PaymentReconciliation - FHIR Resource (stu3)


This PaymentReconciliation Resource uses the FHIR API standard for access and structure.

Validate an PaymentReconciliation FHIR Resource (stu3)



Resource Attributes

AttributeField is listTypeDescription
createdfalsedateTime Creation date
detailtrueData Type List of settlements
dispositionfalsestring Disposition Message
formfalseCodeableConcept Printed Form Identifier
identifiertrueIdentifier Business Identifier
organizationfalseReference Insurer
outcomefalseCodeableConcept complete | error | partial
periodfalsePeriod Period covered
processNotetrueData Type Processing comments
requestfalseReference Claim reference
requestOrganizationfalseReference Responsible organization
requestProviderfalseReference Responsible practitioner
statusfalsecode active | cancelled | draft | entered-in-error
totalfalseMoney Total amount of Payment

PaymentReconciliation Example

{
  "status": "active",
  "requestOrganization": {
    "reference": "Organization/1"
  },
  "outcome": {
    "coding": [
      {
        "code": "complete",
        "system": "http://hl7.org/fhir/remittance-outcome"
      }
    ]
  },
  "form": {
    "coding": [
      {
        "code": "PAYREC/2016/01B",
        "system": "http://ncforms.org/formid"
      }
    ]
  },
  "created": "2014-08-16",
  "resourceType": "PaymentReconciliation",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the PaymentReconciliation</div>"
  },
  "request": {
    "reference": "http://www.BenefitsInc.com/fhir/eligibility/225476332402"
  },
  "period": {
    "start": "2014-08-16",
    "end": "2014-08-31"
  },
  "detail": [
    {
      "payee": {
        "reference": "Organization/1"
      },
      "request": {
        "identifier": {
          "system": "http://happyvalleyclinic.com/claim",
          "value": "AB12345"
        }
      },
      "date": "2014-08-16",
      "amount": {
        "code": "USD",
        "system": "urn:iso:std:iso:4217",
        "value": 1000
      },
      "submitter": {
        "reference": "Organization/1"
      },
      "type": {
        "coding": [
          {
            "code": "payment",
            "system": "http://hl7.org/fhir/payment-type"
          }
        ]
      },
      "response": {
        "identifier": {
          "system": "http://www.BenefitsInc.com/fhir/claimresponse",
          "value": "CR20140815-AB12345"
        }
      }
    },
    {
      "date": "2014-08-12",
      "request": {
        "reference": "http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699"
      },
      "amount": {
        "code": "USD",
        "system": "urn:iso:std:iso:4217",
        "value": 4000
      },
      "type": {
        "coding": [
          {
            "code": "payment",
            "system": "http://hl7.org/fhir/payment-type"
          }
        ]
      }
    },
    {
      "date": "2014-08-16",
      "amount": {
        "code": "USD",
        "system": "urn:iso:std:iso:4217",
        "value": -1500
      },
      "type": {
        "coding": [
          {
            "code": "advance",
            "system": "http://hl7.org/fhir/payment-type"
          }
        ]
      }
    }
  ],
  "disposition": "2014 August mid-month settlement.",
  "requestProvider": {
    "reference": "Practitioner/example"
  },
  "total": {
    "code": "USD",
    "system": "urn:iso:std:iso:4217",
    "value": 3500
  },
  "organization": {
    "reference": "Organization/2"
  },
  "identifier": [
    {
      "system": "http://www.BenefitsInc.com/fhir/enrollmentresponse",
      "value": "781234"
    }
  ],
  "processNote": [
    {
      "text": "Due to the year end holiday the cutoff for submissions for December will be the 28th.",
      "type": {
        "coding": [
          {
            "code": "display",
            "system": "http://hl7.org/fhir/note-type"
          }
        ]
      }
    }
  ],
  "id": "ER2500"
}

PaymentReconciliation Structure


  
{
  "resourceType" : "PaymentReconciliation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier
  "status" : "<code>", // active | cancelled | draft | entered-in-error
  "period" : { Period }, // Period covered
  "created" : "<dateTime>", // Creation date
  "organization" : { Reference(Organization) }, // Insurer
  "request" : { Reference(ProcessRequest) }, // Claim reference
  "outcome" : { CodeableConcept }, // complete | error | partial
  "disposition" : "<string>", // Disposition Message
  "requestProvider" : { Reference(Practitioner) }, // Responsible practitioner
  "requestOrganization" : { Reference(Organization) }, // Responsible organization
  "detail" : [{ // List of settlements
    "type" : { CodeableConcept }, // R!  Type code
    "request" : { Reference(Any) }, // Claim
    "response" : { Reference(Any) }, // Claim Response
    "submitter" : { Reference(Organization) }, // Organization which submitted the claim
    "payee" : { Reference(Organization) }, // Organization which is receiving the payment
    "date" : "<date>", // Invoice date
    "amount" : { Money } // Amount being paid
  }],
  "form" : { CodeableConcept }, // Printed Form Identifier
  "total" : { Money }, // Total amount of Payment
  "processNote" : [{ // Processing comments
    "type" : { CodeableConcept }, // display | print | printoper
    "text" : "<string>" // Comment on the processing
  }]
}


 

PaymentReconciliation Search Parameters

The following search parameters can be used to query PaymentReconciliation resources. Just submit the like so:

https://api.1up.health/fhir/stu3/PaymentReconciliation?query-param=queryvalue
Search ParameterField TypeResource Fields Searched
createddatecreated
dispositiontextdisposition
identifiertextidentifier
organizationreferenceorganization
outcometextoutcome
requestreferencerequest
request-organizationreferencerequestOrganization
request-providerreferencerequestProvider