FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5
0.0.1-snapshot-2 - informative International flag

FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 - Version 0.0.1-snapshot-2. See the Directory of published versions

ValueSet: Cross-version VS for R5.ActInvoiceAdjudicationPaymentCode for use in FHIR R4

Official URL: http://hl7.org/fhir/5.0/ValueSet/R5-v3-ActInvoiceAdjudicationPaymentCode-for-R4 Version: 0.0.1-snapshot-2
Standards status: Informative Maturity Level: 0 Computable Name: R5_v3_ActInvoiceAdjudicationPaymentCode_for_R4

This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentCode 2.0.0 for use in FHIR R4. Concepts not present here have direct equivalent mappings crossing all versions from R5 to R4.

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.
    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..
    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
    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.
    TRANtransaction feeFees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.
    CONTcontractTransaction counts and value totals by Contract Identifier.
    DAYdayTransaction counts and value totals for each calendar day within the date range specified.
    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.
    PERIODperiodTransaction counts and value totals for the date range specified.
    PROVproviderTransaction counts and value totals by Provider Identifier.
    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.
    INVTYPEinvoice typeTransaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)
    PAYEEpayeeTransaction counts and value totals by each instance of an invoice payee.
    PAYORpayorTransaction counts and value totals by each instance of an invoice 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.

 

Expansion

This value set expansion contains 25 concepts.

CodeSystemDisplayDefinition
  ALEChttp://terminology.hl7.org/CodeSystem/v3-ActCodealternate 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).

  BONUShttp://terminology.hl7.org/CodeSystem/v3-ActCodebonus

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

  CFWDhttp://terminology.hl7.org/CodeSystem/v3-ActCodecarry 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.

  EDUhttp://terminology.hl7.org/CodeSystem/v3-ActCodeeducation fees

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

  EPYMThttp://terminology.hl7.org/CodeSystem/v3-ActCodeearly payment fee

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

  GARNhttp://terminology.hl7.org/CodeSystem/v3-ActCodegarnishee

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

  INVOICEhttp://terminology.hl7.org/CodeSystem/v3-ActCodesubmitted invoice

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

  PINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodepaper invoice

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

  PPRDhttp://terminology.hl7.org/CodeSystem/v3-ActCodeprior period adjustment

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

  PROAhttp://terminology.hl7.org/CodeSystem/v3-ActCodeprofessional association deduction

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

  RECOVhttp://terminology.hl7.org/CodeSystem/v3-ActCoderecovery

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

  RETROhttp://terminology.hl7.org/CodeSystem/v3-ActCoderetro adjustment

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

  TRANhttp://terminology.hl7.org/CodeSystem/v3-ActCodetransaction fee

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

  CONThttp://terminology.hl7.org/CodeSystem/v3-ActCodecontract

Transaction counts and value totals by Contract Identifier.

  DAYhttp://terminology.hl7.org/CodeSystem/v3-ActCodeday

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

  LOChttp://terminology.hl7.org/CodeSystem/v3-ActCodelocation

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

  MONTHhttp://terminology.hl7.org/CodeSystem/v3-ActCodemonth

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

  PERIODhttp://terminology.hl7.org/CodeSystem/v3-ActCodeperiod

Transaction counts and value totals for the date range specified.

  PROVhttp://terminology.hl7.org/CodeSystem/v3-ActCodeprovider

Transaction counts and value totals by Provider Identifier.

  WEEKhttp://terminology.hl7.org/CodeSystem/v3-ActCodeweek

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

  YEARhttp://terminology.hl7.org/CodeSystem/v3-ActCodeyear

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

  INVTYPEhttp://terminology.hl7.org/CodeSystem/v3-ActCodeinvoice type

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

  PAYEEhttp://terminology.hl7.org/CodeSystem/v3-ActCodepayee

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

  PAYORhttp://terminology.hl7.org/CodeSystem/v3-ActCodepayor

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

  SENDAPPhttp://terminology.hl7.org/CodeSystem/v3-ActCodesending 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.


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