

The individual or set of individuals receiving the goods and services billed in this invoice.

Control0..1
TypeReference(Patient | Group)
Requirements

Links the event to the Patient context.

Alternate Namespatient
Summarytrue
Invoice.recipient
Definition

The individual or Organization responsible for balancing of this invoice.

Control0..1
TypeReference(Organization | Patient | RelatedPerson)
Summarytrue
Invoice.date
Definition

Date/time(s) of when this Invoice was posted.

Control0..1
TypedateTime
Summarytrue
Comments

The list of types may be constrained as appropriate for the type of charge item.

Invoice.participant
Definition

Indicates who or what performed or participated in the charged service.

Control0..*
Summaryfalse
Invoice.participant.role
Definition

Describes the type of involvement (e.g. transcriptionist, creator etc.). If the invoice has been created automatically, the Participant may be a billing engine or another kind of device.

Control0..1
TypeCodeableConcept
Summaryfalse
Invoice.participant.actor
Definition

The device, practitioner, etc. who performed or participated in the service.

Control1..1
TypeReference(Practitioner | Organization | Patient | Device | RelatedPerson)
Summaryfalse
Invoice.issuer
Definition

The organizationissuing the Invoice.

Control0..1
TypeReference(Organization)
Summaryfalse
Comments

Practitioners and Devices can be associated with multiple organizations. It has to be made clear, on behalf of which Organization the services have been rendered.

Invoice.account
Definition

Account which is supposed to be balanced with this Invoice.

Control0..1
TypeReference(Account)
Summaryfalse
Comments

Systems posting the ChargeItems might not always be able to determine, which accounts the Items need to be places into. It is up to the potprocessing Financial System to apply internal rules to decide based on the Encounter/EpisodeOfCare/Patient/Coverage context and the type of ChargeItem, which Account is appropriate.

Invoice.lineItem
Definition

Each line item represents one charge for goods ond services rendered. Details such as date, code and amount are found in the referenced ChargeItem resource.

Control0..*
Summaryfalse
Invoice.lineItem.sequence
Definition

Sequence in which the items appear on the invoice.

Control0..1
TypepositiveInt
Summaryfalse
Invoice.lineItem.chargeItem
Definition

The ChargeItem contains information such as the billing code, date, amount etc.

Control1..1
TypeReference(ChargeItem)
Summaryfalse
Invoice.lineItem.priceComponent
Definition

The price for a ChargeItem may be calculated as a base price with surcharges/deductions that apply in certain conditions. A ChargeItemDefinition resource that defines the prices, factors and conditions that apply to a billing code is currently under developement. The priceComponent element can be used to offer transparency to the recipient of the Invoice of how the prices have been calculated.

Control0..*
Summaryfalse
Invoice.lineItem.priceComponent.type
Definition

This code identifies the type of the component.

Control1..1
Terminology BindingInvoicePriceComponentType (Required)
Typecode
Summaryfalse
Invoice.lineItem.priceComponent.code
Definition

A code that identifies the component. Codes may be used to differentiate between kinds of taxes, surcharges, discounts etc.

Control0..1
TypeCodeableConcept
Summaryfalse
Invoice.lineItem.priceComponent.factor
Definition

The amount calculated for this component.

Control0..1
TypeMoney
Summaryfalse
Comments

There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.

Invoice.lineItem.priceComponent.amount
Definition

The factor that has been applied on the base price for calculating this component.

Control0..1
Typedecimal
Summaryfalse
Comments

There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.

Invoice.totalPriceComponent
Definition

The total amount for the Invoice may be calculated as the sum of the line items with surcharges/deductions that apply in certain conditions. The priceComponent element can be used to offer transparency to the recipient of the Invoice of how the total price was calculated.

Control0..*
TypeSee Invoice.lineItem.priceComponent
Summaryfalse
Invoice.totalNet
Definition

Invoice total , taxes excluded.

Control0..1
TypeMoney
Summarytrue
Comments

There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.

Invoice.totalGross
Definition

Invoice total, tax included.

Control0..1
TypeMoney
Summarytrue
Comments

There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.

Invoice.paymentTerms
Definition

Payment details such as banking details, period of payment, deductables, methods of payment.

Control0..1
Typemarkdown
Summaryfalse
Comments

Derived Profiles may chose to add invariants requiring this field to be populated if either priceOverride or factorOverride have been filled.

Invoice.note
Definition

Comments made about the invoice by the issuer, subject or other participants.

Control0..*
TypeAnnotation
Summaryfalse