R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Patient Administration Work GroupMaturity Level: 2 Trial Use Compartments: Device, Patient, Practitioner

Detailed Descriptions for the elements in the Account resource.

Account
Definition

A financial tool for tracking value accrued for a particular purpose. In the healthcare field, used to track charges for a patient, cost centers, etc.

Control1..1
Alternate NamesCost center; Record
Account.identifier
Definition

Unique identifier used to reference the account. Might or might not be intended for human use (e.g. credit card number).

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
Summarytrue
Account.status
Definition

Indicates whether the account is presently used/usable or not.

Control0..1
Terminology BindingAccountStatus (Required)
Typecode
Is Modifiertrue
Summarytrue
Comments

This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the Account as not currently valid.

Account.type
Definition

Categorizes the account for reporting and searching purposes.

Control0..1
Terminology BindingAccount Types (Example)
TypeCodeableConcept
Summarytrue
Account.name
Definition

Name used for the account when displaying it to humans in reports, etc.

Control0..1
Typestring
Alternate NamesTitle
Summarytrue
Account.subject
Definition

Identifies the patient, device, practitioner, location or other object the account is associated with.

Control0..1
TypeReference(Patient | Device | Practitioner | Location | HealthcareService | Organization)
Alternate Namestarget
Summarytrue
Comments

Accounts can be applied to non patients for tracking other non patient related activities, such as group services (patients not tracked, and costs charged to another body), or might not be allocated.

Account.period
Definition

Identifies the period of time the account applies to; e.g. accounts created per fiscal year, quarter, etc.

Control0..1
TypePeriod
Summarytrue
Comments

It is possible for transactions relevant to a coverage period to be posted to the account before or after the coverage period, however the services that are being charged for must be within this period.

Account.active
Definition

Indicates the period of time over which the account is allowed to have transactions posted to it. This period may be different to the coveragePeriod which is the duration of time that services may occur.

Control0..1
TypePeriod
Requirements

Accounts are able to be active only during a specific period, and the dates to which charges should be able to be applied.

Summarytrue
Account.coverage
Definition

The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account.

Control0..*
Summarytrue
Comments

Typically this may be some form of insurance, internal charges, or self-pay.

Local or jurisdicational business rules may determine which coverage covers which types of billable items charged to the account, and in which order. Where the order is important, a local/jurisdicational extension may be defined to specify the order for the type of charge.

Account.coverage.coverage
Definition

The party(s) that are responsible for payment (or part of) of charges applied to this account (including self-pay).

A coverage may only be resposible for specific types of charges, and the sequence of the coverages in the account could be important when processing billing.

Control1..1
TypeReference(Coverage)
Summarytrue
Account.coverage.priority
Definition

The priority of the coverage in the context of this account.

Control0..1
TypepositiveInt
Alternate Namescoordination of benefit priority
Summarytrue
Comments

It is common in some jurisdictions for there to be multiple coverages allocated to an account, and a sequence is required to order the settling of the account (often with insurance claiming).

Account.owner
Definition

Indicates the organization, department, etc. with responsibility for the account.

Control0..1
TypeReference(Organization)
Summarytrue
Account.description
Definition

Provides additional information about what the account tracks and how it is used.

Control0..1
Typestring
Summarytrue
Account.guarantor
Definition

Parties financially responsible for the account.

Control0..*
Account.guarantor.party
Definition

The entity who is responsible.

Control1..1
TypeReference(Patient | RelatedPerson | Organization)
Account.guarantor.onHold
Definition

A guarantor may be placed on credit hold or otherwise have their role temporarily suspended.

Control0..1
Typeboolean
Account.guarantor.period
Definition

The timeframe during which the guarantor accepts responsibility for the account.

Control0..1
TypePeriod
Account.partOf
Definition

Reference to a parent Account.

Control0..1
TypeReference(Account)