HL7 Electronic Health Record System Functional Model, Release 2.1.1
2.1.1-ballot - Normative Ballot
HL7 Electronic Health Record System Functional Model, Release 2.1.1
2.1.1-ballot - Normative Ballot
This page is part of the HL7 Electronic Health Record System Functional Model, Release 2.1.1 (v2.1.1-ballot: Normative 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. No current official version has been published yet. For a full list of available versions, see the Directory of published versions
| Page standards status: Informative |
{
"resourceType" : "Requirements",
"id" : "EHRSFMR2-AS.9.5",
"meta" : {
"profile" : [
🔗 "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/FMFunction"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <span id=\"description\"><b>Statement <a href=\"https://hl7.org/fhir/versions.html#std-process\" title=\"Normative Content\" class=\"normative-flag\">N</a>:</b> <div><p>Support interactions with other systems, applications, and modules to enable the creation of claims and encounter reports for reimbursement.</p>\n</div></span>\n\n \n <span id=\"purpose\"><b>Description <a href=\"https://hl7.org/fhir/versions.html#std-process\" title=\"Informative Content\" class=\"informative-flag\">I</a>:</b> <div><p>Retrieves information needed to support claims and encounter reporting. This reporting occurs at the appropriate juncture in the encounter workflow in a manual or automated fashion. For example this could occur at an initial, interim or final billing. The system may also present the information that is provided for audit and review.</p>\n</div></span>\n \n\n \n <span id=\"actors\"><b>Actors:</b><br/> ehr</span>\n \n\n \n <span id=\"requirements\"><b>Criteria <a href=\"https://hl7.org/fhir/versions.html#std-process\" title=\"Normative Content\" class=\"normative-flag\">N</a>:</b></span>\n \n <table id=\"statements\" class=\"grid dict\">\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.9.5#01</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>SHALL</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system SHALL provide the ability to render available information needed to enable the creation of claims and encounter reports for reimbursement.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.9.5#02</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n <i>dependent</i>\n \n \n \n <span>SHALL</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system SHALL provide the ability to capture and render available data as required for audit and review according to scope of practice, organizational policy, and/or jurisdictional law.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.9.5#03</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>MAY</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system MAY provide the ability to render available data in a computer readable form when needed to enable the creation of claims and encounter reports for reimbursement.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.9.5#04</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>MAY</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system MAY provide the ability to render data, using either internal or external reporting tools, to support coding of diagnosis, procedure and outcomes.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n </table>\n</div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "ehr"
}
],
"url" : "http://hl7.org/ehrs/uv/ehrsfmr2/Requirements/EHRSFMR2-AS.9.5",
"version" : "2.1.1-ballot",
"name" : "AS_9_5_Support_Financial_Claims___Encounter_Reports",
"title" : "AS.9.5 Support Financial Claims & Encounter Reports (Function)",
"status" : "active",
"date" : "2025-04-04T11:04:36+11:00",
"publisher" : "HL7 International / Electronic Health Records",
"contact" : [
{
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/ehr"
}
]
}
],
"description" : "Support interactions with other systems, applications, and modules to enable the creation of claims and encounter reports for reimbursement.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code" : "001",
"display" : "World"
}
]
}
],
"purpose" : "Retrieves information needed to support claims and encounter reporting. This reporting occurs at the appropriate juncture in the encounter workflow in a manual or automated fashion. For example this could occur at an initial, interim or final billing. The system may also present the information that is provided for audit and review.",
"statement" : [
{
"extension" : [
{
"url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
"valueBoolean" : false
}
],
"key" : "EHRSFMR2-AS.9.5-01",
"label" : "AS.9.5#01",
"conformance" : [
"SHALL"
],
"conditionality" : false,
"requirement" : "The system SHALL provide the ability to render available information needed to enable the creation of claims and encounter reports for reimbursement.",
"derivedFrom" : "EHR-S_FM_R1.1 S.3.3.5#1"
},
{
"extension" : [
{
"url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
"valueBoolean" : true
}
],
"key" : "EHRSFMR2-AS.9.5-02",
"label" : "AS.9.5#02",
"conformance" : [
"SHALL"
],
"conditionality" : false,
"requirement" : "The system SHALL provide the ability to capture and render available data as required for audit and review according to scope of practice, organizational policy, and/or jurisdictional law.",
"derivedFrom" : "EHR-S_FM_R1.1 S.3.3.5#2"
},
{
"extension" : [
{
"url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
"valueBoolean" : false
}
],
"key" : "EHRSFMR2-AS.9.5-03",
"label" : "AS.9.5#03",
"conformance" : [
"MAY"
],
"conditionality" : false,
"requirement" : "The system MAY provide the ability to render available data in a computer readable form when needed to enable the creation of claims and encounter reports for reimbursement.",
"derivedFrom" : "EHR-S_FM_R1.1 S.3.3.5#3"
},
{
"extension" : [
{
"url" : "http://hl7.org/ehrs/uv/ehrsfmr2/StructureDefinition/requirements-dependent",
"valueBoolean" : false
}
],
"key" : "EHRSFMR2-AS.9.5-04",
"label" : "AS.9.5#04",
"conformance" : [
"MAY"
],
"conditionality" : false,
"requirement" : "The system MAY provide the ability to render data, using either internal or external reporting tools, to support coding of diagnosis, procedure and outcomes."
}
]
}
IG © 2025 HL7 International / Electronic Health Records. Package hl7.ehrs.uv.ehrsfmr2#2.1.1-ballot based on FHIR 5.0.0. Generated 2025-04-04
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