Profile_R5_PaymentReconciliation_R4B - Definitions - Extensions for Using Data Elements from FHIR R5 in FHIR R4B v0.1.0

Is Modifier false

Must Support false

Summary true

4. PaymentReconciliation.meta

Definition

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.

Short Metadata about the resource

Control 0..1

Meta

Is Modifier false

Must Support false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

6. PaymentReconciliation.implicitRules

Definition

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.

Short A set of rules under which this content was created

Comments

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 it's narrative along with other profiles, value sets, etc.

Control 0..1

uri

Is Modifier true because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

8. PaymentReconciliation.language

Definition

The base language in which the resource is written.

Short Language of the resource content

Comments

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).

Control 0..1

The codes SHOULD be taken from CommonLanguages
(preferred to http://hl7.org/fhir/ValueSet/languages|4.3.0)

IETF language tag

Additional Bindings

Purpose

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

10. PaymentReconciliation.text

Definition

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.

Short Text summary of the resource, for human interpretation

Comments

Contained resources do not have 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.

Control 0..1

Narrative

Is Modifier false

Must Support false

Summary false

Alternate Names narrative, html, xhtml, display

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

12. PaymentReconciliation.contained

Definition

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

Short Contained, inline Resources

Comments

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.

Control 0..*

Resource

Is Modifier false

Must Support false

Summary false

Alternate Names inline resources, anonymous resources, contained resources

Invariants dom-r4b: Containing new R4B resources within R4 resources may cause interoperability issues if instances are shared with R4 systems (($this is Citation or $this is Evidence or $this is EvidenceReport or $this is EvidenceVariable or $this is MedicinalProductDefinition or $this is PackagedProductDefinition or $this is AdministrableProductDefinition or $this is Ingredient or $this is ClinicalUseDefinition or $this is RegulatedAuthorization or $this is SubstanceDefinition or $this is SubscriptionStatus or $this is SubscriptionTopic) implies (%resource is Citation or %resource is Evidence or %resource is EvidenceReport or %resource is EvidenceVariable or %resource is MedicinalProductDefinition or %resource is PackagedProductDefinition or %resource is AdministrableProductDefinition or %resource is Ingredient or %resource is ClinicalUseDefinition or %resource is RegulatedAuthorization or %resource is SubstanceDefinition or %resource is SubscriptionStatus or %resource is SubscriptionTopic))

14. PaymentReconciliation.extension

Definition

An Extension

Short Extension

Control 1..*

Is Modifier false

Must Support false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

This element introduces a set of slices on PaymentReconciliation.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

16. PaymentReconciliation.extension:type

Slice Name type

Definition

R5: PaymentReconciliation.type (new:CodeableConcept)

Short R5: Category of payment (new)

Comments

Element PaymentReconciliation.type has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.type has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 1..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Category of payment (new)) (Extension Type: CodeableConcept)

Is Modifier false

Must Support false

Summary false

Invariants ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())

18. PaymentReconciliation.extension:kind

Slice Name kind

Definition

R5: PaymentReconciliation.kind (new:CodeableConcept)

Short R5: Workflow originating payment (new)

Comments

Element PaymentReconciliation.kind has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.kind has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Workflow originating payment (new)) (Extension Type: CodeableConcept)

Is Modifier false

Must Support false

Summary false

20. PaymentReconciliation.extension:enterer

Slice Name enterer

Definition

R5: PaymentReconciliation.enterer (new:Reference(Practitioner,PractitionerRole,Organization))

Short R5: Who entered the payment (new)

Comments

Element PaymentReconciliation.enterer has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.enterer has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Who entered the payment (new)) (Extension Type: Reference(Cross-version Profile for R5.Practitioner for use in FHIR R4B, Practitioner, Cross-version Profile for R5.PractitionerRole for use in FHIR R4B, PractitionerRole, Cross-version Profile for R5.Organization for use in FHIR R4B, Organization))

Is Modifier false

Must Support false

Summary false

22. PaymentReconciliation.extension:issuerType

Slice Name issuerType

Definition

R5: PaymentReconciliation.issuerType (new:CodeableConcept)

Short R5: Nature of the source (new)

Comments

Element PaymentReconciliation.issuerType has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.issuerType has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Nature of the source (new)) (Extension Type: CodeableConcept)

Is Modifier false

Must Support false

Summary false

24. PaymentReconciliation.extension:location

Slice Name location

Definition

R5: PaymentReconciliation.location (new:Reference(Location))

Short R5: Where payment collected (new)

Comments

Element PaymentReconciliation.location has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.location has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Where payment collected (new)) (Extension Type: Reference(Cross-version Profile for R5.Location for use in FHIR R4B, Location))

Is Modifier false

Must Support false

Summary false

26. PaymentReconciliation.extension:method

Slice Name method

Definition

R5: PaymentReconciliation.method (new:CodeableConcept)

Short R5: Payment instrument (new)

Comments

Element PaymentReconciliation.method has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.method has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Payment instrument (new)) (Extension Type: CodeableConcept)

Is Modifier false

Must Support false

Summary false

28. PaymentReconciliation.extension:cardBrand

Slice Name cardBrand

Definition

R5: PaymentReconciliation.cardBrand (new:string)

Short R5: Type of card (new)

Comments

Element PaymentReconciliation.cardBrand has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.cardBrand has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Type of card (new)) (Extension Type: string)

Is Modifier false

Must Support false

Summary false

30. PaymentReconciliation.extension:accountNumber

Slice Name accountNumber

Definition

R5: PaymentReconciliation.accountNumber (new:string)

Short R5: Digits for verification (new)

Comments

Element PaymentReconciliation.accountNumber has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.accountNumber has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Digits for verification (new)) (Extension Type: string)

Is Modifier false

Must Support false

Summary false

32. PaymentReconciliation.extension:expirationDate

Slice Name expirationDate

Definition

R5: PaymentReconciliation.expirationDate (new:date)

Short R5: Expiration year-month (new)

Comments

Element PaymentReconciliation.expirationDate has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.expirationDate has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Expiration year-month (new)) (Extension Type: date)

Is Modifier false

Must Support false

Summary false

34. PaymentReconciliation.extension:processor

Slice Name processor

Definition

R5: PaymentReconciliation.processor (new:string)

Short R5: Processor name (new)

Comments

Element PaymentReconciliation.processor has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.processor has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Processor name (new)) (Extension Type: string)

Is Modifier false

Must Support false

Summary false

36. PaymentReconciliation.extension:referenceNumber

Slice Name referenceNumber

Definition

R5: PaymentReconciliation.referenceNumber (new:string)

Short R5: Check number or payment reference (new)

Comments

Element PaymentReconciliation.referenceNumber has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.referenceNumber has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Check number or payment reference (new)) (Extension Type: string)

Is Modifier false

Must Support false

Summary false

38. PaymentReconciliation.extension:authorization

Slice Name authorization

Definition

R5: PaymentReconciliation.authorization (new:string)

Short R5: Authorization number (new)

Comments

Element PaymentReconciliation.authorization has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.authorization has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Authorization number (new)) (Extension Type: string)

Is Modifier false

Must Support false

Summary false

40. PaymentReconciliation.extension:tenderedAmount

Slice Name tenderedAmount

Definition

R5: PaymentReconciliation.tenderedAmount (new:Money)

Short R5: Amount offered by the issuer (new)

Comments

Element PaymentReconciliation.tenderedAmount has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.tenderedAmount has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Amount offered by the issuer (new)) (Extension Type: Money)

Is Modifier false

Must Support false

Summary false

42. PaymentReconciliation.extension:returnedAmount

Slice Name returnedAmount

Definition

R5: PaymentReconciliation.returnedAmount (new:Money)

Short R5: Amount returned by the receiver (new)

Comments

Element PaymentReconciliation.returnedAmount has a context of PaymentReconciliation based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.returnedAmount has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Amount returned by the receiver (new)) (Extension Type: Money)

Is Modifier false

Must Support false

Summary false

44. PaymentReconciliation.modifierExtension

Definition

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 manageable, 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).

Short Extensions that cannot be ignored

Comments

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.

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them

Must Support false

Summary false

Requirements

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.

Alternate Names extensions, user content

46. PaymentReconciliation.identifier

Definition

A unique identifier assigned to this payment reconciliation.

Short Business Identifier for a payment reconciliation

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..*

Is Modifier false

Must Support false

Summary false

Requirements

Allows payment reconciliations to be distinguished and referenced.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

48. PaymentReconciliation.status

Definition

The status of the resource instance.

Short active | cancelled | draft | entered-in-error

Comments

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

Control 1..1

The codes SHALL be taken from FinancialResourceStatusCodes
(required to http://hl7.org/fhir/ValueSet/fm-status|4.3.0)

A code specifying the state of the resource instance.

code

Is Modifier true because 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

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support false

Summary true

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'.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

50. PaymentReconciliation.period

Definition

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

Short Period covered

Control 0..1

Period

Is Modifier false

Must Support false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

52. PaymentReconciliation.created

Definition

The date when the resource was created.

Short Creation date

Control 1..1

dateTime

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

54. PaymentReconciliation.paymentIssuer

Definition

The party who generated the payment.

Short Party generating payment

Comments

This party is also responsible for the reconciliation.

Control 0..1

Type Reference(Organization)

Is Modifier false

Must Support false

Summary true

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

56. PaymentReconciliation.paymentIssuer.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

58. PaymentReconciliation.paymentIssuer.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on PaymentReconciliation.paymentIssuer.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

60. PaymentReconciliation.paymentIssuer.extension:paymentIssuer

Slice Name paymentIssuer

Definition

R5: PaymentReconciliation.paymentIssuer

Short R5: paymentIssuer

Comments

Element PaymentReconciliation.paymentIssuer is mapped to FHIR R4B element PaymentReconciliation.paymentIssuer as SourceIsBroaderThanTarget. The standard extension alternate-reference has been mapped as the representation of FHIR R5 element PaymentReconciliation.paymentIssuer with unmapped reference targets: Patient, RelatedPerson. This party is also responsible for the reconciliation.

Control 0..1

Type Extension(Alternate Reference) (Extension Type: Reference(Resource))

Is Modifier false

Summary false

62. PaymentReconciliation.paymentIssuer.reference

Definition

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.

Short Literal reference, Relative, internal or absolute URL

Comments

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.

Control 0..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

64. PaymentReconciliation.paymentIssuer.type

Definition

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).

Short Type the reference refers to (e.g. "Patient")

Comments

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 RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

Control 0..1

Binding Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)

uri

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

66. PaymentReconciliation.paymentIssuer.identifier

Definition

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.

Short Logical reference, when literal reference is not known

Comments

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).

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

68. PaymentReconciliation.paymentIssuer.display

Definition

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

Short Text alternative for the resource

Comments

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.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

70. PaymentReconciliation.request

Definition

Original request resource reference.

Short Reference to requesting resource

Control 0..1

Type Reference(Task)

Is Modifier false

Must Support false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

72. PaymentReconciliation.requestor

Definition

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

Short Responsible practitioner

Control 0..1

Type Reference(Practitioner, PractitionerRole, Organization)

Is Modifier false

Must Support false

Summary false

Requirements

Need to identify the party responsible for the request.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

74. PaymentReconciliation.outcome

Definition

The outcome of a request for a reconciliation.

Short queued | complete | error | partial

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).

Control 0..1

The codes SHALL be taken from RemittanceOutcome
(required to http://hl7.org/fhir/ValueSet/remittance-outcome|4.3.0)

The outcome of the processing.

code

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support false

Summary false

Requirements

To advise the requestor of an overall processing outcome.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

76. PaymentReconciliation.disposition

Definition

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

Short Disposition message

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support false

Summary false

Requirements

Provided for user display.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

78. PaymentReconciliation.paymentDate

Definition

The date of payment as indicated on the financial instrument.

Short When payment issued

Control 1..1

date

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support false

Summary true

Requirements

To advise the payee when payment can be expected.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

80. PaymentReconciliation.paymentAmount

Definition

Total payment amount as indicated on the financial instrument.

Short Total amount of Payment

Control 1..1

Money

Is Modifier false

Must Support false

Summary true

Requirements

Needed to provide the actual payment amount.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

82. PaymentReconciliation.paymentIdentifier

Definition

Issuer's unique identifier for the payment instrument.

Short Business identifier for the payment

Comments

For example: EFT number or check number.

Control 0..1

Is Modifier false

Must Support false

Summary false

Requirements

Enable the receiver to reconcile when payment is received.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

84. PaymentReconciliation.detail

Definition

Distribution of the payment amount for a previously acknowledged payable.

Short Settlement particulars

Control 0..*

BackboneElement

Is Modifier false

Must Support false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)

86. PaymentReconciliation.detail.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

88. PaymentReconciliation.detail.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on PaymentReconciliation.detail.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

90. PaymentReconciliation.detail.extension:target

Slice Name target

Definition

R5: PaymentReconciliation.allocation.target (new:Reference(Claim,Account,Invoice,ChargeItem,Encounter,Contract))

Short R5: Subject of the payment (new)

Comments

Element PaymentReconciliation.allocation.target has a context of PaymentReconciliation.detail based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.allocation.target has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Subject of the payment (new)) (Extension Type: Reference(Cross-version Profile for R5.Claim for use in FHIR R4B, Claim, Cross-version Profile for R5.Account for use in FHIR R4B, Account, Cross-version Profile for R5.Invoice for use in FHIR R4B, Invoice, Cross-version Profile for R5.ChargeItem for use in FHIR R4B, ChargeItem, Cross-version Profile for R5.Encounter for use in FHIR R4B, Encounter, Cross-version Profile for R5.Contract for use in FHIR R4B, Contract))

Is Modifier false

Summary false

92. PaymentReconciliation.detail.extension:targetItem

Slice Name targetItem

Definition

R5: PaymentReconciliation.allocation.targetItem[x] (new:Identifier, positiveInt, string)

Short R5: Sub-element of the subject (new)

Comments

Element PaymentReconciliation.allocation.targetItem[x] has a context of PaymentReconciliation.detail based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.allocation.targetItem[x] has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Sub-element of the subject (new)) (Extension Type: Choice of: string, Identifier, positiveInt)

Is Modifier false

Summary false

94. PaymentReconciliation.detail.extension:encounter

Slice Name encounter

Definition

R5: PaymentReconciliation.allocation.encounter (new:Reference(Encounter))

Short R5: Applied-to encounter (new)

Comments

Element PaymentReconciliation.allocation.encounter has a context of PaymentReconciliation.detail based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.allocation.encounter has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Applied-to encounter (new)) (Extension Type: Reference(Cross-version Profile for R5.Encounter for use in FHIR R4B, Encounter))

Is Modifier false

Summary false

96. PaymentReconciliation.detail.extension:account

Slice Name account

Definition

R5: PaymentReconciliation.allocation.account (new:Reference(Account))

Short R5: Applied-to account (new)

Comments

Element PaymentReconciliation.allocation.account has a context of PaymentReconciliation.detail based on following the parent source element upwards and mapping to PaymentReconciliation. Element PaymentReconciliation.allocation.account has no mapping targets in FHIR R4B. Typically, this is because the element has been added (is a new element).

Control 0..1
This element is affected by the following invariants: ele-1

Type Extension(R5: Applied-to account (new)) (Extension Type: Reference(Cross-version Profile for R5.Account for use in FHIR R4B, Account))

Is Modifier false

Summary false

98. PaymentReconciliation.detail.modifierExtension

Definition

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 manageable, 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).

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*

Is Modifier true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them

Summary true

Requirements

Alternate Names extensions, user content, modifiers

100. PaymentReconciliation.detail.identifier

Definition

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

Short Business identifier of the payment detail

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Must Support false

Summary false

Requirements

Needed for reconciliation of payments.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

102. PaymentReconciliation.detail.predecessor

Definition

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

Short Business identifier of the prior payment detail

Control 0..1

Is Modifier false

Must Support false

Summary false

Requirements

Needed for reconciliation of payments.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

104. PaymentReconciliation.detail.type

Definition

Code to indicate the nature of the payment.

Short Category of payment

Comments

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

Control 1..1

For example codes, see PaymentTypeCodes
(example to http://hl7.org/fhir/ValueSet/payment-type|4.3.0)

The reason for the amount: payment, adjustment, advance.

CodeableConcept

Is Modifier false

Must Support false

Summary false

Requirements

Needed to provide context for the amount.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

106. PaymentReconciliation.detail.request

Definition

A resource, such as a Claim, the evaluation of which could lead to payment.

Short Request giving rise to the payment

Control 0..1

Type Reference(Resource)

Is Modifier false

Must Support false

Summary false

Requirements

Needed to provide a linkage to the original request.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

108. PaymentReconciliation.detail.submitter

Definition

The party which submitted the claim or financial transaction.

Short Submitter of the request

Control 0..1

Type Reference(Practitioner, PractitionerRole, Organization)

Is Modifier false

Must Support false

Summary false

Requirements

Needed for audit and validation.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

110. PaymentReconciliation.detail.response

Definition

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

Short Response committing to a payment

Control 0..1

Type Reference(Resource)

Is Modifier false

Must Support false

Summary false

Requirements

Needed to provide a linkage to the payment commitment.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

112. PaymentReconciliation.detail.response.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

114. PaymentReconciliation.detail.response.extension

Definition

An Extension

Short Extension

Control 0..*

Is Modifier false

Summary false

This element introduces a set of slices on PaymentReconciliation.detail.response.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:

value @ url

116. PaymentReconciliation.detail.response.extension:response

Slice Name response

Definition

R5: PaymentReconciliation.allocation.response additional types from child elements (display, identifier, reference, type)

Short R5: response additional types

Comments

Element PaymentReconciliation.allocation.response is mapped to FHIR R4B element PaymentReconciliation.detail.response as SourceIsBroaderThanTarget. The mappings for PaymentReconciliation.allocation.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 R5 element PaymentReconciliation.allocation.response with unmapped reference targets: ClaimResponse.

Control 0..1

Type Extension(Alternate Reference) (Extension Type: Reference(Resource))

Is Modifier false

Summary false

118. PaymentReconciliation.detail.response.reference

Definition

Short Literal reference, Relative, internal or absolute URL

Comments

Control 0..1
This element is affected by the following invariants: ref-1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

120. PaymentReconciliation.detail.response.type

Definition

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.

Short Type the reference refers to (e.g. "Patient")

Comments

Control 0..1

Binding Unless not suitable, these codes SHALL be taken from ResourceType
(extensible to http://hl7.org/fhir/ValueSet/resource-types|4.3.0)

uri

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

122. PaymentReconciliation.detail.response.identifier

Definition

Short Logical reference, when literal reference is not known

Comments

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

Note This is a business identifier, not a resource identifier (see discussion)

Control 0..1

Is Modifier false

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

124. PaymentReconciliation.detail.response.display

Definition

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

Short Text alternative for the resource

Comments

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.

Control 0..1

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Summary true

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

126. PaymentReconciliation.detail.date

Definition

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

Short Date of commitment to pay

Control 0..1

date

Is Modifier false

Primitive Value This primitive element may be present, or absent, or replaced by an extension

Must Support false

Summary false

Requirements

Needed for audit and validation.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

128. PaymentReconciliation.detail.responsible

Definition

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

Short Contact for the response

Control 0..1

Type Reference(PractitionerRole)

Is Modifier false

Must Support false

Summary false

Requirements

To provide contact information.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

130. PaymentReconciliation.detail.payee

Definition

The party which is receiving the payment.

Short Recipient of the payment

Control 0..1

Type Reference(Practitioner, PractitionerRole, Organization)

Is Modifier false

Must Support false

Summary false

Requirements

Needed for audit and validation.

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

132. PaymentReconciliation.detail.amount

Definition

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

Short Amount allocated to this payable

Control 0..1

Money

Is Modifier false

Must Support false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

134. PaymentReconciliation.formCode

Definition

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

Short Printed form identifier

Comments

May be needed to identify specific jurisdictional forms.

Control 0..1

For example codes, see Form Codes
(example to http://hl7.org/fhir/ValueSet/forms|4.3.0)

The forms codes.

CodeableConcept

Is Modifier false

Must Support false

Summary false

Requirements

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

Invariants ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

136. PaymentReconciliation.processNote

Definition

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

Short Note concerning processing

Control 0..*

BackboneElement

Is Modifier false

Must Support false

Summary false

Requirements

Provides the specific textual explanations associated with the processing.

Invariants ele-1: All FHIR elements must have a @value or children unless an empty Parameters resource (hasValue() or (children().count() > id.count()) or $this is Parameters)

138. PaymentReconciliation.processNote.id

Definition

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

Short Unique id for inter-element referencing

Control 0..1

Is Modifier false

XML Format In the XML format, this property is represented as an attribute.

Summary false

140. PaymentReconciliation.processNote.extension

Definition

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 manageable, 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.

Short Additional content defined by implementations

Comments

Control 0..*

Is Modifier false

Summary false

Alternate Names extensions, user content

142. PaymentReconciliation.processNote.modifierExtension

Definition

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

Short Extensions that cannot be ignored even if unrecognized

Comments

Control 0..*