This page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - see ballot notes). 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. |
Short Display | PaymentReconciliation resource |
Cardinality | 0..* |
Type | DomainResource |
Summary | false |
PaymentReconciliation.identifier | |
Element Id | PaymentReconciliation.identifier |
Definition | A unique identifier assigned to this payment reconciliation. |
Short Display | Business Identifier for a 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. |
Summary | false |
PaymentReconciliation.type | |
Element Id | PaymentReconciliation.type |
Definition | Code to indicate the nature of the payment such as payment, adjustment. |
Short Display | Category of payment |
Cardinality | 1..1 |
Terminology Binding | Payment Type Codes (Extensible) |
Type | CodeableConcept |
Summary | true |
PaymentReconciliation.status | |
Element Id | PaymentReconciliation.status |
Definition | The status of the resource instance. |
Short Display | active | cancelled | draft | entered-in-error |
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.kind | |
Element Id | PaymentReconciliation.kind |
Definition | The workflow or activity which gave rise to or during which the payment ocurred such as a kiosk, deposit on account, periodic payment etc. |
Short Display | Workflow originating payment |
Cardinality | 0..1 |
Terminology Binding | Payment Kind (Extensible) |
Type | CodeableConcept |
Summary | false |
PaymentReconciliation.period | |
Element Id | PaymentReconciliation.period |
Definition | The period of time for which payments have been gathered into this bulk payment for settlement. |
Short Display | Period covered |
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. |
Short Display | Creation date |
Cardinality | 1..1 |
Type | dateTime |
Requirements | Need to record a timestamp for use by both the recipient and the issuer. |
Summary | true |
PaymentReconciliation.enterer | |
Element Id | PaymentReconciliation.enterer |
Definition | Payment enterer if not the actual payment issuer. |
Short Display | Who entered the payment |
Cardinality | 0..1 |
Type | Reference(Practitioner | PractitionerRole | Organization) |
Summary | false |
PaymentReconciliation.issuerType | |
Element Id | PaymentReconciliation.issuerType |
Definition | The type of the source such as patient or insurance. |
Short Display | Nature of the source |
Cardinality | 0..1 |
Terminology Binding | Payment Issuer Type (Extensible) |
Type | CodeableConcept |
Requirements | Providers may need to identify the source to know to which sub-ledger to apply the payment. |
Summary | false |
PaymentReconciliation.paymentIssuer | |
Element Id | PaymentReconciliation.paymentIssuer |
Definition | The party who generated the payment. |
Short Display | Party generating payment |
Cardinality | 0..1 |
Type | Reference(Organization | Patient | Person | RelatedPerson) |
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. |
Short Display | Reference to requesting resource |
Cardinality | 0..1 |
Type | Reference(Task) |
Requirements | Needed to allow the response to be linked to the request. |
Summary | false |
PaymentReconciliation.requestor | |
Element Id | PaymentReconciliation.requestor |
Definition | The practitioner who is responsible for the services rendered to the patient. |
Short Display | Responsible practitioner |
Cardinality | 0..1 |
Type | Reference(Practitioner | PractitionerRole | Organization) |
Requirements | Need to identify the party responsible for the request. |
Summary | false |
PaymentReconciliation.outcome | |
Element Id | PaymentReconciliation.outcome |
Definition | The outcome of a request for a reconciliation. |
Short Display | queued | complete | error | partial |
Cardinality | 0..1 |
Terminology Binding | Payment Outcome (Required) |
Type | code |
Requirements | To advise the requestor of an overall processing outcome. |
Summary | false |
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. |
Short Display | Disposition message |
Cardinality | 0..1 |
Type | string |
Requirements | Provided for user display. |
Summary | false |
PaymentReconciliation.date | |
Element Id | PaymentReconciliation.date |
Definition | The date of payment as indicated on the financial instrument. |
Short Display | When payment issued |
Cardinality | 1..1 |
Type | date |
Requirements | To advise the payee when payment can be expected. |
Summary | true |
PaymentReconciliation.location | |
Element Id | PaymentReconciliation.location |
Definition | The location of the site or device for electronic transfers or physical location for cash payments. |
Short Display | Where payment collected |
Cardinality | 0..1 |
Type | Reference(Location) |
Summary | false |
PaymentReconciliation.method | |
Element Id | PaymentReconciliation.method |
Definition | The means of payment such as check, card cash, or electronic funds transfer. |
Short Display | Payment instrument |
Cardinality | 0..1 |
Terminology Binding | hl7VS-paymentMethodCode (Extensible) |
Type | CodeableConcept |
Summary | false |
PaymentReconciliation.cardBrand | |
Element Id | PaymentReconciliation.cardBrand |
Definition | The card brand such as debit, Visa, Amex etc. used if a card is the method of payment. |
Short Display | Type of card |
Cardinality | 0..1 |
Type | string |
Summary | false |
PaymentReconciliation.accountNumber | |
Element Id | PaymentReconciliation.accountNumber |
Definition | A portion of the account number, often the last 4 digits, used for verification not charging purposes. |
Short Display | Digits for verification |
Cardinality | 0..1 |
Type | string |
Summary | false |
PaymentReconciliation.expirationDate | |
Element Id | PaymentReconciliation.expirationDate |
Definition | The year and month (YYYY-MM) when the instrument, typically card, expires. |
Short Display | Expiration year-month |
Cardinality | 0..1 |
Type | date |
Summary | false |
PaymentReconciliation.processor | |
Element Id | PaymentReconciliation.processor |
Definition | The name of the card processor, etf processor, bank for checks. |
Short Display | Processor name |
Cardinality | 0..1 |
Type | string |
Summary | false |
PaymentReconciliation.referenceNumber | |
Element Id | PaymentReconciliation.referenceNumber |
Definition | The check number, eft reference, car processor reference. |
Short Display | Check number or payment reference |
Cardinality | 0..1 |
Type | string |
Summary | false |
PaymentReconciliation.authorization | |
Element Id | PaymentReconciliation.authorization |
Definition | An alphanumeric issued by the processor to confirm the successful issuance of payment. |
Short Display | Authorization number |
Cardinality | 0..1 |
Type | string |
Summary | false |
PaymentReconciliation.tenderedAmount | |
Element Id | PaymentReconciliation.tenderedAmount |
Definition | The amount offered by the issuer, typically applies to cash when the issuer provides an amount in bank note denominations equal to or excess of the amount actually being paid. |
Short Display | Amount offered by the issuer |
Cardinality | 0..1 |
Type | Money |
Summary | false |
PaymentReconciliation.returnedAmount | |
Element Id | PaymentReconciliation.returnedAmount |
Definition | The amount returned by the receiver which is excess to the amount payable, often referred to as 'change'. |
Short Display | Amount returned by the receiver |
Cardinality | 0..1 |
Type | Money |
Summary | false |
PaymentReconciliation.amount | |
Element Id | PaymentReconciliation.amount |
Definition | Total payment amount as indicated on the financial instrument. |
Short Display | Total amount of Payment |
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. |
Short Display | Business identifier for the payment |
Cardinality | 0..1 |
Type | Identifier |
Requirements | Enable the receiver to reconcile when payment is received. |
Summary | false |
Comments | For example: EFT number or check number. |
PaymentReconciliation.allocation | |
Element Id | PaymentReconciliation.allocation |
Definition | Distribution of the payment amount for a previously acknowledged payable. |
Short Display | Settlement particulars |
Cardinality | 0..* |
Requirements | Needed to show how the payment amount is distributed across the payables. |
Summary | false |
PaymentReconciliation.allocation.identifier | |
Element Id | PaymentReconciliation.allocation.identifier |
Definition | Unique identifier for the current payment item for the referenced payable. |
Short Display | Business identifier of the payment detail |
Note | This is a business identifier, not a resource identifier (see discussion) |
Cardinality | 0..1 |
Type | Identifier |
Requirements | Needed for reconciliation of payments. |
Summary | false |
PaymentReconciliation.allocation.predecessor | |
Element Id | PaymentReconciliation.allocation.predecessor |
Definition | Unique identifier for the prior payment item for the referenced payable. |
Short Display | Business identifier of the prior payment detail |
Cardinality | 0..1 |
Type | Identifier |
Requirements | Needed for reconciliation of payments. |
Summary | false |
PaymentReconciliation.allocation.target | |
Element Id | PaymentReconciliation.allocation.target |
Definition | Specific resource to which the payment/adjustment/advance applies. |
Short Display | Subject of the payment |
Cardinality | 0..1 |
Type | Reference(Claim | Account | Invoice | ChargeItem | Encounter | Contract) |
Summary | false |
PaymentReconciliation.allocation.targetItem[x] | |
Element Id | PaymentReconciliation.allocation.targetItem[x] |
Definition | Identifies the claim line item, encounter or other sub-element being paid. Note payment may be partial, that is not match the then outstanding balance or amount incurred. |
Short Display | Sub-element of the subject |
Cardinality | 0..1 |
Type | string|Identifier|positiveInt |
[x] Note | See Choice of Datatypes for further information about how to use [x] |
Summary | false |
PaymentReconciliation.allocation.encounter | |
Element Id | PaymentReconciliation.allocation.encounter |
Definition | The Encounter to which this payment applies, may be completed by the receiver, used for search. |
Short Display | Applied-to encounter |
Cardinality | 0..1 |
Type | Reference(Encounter) |
Summary | false |
PaymentReconciliation.allocation.account | |
Element Id | PaymentReconciliation.allocation.account |
Definition | The Account to which this payment applies, may be completed by the receiver, used for search. |
Short Display | Applied-to account |
Cardinality | 0..1 |
Type | Reference(Account) |
Summary | false |
PaymentReconciliation.allocation.type | |
Element Id | PaymentReconciliation.allocation.type |
Definition | Code to indicate the nature of the payment. |
Short Display | Category of payment |
Cardinality | 0..1 |
Terminology Binding | Payment Type Codes (Extensible) |
Type | CodeableConcept |
Requirements | Needed to provide context for the amount. |
Summary | false |
Comments | For example: payment, adjustment, funds advance, etc. |
PaymentReconciliation.allocation.submitter | |
Element Id | PaymentReconciliation.allocation.submitter |
Definition | The party which submitted the claim or financial transaction. |
Short Display | Submitter of the request |
Cardinality | 0..1 |
Type | Reference(Practitioner | PractitionerRole | Organization) |
Requirements | Needed for audit and validation. |
Summary | false |
PaymentReconciliation.allocation.response | |
Element Id | PaymentReconciliation.allocation.response |
Definition | A resource, such as a ClaimResponse, which contains a commitment to payment. |
Short Display | Response committing to a payment |
Cardinality | 0..1 |
Type | Reference(ClaimResponse) |
Requirements | Needed to provide a linkage to the payment commitment. |
Summary | false |
PaymentReconciliation.allocation.date | |
Element Id | PaymentReconciliation.allocation.date |
Definition | The date from the response resource containing a commitment to pay. |
Short Display | Date of commitment to pay |
Cardinality | 0..1 |
Type | date |
Requirements | Needed for audit and validation. |
Summary | false |
PaymentReconciliation.allocation.responsible | |
Element Id | PaymentReconciliation.allocation.responsible |
Definition | A reference to the individual who is responsible for inquiries regarding the response and its payment. |
Short Display | Contact for the response |
Cardinality | 0..1 |
Type | Reference(PractitionerRole) |
Requirements | To provide contact information. |
Summary | false |
PaymentReconciliation.allocation.payee | |
Element Id | PaymentReconciliation.allocation.payee |
Definition | The party which is receiving the payment. |
Short Display | Recipient of the payment |
Cardinality | 0..1 |
Type | Reference(Practitioner | PractitionerRole | Organization) |
Requirements | Needed for audit and validation. |
Summary | false |
PaymentReconciliation.allocation.amount | |
Element Id | PaymentReconciliation.allocation.amount |
Definition | The monetary amount allocated from the total payment to the payable. |
Short Display | Amount allocated to this payable |
Cardinality | 0..1 |
Type | Money |
Requirements | Needed to explain the distribution of the payment to the payables. |
Summary | false |
PaymentReconciliation.formCode | |
Element Id | PaymentReconciliation.formCode |
Definition | A code for the form to be used for printing the content. |
Short Display | Printed form identifier |
Cardinality | 0..1 |
Terminology Binding | Form Codes (Example) |
Type | CodeableConcept |
Requirements | Needed to specify the specific form used for producing output for this response. |
Summary | false |
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. |
Short Display | Note concerning processing |
Cardinality | 0..* |
Requirements | Provides the specific textual explanations associated with the processing. |
Summary | false |
PaymentReconciliation.processNote.type | |
Element Id | PaymentReconciliation.processNote.type |
Definition | The business purpose of the note text. |
Short Display | display | print | printoper |
Cardinality | 0..1 |
Terminology Binding | NoteType (Required) |
Type | code |
Requirements | To convey the expectation for when the text is used. |
Summary | false |
PaymentReconciliation.processNote.text | |
Element Id | PaymentReconciliation.processNote.text |
Definition | The explanation or description associated with the processing. |
Short Display | Note explanatory text |
Cardinality | 0..1 |
Type | string |
Requirements | Required to provide human readable explanation. |
Summary | false |