This resource provides the details including amount of a payment and allocates the payment items being paid.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Code to indicate the nature of the payment such as payment, adjustment.

The status of the resource instance.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

A code specifying the state of the resource instance.

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'.

The date when the resource was created.

Need to record a timestamp for use by both the recipient and the issuer.

The date of payment as indicated on the financial instrument.

To advise the payee when payment can be expected.

Total payment amount as indicated on the financial instrument.

Needed to provide the actual payment amount.

R4B: PaymentReconciliation.detail.request (new:Reference(Resource))

Element PaymentReconciliation.detail.request has a context of PaymentReconciliation.allocation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.detail.request has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

R4B: PaymentReconciliation.detail.response additional types from child elements (display, identifier, reference, type)

Element PaymentReconciliation.detail.response is mapped to FHIR R5 element PaymentReconciliation.allocation.response as SourceIsBroaderThanTarget. The mappings for PaymentReconciliation.detail.response do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element PaymentReconciliation.detail.response with unmapped reference targets: Resource.

This resource provides the details including amount of a payment and allocates the payment items being paid.

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

Within the context of the FHIR RESTful interactions, the resource has an id except for cases like the create and conditional update. Otherwise, the use of the resouce id depends on the given use case.

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of its narrative along with other profiles, value sets, etc.

The base language in which the resource is written.

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

IETF language tag for a human language

A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

Contained resources do not have a narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, nor can they have their own independent transaction scope. This is allowed to be a Parameters resource if and only if it is referenced by a resource that provides context/meaning.

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags in their meta elements, but SHALL NOT have security labels.

May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

A unique identifier assigned to this payment reconciliation.

Allows payment reconciliations to be distinguished and referenced.

Code to indicate the nature of the payment such as payment, adjustment.

The status of the resource instance.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

A code specifying the state of the resource instance.

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'.

The workflow or activity which gave rise to or during which the payment ocurred such as a kiosk, deposit on account, periodic payment etc.

The period of time for which payments have been gathered into this bulk payment for settlement.

Needed to allow receivers to monitor and reconcile payment issuer schedules.

The date when the resource was created.

Need to record a timestamp for use by both the recipient and the issuer.

Payment enterer if not the actual payment issuer.

The type of the source such as patient or insurance.

Providers may need to identify the source to know to which sub-ledger to apply the payment.

The party who generated the payment.

This party is also responsible for the reconciliation.

Need to identify the party resonsible for the payment and this resource.

Original request resource reference.

Needed to allow the response to be linked to the request.

The practitioner who is responsible for the services rendered to the patient.

Need to identify the party responsible for the request.

The outcome of a request for a reconciliation.

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).

The outcome of the processing.

To advise the requestor of an overall processing outcome.

A human readable description of the status of the request for the reconciliation.

Provided for user display.

The date of payment as indicated on the financial instrument.

To advise the payee when payment can be expected.

The location of the site or device for electronic transfers or physical location for cash payments.

The means of payment such as check, card cash, or electronic funds transfer.

The card brand such as debit, Visa, Amex etc. used if a card is the method of payment.

A portion of the account number, often the last 4 digits, used for verification not charging purposes.

The year and month (YYYY-MM) when the instrument, typically card, expires.

The name of the card processor, etf processor, bank for checks.

The check number, eft reference, car processor reference.

An alphanumeric issued by the processor to confirm the successful issuance of payment.

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.

The amount returned by the receiver which is excess to the amount payable, often referred to as 'change'.

Total payment amount as indicated on the financial instrument.

Needed to provide the actual payment amount.

Issuer's unique identifier for the payment instrument.

For example: EFT number or check number.

Enable the receiver to reconcile when payment is received.

Distribution of the payment amount for a previously acknowledged payable.

Needed to show how the payment amount is distributed across the payables.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R4B: PaymentReconciliation.detail.request (new:Reference(Resource))

Element PaymentReconciliation.detail.request has a context of PaymentReconciliation.allocation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.detail.request has no mapping targets in FHIR R5. Typically, this is because the element has been added (is a new element).

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Unique identifier for the current payment item for the referenced payable.

Needed for reconciliation of payments.

Unique identifier for the prior payment item for the referenced payable.

Needed for reconciliation of payments.

Specific resource to which the payment/adjustment/advance applies.

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.

The Encounter to which this payment applies, may be completed by the receiver, used for search.

The Account to which this payment applies, may be completed by the receiver, used for search.

Code to indicate the nature of the payment.

For example: payment, adjustment, funds advance, etc.

Needed to provide context for the amount.

The party which submitted the claim or financial transaction.

Needed for audit and validation.

A resource, such as a ClaimResponse, which contains a commitment to payment.

Needed to provide a linkage to the payment commitment.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

An Extension

R4B: PaymentReconciliation.detail.response additional types from child elements (display, identifier, reference, type)

Element PaymentReconciliation.detail.response is mapped to FHIR R5 element PaymentReconciliation.allocation.response as SourceIsBroaderThanTarget. The mappings for PaymentReconciliation.detail.response do not cover the following types based on type expansion: display, identifier, reference, type. The standard extension alternate-reference has been mapped as the representation of FHIR R4B element PaymentReconciliation.detail.response with unmapped reference targets: Resource.

A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a known RESTful URL) or by resolving the target of the reference.

Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|5.0.0)

Aa resource (or, for logical models, the URI of the logical model).

An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

This element only allows for a single identifier. In the case where additional identifers are required, use the http://hl7.org/fhir/StructureDefinition/additionalIdentifier extension.

Plain text narrative that identifies the resource in addition to the resource reference.

This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

The date from the response resource containing a commitment to pay.

Needed for audit and validation.

A reference to the individual who is responsible for inquiries regarding the response and its payment.

To provide contact information.

The party which is receiving the payment.

Needed for audit and validation.

The monetary amount allocated from the total payment to the payable.

Needed to explain the distribution of the payment to the payables.

A code for the form to be used for printing the content.

May be needed to identify specific jurisdictional forms.

The forms codes.

Needed to specify the specific form used for producing output for this response.

A note that describes or explains the processing in a human readable form.

Provides the specific textual explanations associated with the processing.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

The business purpose of the note text.

The presentation types of notes.

To convey the expectation for when the text is used.

The explanation or description associated with the processing.

Required to provide human readable explanation.