FHIR Implementation Guide for HCX
0.7.0 - CI Build
FHIR Implementation Guide for HCX - Local Development build (v0.7.0). See the Directory of published versions
| Defining URL: | https://ig.hcxprotocol.io/v0.7/StructureDefinition-PaymentReconciliation.html | 
| Version: | 0.7.0 | 
| Name: | PaymentReconciliation | 
| Status: | Draft as of 2021-08-16 10:29:23+1100 (Standards Status: Trial Use) | 
| Definition: | This resource provides the details including amount of a payment and allocates the payment items being paid. | 
| Publisher: | HCX Open Community | 
| Maturity: | 0 | 
| Source Resource: | XML / JSON / Turtle | 
The official URL for this profile is:
https://ig.hcxprotocol.io/v0.7/StructureDefinition-PaymentReconciliation.html
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from PaymentReconciliation
Summary
Mandatory: 3 elements
Structures
This structure refers to these other structures:
Maturity: 0
This structure is derived from PaymentReconciliation
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   PaymentReconciliation | 0..* | PaymentReconciliation | PaymentReconciliation resource | |
|    identifier | 0..* | Identifier | Business Identifier for a payment reconciliation | |
|    paymentIssuer | Σ | 0..1 | Reference(Organization) | Party generating payment | 
|    requestor | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Responsible practitioner | |
|    outcome | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. | |
|    paymentIdentifier | 1..1 | Identifier | Business identifier for the payment | |
|    detail | ||||
|     submitter | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Submitter of the request | |
|     responsible | 0..1 | Reference(PractitionerRole) | Contact for the response | |
|     payee | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Recipient of the payment | |
|  Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints  | ||||
|---|---|---|---|---|---|---|---|---|
|   PaymentReconciliation | 0..* | PaymentReconciliation | PaymentReconciliation resource | |||||
|    id | Σ | 0..1 | id | Logical id of this artifact | ||||
|    meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
|    language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language. 
 | |||||
|    text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
|    contained | 0..* | Resource | Contained, inline Resources | |||||
|    extension | 0..* | Extension | Additional content defined by implementations | |||||
|    modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
|    identifier | 0..* | Identifier | Business Identifier for a payment reconciliation | |||||
|    status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
|    period | Σ | 0..1 | Period | Period covered | ||||
|    created | Σ | 1..1 | dateTime | Creation date | ||||
|    paymentIssuer | Σ | 0..1 | Reference(Organization) | Party generating payment | ||||
|    request | 0..1 | Reference(Task) | Reference to requesting resource | |||||
|    requestor | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Responsible practitioner | |||||
|    outcome | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. | |||||
|    disposition | 0..1 | string | Disposition message | |||||
|    paymentDate | Σ | 1..1 | date | When payment issued | ||||
|    paymentAmount | Σ | 1..1 | Money | Total amount of Payment | ||||
|    paymentIdentifier | 1..1 | Identifier | Business identifier for the payment | |||||
|    detail | 0..* | BackboneElement | Settlement particulars | |||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     identifier | 0..1 | Identifier | Business identifier of the payment detail | |||||
|     predecessor | 0..1 | Identifier | Business identifier of the prior payment detail | |||||
|     type | 1..1 | CodeableConcept | Category of payment Binding: PaymentTypeCodes (example): The reason for the amount: payment, adjustment, advance. | |||||
|     request | 0..1 | Reference(Resource) | Request giving rise to the payment | |||||
|     submitter | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Submitter of the request | |||||
|     response | 0..1 | Reference(Resource) | Response committing to a payment | |||||
|     date | 0..1 | date | Date of commitment to pay | |||||
|     responsible | 0..1 | Reference(PractitionerRole) | Contact for the response | |||||
|     payee | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Recipient of the payment | |||||
|     amount | 0..1 | Money | Amount allocated to this payable | |||||
|    formCode | 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |||||
|    processNote | 0..* | BackboneElement | Note concerning processing | |||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     type | 0..1 | code | display | print | printoper Binding: NoteType (required): The presentation types of notes. | |||||
|     text | 0..1 | string | Note explanatory text | |||||
|  Documentation for this format | ||||||||
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   PaymentReconciliation | 0..* | PaymentReconciliation | PaymentReconciliation resource | |
|  Documentation for this format | ||||
This structure is derived from PaymentReconciliation
Summary
Mandatory: 3 elements
Structures
This structure refers to these other structures:
Maturity: 0
Differential View
This structure is derived from PaymentReconciliation
| Name | Flags | Card. | Type | Description & Constraints  | 
|---|---|---|---|---|
|   PaymentReconciliation | 0..* | PaymentReconciliation | PaymentReconciliation resource | |
|    identifier | 0..* | Identifier | Business Identifier for a payment reconciliation | |
|    paymentIssuer | Σ | 0..1 | Reference(Organization) | Party generating payment | 
|    requestor | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Responsible practitioner | |
|    outcome | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. | |
|    paymentIdentifier | 1..1 | Identifier | Business identifier for the payment | |
|    detail | ||||
|     submitter | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Submitter of the request | |
|     responsible | 0..1 | Reference(PractitionerRole) | Contact for the response | |
|     payee | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Recipient of the payment | |
|  Documentation for this format | ||||
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints  | ||||
|---|---|---|---|---|---|---|---|---|
|   PaymentReconciliation | 0..* | PaymentReconciliation | PaymentReconciliation resource | |||||
|    id | Σ | 0..1 | id | Logical id of this artifact | ||||
|    meta | Σ | 0..1 | Meta | Metadata about the resource | ||||
|    implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
|    language | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language. 
 | |||||
|    text | 0..1 | Narrative | Text summary of the resource, for human interpretation | |||||
|    contained | 0..* | Resource | Contained, inline Resources | |||||
|    extension | 0..* | Extension | Additional content defined by implementations | |||||
|    modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored | ||||
|    identifier | 0..* | Identifier | Business Identifier for a payment reconciliation | |||||
|    status | ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. | ||||
|    period | Σ | 0..1 | Period | Period covered | ||||
|    created | Σ | 1..1 | dateTime | Creation date | ||||
|    paymentIssuer | Σ | 0..1 | Reference(Organization) | Party generating payment | ||||
|    request | 0..1 | Reference(Task) | Reference to requesting resource | |||||
|    requestor | 1..1 | Reference(Practitioner | PractitionerRole | Organization) | Responsible practitioner | |||||
|    outcome | 1..1 | code | queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. | |||||
|    disposition | 0..1 | string | Disposition message | |||||
|    paymentDate | Σ | 1..1 | date | When payment issued | ||||
|    paymentAmount | Σ | 1..1 | Money | Total amount of Payment | ||||
|    paymentIdentifier | 1..1 | Identifier | Business identifier for the payment | |||||
|    detail | 0..* | BackboneElement | Settlement particulars | |||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     identifier | 0..1 | Identifier | Business identifier of the payment detail | |||||
|     predecessor | 0..1 | Identifier | Business identifier of the prior payment detail | |||||
|     type | 1..1 | CodeableConcept | Category of payment Binding: PaymentTypeCodes (example): The reason for the amount: payment, adjustment, advance. | |||||
|     request | 0..1 | Reference(Resource) | Request giving rise to the payment | |||||
|     submitter | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Submitter of the request | |||||
|     response | 0..1 | Reference(Resource) | Response committing to a payment | |||||
|     date | 0..1 | date | Date of commitment to pay | |||||
|     responsible | 0..1 | Reference(PractitionerRole) | Contact for the response | |||||
|     payee | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Recipient of the payment | |||||
|     amount | 0..1 | Money | Amount allocated to this payable | |||||
|    formCode | 0..1 | CodeableConcept | Printed form identifier Binding: Form Codes (example): The forms codes. | |||||
|    processNote | 0..* | BackboneElement | Note concerning processing | |||||
|     id | 0..1 | string | Unique id for inter-element referencing | |||||
|     extension | 0..* | Extension | Additional content defined by implementations | |||||
|     modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized | ||||
|     type | 0..1 | code | display | print | printoper Binding: NoteType (required): The presentation types of notes. | |||||
|     text | 0..1 | string | Note explanatory text | |||||
|  Documentation for this format | ||||||||
Other representations of profile: CSV, Excel, Schematron
| Path | Conformance | ValueSet | ||||
| PaymentReconciliation.language | preferred | CommonLanguages 
 | ||||
| PaymentReconciliation.status | required | FinancialResourceStatusCodes | ||||
| PaymentReconciliation.outcome | required | ClaimProcessingCodes | ||||
| PaymentReconciliation.detail.type | example | PaymentTypeCodes | ||||
| PaymentReconciliation.formCode | example | Form Codes | ||||
| PaymentReconciliation.processNote.type | required | NoteType | 
| Id | Grade | Path(s) | Details | Requirements | 
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count()) | |
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both : extension.exists() != value.exists() |