Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Paymentreconciliation.shex

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Practitioner

Raw ShEx

ShEx statement for paymentreconciliation

PREFIX fhir: <http://hl7.org/fhir/> 
PREFIX fhirvs: <http://hl7.org/fhir/ValueSet/>
PREFIX xsd: <http://www.w3.org/2001/XMLSchema#> 
PREFIX rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> 

IMPORT <code.shex>
IMPORT <Task.shex>
IMPORT <date.shex>
IMPORT <Money.shex>
IMPORT <Claim.shex>
IMPORT <Period.shex>
IMPORT <string.shex>
IMPORT <Patient.shex>
IMPORT <Account.shex>
IMPORT <Invoice.shex>
IMPORT <dateTime.shex>
IMPORT <Location.shex>
IMPORT <Contract.shex>
IMPORT <Reference.shex>
IMPORT <Encounter.shex>
IMPORT <Identifier.shex>
IMPORT <ChargeItem.shex>
IMPORT <positiveInt.shex>
IMPORT <Organization.shex>
IMPORT <Practitioner.shex>
IMPORT <RelatedPerson.shex>
IMPORT <ClaimResponse.shex>
IMPORT <DomainResource.shex>
IMPORT <CodeableConcept.shex>
IMPORT <BackboneElement.shex>
IMPORT <PractitionerRole.shex>


start=@<PaymentReconciliation> AND {fhir:nodeRole [fhir:treeRoot]}

# PaymentReconciliation resource
<PaymentReconciliation> EXTENDS @<DomainResource> CLOSED {   

    a [fhir:PaymentReconciliation]?;
    fhir:nodeRole [fhir:treeRoot]?;

    fhir:identifier @<OneOrMore_Identifier>?;  # Business Identifier for a payment 
                                            # reconciliation 
    fhir:type @<CodeableConcept>;           # Category of payment
    fhir:status @<code> AND
    	{fhir:v @fhirvs:fm-status};  # active | cancelled | draft | 
                                            # entered-in-error 
    fhir:kind @<CodeableConcept>?;          # Workflow originating payment
    fhir:period @<Period>?;                 # Period covered
    fhir:created @<dateTime>;               # Creation date
    fhir:enterer @<Reference> AND {fhir:link 
    			@<Organization> OR 
    			@<Practitioner> OR 
    			@<PractitionerRole> ? }?;  # Who entered the payment
    fhir:issuerType @<CodeableConcept>?;    # Nature of the source
    fhir:paymentIssuer @<Reference> AND {fhir:link 
    			@<Organization> OR 
    			@<Patient> OR 
    			@<RelatedPerson> ? }?;  # Party generating payment
    fhir:request @<Reference> AND {fhir:link 
    			@<Task> ? }?;  # Reference to requesting resource
    fhir:requestor @<Reference> AND {fhir:link 
    			@<Organization> OR 
    			@<Practitioner> OR 
    			@<PractitionerRole> ? }?;  # Responsible practitioner
    fhir:outcome @<code> AND
    	{fhir:v @fhirvs:payment-outcome}?;  # queued | complete | error | partial
    fhir:disposition @<string>?;            # Disposition message
    fhir:date @<date>;                      # When payment issued
    fhir:location @<Reference> AND {fhir:link 
    			@<Location> ? }?;  # Where payment collected
    fhir:method @<CodeableConcept>?;        # Payment instrument
    fhir:cardBrand @<string>?;              # Type of card
    fhir:accountNumber @<string>?;          # Digits for verification
    fhir:expirationDate @<date>?;           # Expiration year-month
    fhir:processor @<string>?;              # Processor name
    fhir:referenceNumber @<string>?;        # Check number or payment reference
    fhir:authorization @<string>?;          # Authorization number
    fhir:tenderedAmount @<Money>?;          # Amount offered by the issuer
    fhir:returnedAmount @<Money>?;          # Amount returned by the receiver
    fhir:amount @<Money>;                   # Total amount of Payment
    fhir:paymentIdentifier @<Identifier>?;  # Business identifier for the payment
    fhir:allocation @<OneOrMore_PaymentReconciliation.allocation>?;  # Settlement particulars
    fhir:formCode @<CodeableConcept>?;      # Printed form identifier
    fhir:processNote @<OneOrMore_PaymentReconciliation.processNote>?;  # Note concerning processing
}  

# Note concerning processing
<PaymentReconciliation.processNote> EXTENDS @<BackboneElement> CLOSED {   
    fhir:type @<code> AND
    	{fhir:v @fhirvs:note-type}?;  # display | print | printoper
    fhir:text @<string>?;                   # Note explanatory text
}  

# Settlement particulars
<PaymentReconciliation.allocation> EXTENDS @<BackboneElement> CLOSED {   
    fhir:identifier @<Identifier>?;         # Business identifier of the payment 
                                            # detail 
    fhir:predecessor @<Identifier>?;        # Business identifier of the prior 
                                            # payment detail 
    fhir:target @<Reference> AND {fhir:link 
    			@<Account> OR 
    			@<ChargeItem> OR 
    			@<Claim> OR 
    			@<Contract> OR 
    			@<Encounter> OR 
    			@<Invoice> ? }?;  # Subject of the payment
    fhir:targetItem @<string>  OR 
    			@<Identifier>  OR 
    			@<positiveInt>  ?;  # Sub-element of the subject
    fhir:encounter @<Reference> AND {fhir:link 
    			@<Encounter> ? }?;  # Applied-to encounter
    fhir:account @<Reference> AND {fhir:link 
    			@<Account> ? }?;  # Applied-to account
    fhir:type @<CodeableConcept>?;          # Category of payment
    fhir:submitter @<Reference> AND {fhir:link 
    			@<Organization> OR 
    			@<Practitioner> OR 
    			@<PractitionerRole> ? }?;  # Submitter of the request
    fhir:response @<Reference> AND {fhir:link 
    			@<ClaimResponse> ? }?;  # Response committing to a payment
    fhir:date @<date>?;                     # Date of commitment to pay
    fhir:responsible @<Reference> AND {fhir:link 
    			@<PractitionerRole> ? }?;  # Contact for the response
    fhir:payee @<Reference> AND {fhir:link 
    			@<Organization> OR 
    			@<Practitioner> OR 
    			@<PractitionerRole> ? }?;  # Recipient of the payment
    fhir:amount @<Money>?;                  # Amount allocated to this payable
}  

#---------------------- Cardinality Types (OneOrMore) -------------------

<OneOrMore_Identifier> CLOSED {
    rdf:first @<Identifier>  ;
    rdf:rest [rdf:nil] OR @<OneOrMore_Identifier> 
}

<OneOrMore_PaymentReconciliation.allocation> CLOSED {
    rdf:first @<PaymentReconciliation.allocation>  ;
    rdf:rest [rdf:nil] OR @<OneOrMore_PaymentReconciliation.allocation> 
}

<OneOrMore_PaymentReconciliation.processNote> CLOSED {
    rdf:first @<PaymentReconciliation.processNote>  ;
    rdf:rest [rdf:nil] OR @<OneOrMore_PaymentReconciliation.processNote> 
}

#---------------------- Value Sets ------------------------

# This value set includes Status codes.
fhirvs:fm-status ["active" "cancelled" "draft" "entered-in-error"]

# The presentation types of notes.
fhirvs:note-type ["display" "print" "printoper"]

# The outcome of the processing.
fhirvs:payment-outcome ["queued" "complete" "error" "partial"]


Usage note: every effort has been made to ensure that the ShEx files are correct and useful, but they are not a normative part of the specification.