Extensions for Using Data Elements from FHIR R5 in FHIR R4B
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Extensions for Using Data Elements from FHIR R5 in FHIR R4B - Downloaded Version null See the Directory of published versions

ValueSet: R5V3ActInvoiceAdjudicationPaymentCodeForR4B

Official URL: http://hl7.org/fhir/uv/xver/ValueSet/R5-v3-ActInvoiceAdjudicationPaymentCode-for-R4B Version: 0.1.0
Standards status: Trial-use Maturity Level: 0 Computable Name: R5V3ActInvoiceAdjudicationPaymentCodeForR4B

This cross-version ValueSet represents content from http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentCode|2.0.0 for use in FHIR R4B.

This value set is part of the cross-version definitions generated to enable use of the value set http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentCode|2.0.0 as defined in FHIR R5 in FHIR R4B.

The source value set is bound to the following FHIR R5 elements:

Note that all concepts are included in this cross-version definition because no concepts have compatible representations

Following are the generation technical comments:

FHIR ValueSet http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentCode|2.0.0, defined in FHIR R5 does not have any mapping to FHIR R4B

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

  • Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode version 📍8.0.0
    CodeDisplayDefinition
    ALECalternate electronicPayment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission).
    BONUSbonusBonus payments based on performance, volume, etc. as agreed to by the payor.
    CFWDcarry forward adjusmentAn amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made.
    CONTcontractTransaction counts and value totals by Contract Identifier.
    DAYdayTransaction counts and value totals for each calendar day within the date range specified.
    EDUeducation feesFees deducted on behalf of a payee for tuition and continuing education.
    EPYMTearly payment feeFees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments.
    GARNgarnisheeFees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.
    INVOICEsubmitted invoicePayment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results..
    INVTYPEinvoice typeTransaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)
    LOClocationTransaction counts and value totals by service location (e.g clinic).
    MONTHmonthTransaction counts and value totals for each calendar month within the date range specified.
    PAYEEpayeeTransaction counts and value totals by each instance of an invoice payee.
    PAYORpayorTransaction counts and value totals by each instance of an invoice payor.
    PERIODperiodTransaction counts and value totals for the date range specified.
    PINVpaper invoicePayment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice.
    PPRDprior period adjustmentAn amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice
    PROAprofessional association deductionProfessional association fee that is collected by the payor from the practitioner/provider on behalf of the association
    PROVproviderTransaction counts and value totals by Provider Identifier.
    RECOVrecoveryRetroactive adjustment such as fee rate adjustment due to contract negotiations.
    RETROretro adjustmentBonus payments based on performance, volume, etc. as agreed to by the payor.
    SENDAPPsending applicationTransaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers.
    TRANtransaction feeFees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.
    WEEKweekTransaction counts and value totals for each calendar week within the date range specified.
    YEARyearTransaction counts and value totals for each calendar year within the date range specified.
    _ActInvoiceAdjudicationPaymentGroupCodeActInvoiceAdjudicationPaymentGroupCodeCodes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.
    _ActInvoiceAdjudicationPaymentSummaryCodeActInvoiceAdjudicationPaymentSummaryCodeCodes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc.
    _ActInvoicePaymentCodeActInvoiceAdjudicationPaymentGroupCodeCodes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.

 

Expansion

This value set expansion contains 28 concepts.

SystemVersionCodeDisplayDefinitionJSONXML
http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  ALECalternate electronic

Payment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission).

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  BONUSbonus

Bonus payments based on performance, volume, etc. as agreed to by the payor.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  CFWDcarry forward adjusment

An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  CONTcontract

Transaction counts and value totals by Contract Identifier.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  DAYday

Transaction counts and value totals for each calendar day within the date range specified.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  EDUeducation fees

Fees deducted on behalf of a payee for tuition and continuing education.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  EPYMTearly payment fee

Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  GARNgarnishee

Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  INVOICEsubmitted invoice

Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results..

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  INVTYPEinvoice type

Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  LOClocation

Transaction counts and value totals by service location (e.g clinic).

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  MONTHmonth

Transaction counts and value totals for each calendar month within the date range specified.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PAYEEpayee

Transaction counts and value totals by each instance of an invoice payee.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PAYORpayor

Transaction counts and value totals by each instance of an invoice payor.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PERIODperiod

Transaction counts and value totals for the date range specified.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PINVpaper invoice

Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PPRDprior period adjustment

An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PROAprofessional association deduction

Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  PROVprovider

Transaction counts and value totals by Provider Identifier.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  RECOVrecovery

Retroactive adjustment such as fee rate adjustment due to contract negotiations.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  RETROretro adjustment

Bonus payments based on performance, volume, etc. as agreed to by the payor.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  SENDAPPsending application

Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  TRANtransaction fee

Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  WEEKweek

Transaction counts and value totals for each calendar week within the date range specified.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  YEARyear

Transaction counts and value totals for each calendar year within the date range specified.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  _ActInvoiceAdjudicationPaymentGroupCodeActInvoiceAdjudicationPaymentGroupCode

Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  _ActInvoiceAdjudicationPaymentSummaryCodeActInvoiceAdjudicationPaymentSummaryCode

Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc.

http://terminology.hl7.org/CodeSystem/v3-ActCode8.0.0  _ActInvoicePaymentCodeActInvoiceAdjudicationPaymentGroupCode

Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.


Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code