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
Financial Management Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Practitioner |
General Payment Reconciliation Example
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- <http://hl7.org/fhir/PaymentReconciliation/ER2500> a fhir:PaymentReconciliation; fhir:nodeRole fhir:treeRoot; fhir:Resource.id [ fhir:value "ER2500"]; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ]; fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the PaymentReconciliation</div>" ]; fhir:PaymentReconciliation.identifier [ fhir:index 0; fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/fhir/enrollmentresponse" ]; fhir:Identifier.value [ fhir:value "781234" ] ]; fhir:PaymentReconciliation.status [ fhir:value "active"]; fhir:PaymentReconciliation.period [ fhir:Period.start [ fhir:value "2014-08-16"^^xsd:date ]; fhir:Period.end [ fhir:value "2014-08-31"^^xsd:date ] ]; fhir:PaymentReconciliation.created [ fhir:value "2014-08-16"^^xsd:date]; fhir:PaymentReconciliation.organization [ fhir:link <http://hl7.org/fhir/Organization/2>; fhir:Reference.reference [ fhir:value "Organization/2" ] ]; fhir:PaymentReconciliation.request [ fhir:link <http://www.BenefitsInc.com/fhir/eligibility/225476332402>; fhir:Reference.reference [ fhir:value "http://www.BenefitsInc.com/fhir/eligibility/225476332402" ] ]; fhir:PaymentReconciliation.outcome [ fhir:value "complete"]; fhir:PaymentReconciliation.disposition [ fhir:value "2014 August mid-month settlement."]; fhir:PaymentReconciliation.requestProvider [ fhir:link <http://hl7.org/fhir/Practitioner/example>; fhir:Reference.reference [ fhir:value "Practitioner/example" ] ]; fhir:PaymentReconciliation.requestOrganization [ fhir:link <http://hl7.org/fhir/Organization/1>; fhir:Reference.reference [ fhir:value "Organization/1" ] ]; fhir:PaymentReconciliation.detail [ fhir:index 0; fhir:PaymentReconciliation.detail.type [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/payment-type" ]; fhir:Coding.code [ fhir:value "payment" ] ] ]; fhir:PaymentReconciliation.detail.request [ fhir:Reference.identifier [ fhir:Identifier.system [ fhir:value "http://happyvalleyclinic.com/claim" ]; fhir:Identifier.value [ fhir:value "AB12345" ] ] ]; fhir:PaymentReconciliation.detail.response [ fhir:Reference.identifier [ fhir:Identifier.system [ fhir:value "http://www.BenefitsInc.com/fhir/claimresponse" ]; fhir:Identifier.value [ fhir:value "CR20140815-AB12345" ] ] ]; fhir:PaymentReconciliation.detail.submitter [ fhir:link <http://hl7.org/fhir/Organization/1>; fhir:Reference.reference [ fhir:value "Organization/1" ] ]; fhir:PaymentReconciliation.detail.payee [ fhir:link <http://hl7.org/fhir/Organization/1>; fhir:Reference.reference [ fhir:value "Organization/1" ] ]; fhir:PaymentReconciliation.detail.date [ fhir:value "2014-08-16"^^xsd:date ]; fhir:PaymentReconciliation.detail.amount [ fhir:Quantity.value [ fhir:value "1000.00"^^xsd:decimal ]; fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ]; fhir:Quantity.code [ fhir:value "USD" ] ] ], [ fhir:index 1; fhir:PaymentReconciliation.detail.type [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/payment-type" ]; fhir:Coding.code [ fhir:value "payment" ] ] ]; fhir:PaymentReconciliation.detail.request [ fhir:link <http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699>; fhir:Reference.reference [ fhir:value "http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699" ] ]; fhir:PaymentReconciliation.detail.date [ fhir:value "2014-08-12"^^xsd:date ]; fhir:PaymentReconciliation.detail.amount [ fhir:Quantity.value [ fhir:value "4000.00"^^xsd:decimal ]; fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ]; fhir:Quantity.code [ fhir:value "USD" ] ] ], [ fhir:index 2; fhir:PaymentReconciliation.detail.type [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/payment-type" ]; fhir:Coding.code [ fhir:value "advance" ] ] ]; fhir:PaymentReconciliation.detail.date [ fhir:value "2014-08-16"^^xsd:date ]; fhir:PaymentReconciliation.detail.amount [ fhir:Quantity.value [ fhir:value "-1500.00"^^xsd:decimal ]; fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ]; fhir:Quantity.code [ fhir:value "USD" ] ] ]; fhir:PaymentReconciliation.form [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://ncforms.org/formid" ]; fhir:Coding.code [ fhir:value "PAYREC/2016/01B" ] ] ]; fhir:PaymentReconciliation.total [ fhir:Quantity.value [ fhir:value "3500.00"^^xsd:decimal ]; fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ]; fhir:Quantity.code [ fhir:value "USD" ] ]; fhir:PaymentReconciliation.processNote [ fhir:index 0; fhir:PaymentReconciliation.processNote.type [ fhir:value "display" ]; fhir:PaymentReconciliation.processNote.text [ fhir:value "Due to the year end holiday the cutoff for submissions for December will be the 28th." ] ] . <http://hl7.org/fhir/Organization/2> a fhir:Organization . <http://hl7.org/fhir/Practitioner/example> a fhir:Practitioner . <http://hl7.org/fhir/Organization/1> a fhir:Organization . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/PaymentReconciliation/ER2500.ttl> a owl:Ontology; owl:imports fhir:fhir.ttl; owl:versionIRI <http://build.fhir.org/PaymentReconciliation/ER2500.ttl> . # -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.