This page is part of the FHIR Specification (v4.4.0: R5 Preview #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
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. |