PaymentReconciliation - FHIR Resource (r4)


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

Validate an PaymentReconciliation FHIR Resource (r4)



Resource Attributes

AttributeField is listTypeDescription
createdfalsedateTime# Creation date
detailtrueData Type# Settlement particulars
dispositionfalsestring# Disposition message
formCodefalseCodeableConcept# Printed form identifier
identifiertrueIdentifier# Business Identifier for a payment reconciliation
outcomefalsecode# queued | complete | error | partial
paymentAmountfalseMoney# Total amount of Payment
paymentDatefalsedate# When payment issued
paymentIdentifierfalseIdentifier# Business identifier for the payment
paymentIssuerfalseReference# Party generating payment
periodfalsePeriod# Period covered
processNotetrueData Type# Note concerning processing
requestfalseReference# Reference to requesting resource
requestorfalseReference# Responsible practitioner
statusfalsecode# active | cancelled | draft | entered-in-error

PaymentReconciliation Example

{
  "resourceType": "PaymentReconciliation",
  "id": "ER2500",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the PaymentReconciliation</div>"
  },
  "identifier": [
    {
      "system": "http://www.BenefitsInc.com/fhir/enrollmentresponse",
      "value": "781234"
    }
  ],
  "status": "active",
  "period": {
    "start": "2014-08-16",
    "end": "2014-08-31"
  },
  "created": "2014-08-16",
  "paymentIssuer": {
    "reference": "Organization/2"
  },
  "request": {
    "reference": "http://www.BenefitsInc.com/fhir/eligibility/225476332402"
  },
  "requestor": {
    "reference": "Organization/1"
  },
  "outcome": "complete",
  "disposition": "2014 August mid-month settlement.",
  "paymentDate": "2014-08-01",
  "paymentAmount": {
    "value": 7000,
    "currency": "USD"
  },
  "paymentIdentifier": {
    "system": "http://www.BenefitsInc.com/payment/2018",
    "value": "10-12345"
  },
  "detail": [
    {
      "identifier": {
        "system": "http://www.BenefitsInc.com/payment/2018/detail",
        "value": "10-12345-001"
      },
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/payment-type",
            "code": "payment"
          }
        ]
      },
      "request": {
        "identifier": {
          "system": "http://happyvalleyclinic.com/claim",
          "value": "AB12345"
        }
      },
      "submitter": {
        "reference": "Organization/1"
      },
      "response": {
        "identifier": {
          "system": "http://www.BenefitsInc.com/fhir/claimresponse",
          "value": "CR20140815-AB12345"
        }
      },
      "date": "2014-08-16",
      "payee": {
        "reference": "Organization/1"
      },
      "amount": {
        "value": 3500,
        "currency": "USD"
      }
    },
    {
      "identifier": {
        "system": "http://www.BenefitsInc.com/payment/2018/detail",
        "value": "10-12345-002"
      },
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/payment-type",
            "code": "payment"
          }
        ]
      },
      "request": {
        "reference": "http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699"
      },
      "date": "2014-08-12",
      "amount": {
        "value": 4000,
        "currency": "USD"
      }
    },
    {
      "identifier": {
        "system": "http://www.BenefitsInc.com/payment/2018/detail",
        "value": "10-12345-003"
      },
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/payment-type",
            "code": "advance"
          }
        ]
      },
      "date": "2014-08-16",
      "amount": {
        "value": -1500,
        "currency": "USD"
      }
    }
  ],
  "formCode": {
    "coding": [
      {
        "system": "http://ncforms.org/formid",
        "code": "PAYREC/2016/01B"
      }
    ]
  },
  "processNote": [
    {
      "type": "display",
      "text": "Due to the year end holiday the cutoff for submissions for December will be the 28th."
    }
  ]
}

PaymentReconciliation Structure

{
  "resourceType" : "PaymentReconciliation",
  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "identifier" : [{ Identifier }], // Business Identifier for a payment reconciliation
  "status" : "<code>", // R!  active | cancelled | draft | entered-in-error
  "period" : { Period }, // Period covered
  "created" : "<dateTime>", // R!  Creation date
  "paymentIssuer" : { Reference(Organization) }, // Party generating payment
  "request" : { Reference(Task) }, // Reference to requesting resource
  "requestor" : { Reference(Practitioner|PractitionerRole|Organization) }, // Responsible practitioner
  "outcome" : "<code>", // queued | complete | error | partial
  "disposition" : "<string>", // Disposition message
  "paymentDate" : "<date>", // R!  When payment issued
  "paymentAmount" : { Money }, // R!  Total amount of Payment
  "paymentIdentifier" : { Identifier }, // Business identifier for the payment
  "detail" : [{ // Settlement particulars
    "identifier" : { Identifier }, // Business identifier of the payment detail
    "predecessor" : { Identifier }, // Business identifier of the prior payment detail
    "type" : { CodeableConcept }, // R!  Category of payment
    "request" : { Reference(Any) }, // Request giving rise to the payment
    "submitter" : { Reference(Practitioner|PractitionerRole|Organization) }, // Submitter of the request
    "response" : { Reference(Any) }, // Response committing to a payment
    "date" : "<date>", // Date of commitment to pay
    "responsible" : { Reference(PractitionerRole) }, // Contact for the response
    "payee" : { Reference(Practitioner|PractitionerRole|Organization) }, // Recipient of the payment
    "amount" : { Money } // Amount allocated to this payable
  }],
  "formCode" : { CodeableConcept }, // Printed form identifier
  "processNote" : [{ // Note concerning processing
    "type" : "<code>", // display | print | printoper
    "text" : "<string>" // Note explanatory text
  }]
}

PaymentReconciliation Search Parameters

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

https://api.1up.health/fhir/r4/PaymentReconciliation?query-param=queryvalue
Search ParameterField TypeResource Fields Searched
createddatecreated
dispositiontextdisposition
identifiertextidentifier
outcometextoutcome
payment-issuerreferencepaymentIssuer
requestreferencerequest
requestorreferencerequestor
statustextstatus