FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions icon

Patient Administration icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Device, Patient, Practitioner

Detailed Descriptions for the elements in the Account resource.

Account
Element IdAccount
Definition

A financial tool for tracking value accrued for a particular purpose. In the healthcare field, used to track charges for a patient, cost centers, etc.

Short DisplayTracks balance, charges, for patient or cost center
Cardinality0..*
TypeDomainResource
Alternate NamesCost center; Record
Summaryfalse
Account.identifier
Element IdAccount.identifier
Definition

Unique identifier used to reference the account. Might or might not be intended for human use (e.g. credit card number).

Short DisplayAccount number
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Summarytrue
Account.status
Element IdAccount.status
Definition

Indicates whether the account is presently used/usable or not.

Short Displayactive | inactive | entered-in-error | on-hold | unknown
Cardinality1..1
Terminology BindingAccount Status (Required)
Typecode
Is Modifiertrue (Reason: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid)
Summarytrue
Comments

This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the Account as not currently valid.

Account.billingStatus
Element IdAccount.billingStatus
Definition

The BillingStatus tracks the lifecycle of the account through the billing process. It indicates how transactions are treated when they are allocated to the account.

Short DisplayTracks the lifecycle of the account through the billing process
Cardinality0..1
Terminology BindingExample Account Billing Statuses (Example)
TypeCodeableConcept
Summarytrue
Account.type
Element IdAccount.type
Definition

Categorizes the account for reporting and searching purposes.

Short DisplayE.g. patient, expense, depreciation
Cardinality0..1
Terminology BindingAccount Types (Example)
TypeCodeableConcept
Summarytrue
Account.name
Element IdAccount.name
Definition

Name used for the account when displaying it to humans in reports, etc.

Short DisplayHuman-readable label
Cardinality0..1
Typestring
Alternate NamesTitle
Summarytrue
Account.subject
Element IdAccount.subject
Definition

Identifies the entity which incurs the expenses. While the immediate recipients of services or goods might be entities related to the subject, the expenses were ultimately incurred by the subject of the Account.

Short DisplayThe entity that caused the expenses
Cardinality0..*
TypeReference(Patient | Device | Practitioner | PractitionerRole | Location | HealthcareService | Organization)
Alternate Namestarget
Summarytrue
Comments

Accounts can be applied to non-patients for tracking other non-patient related activities, such as group services (patients not tracked, and costs charged to another body), or might not be allocated.

Account.servicePeriod
Element IdAccount.servicePeriod
Definition

The date range of services associated with this account.

Short DisplayTransaction window
Cardinality0..1
TypePeriod
Summarytrue
Comments

It is possible for transactions to be posted outside the service period, as long as the service was provided within the defined service period.

Account.covers
Element IdAccount.covers
Definition

An account that collects the charges for a specific set of services offered over a limited time period. For example, a hospital account might contain all charges related to a given admission, including any inpatient appointments, and possibly re-admissions, of the billing for those re-admissions should be grouped with the initial admission for the purpose of claim submission.

Short DisplayEpisodic account covering these encounters/episodes of care
Cardinality0..*
TypeReference(Encounter | EpisodeOfCare)
Summarytrue
Comments

Episode Accounts often exist for the duration of a relatively short billing cycle (for example, a month, or possibly a quarter). One a given billing cycle ends, the associated Episodic Account would close, and a new account would open for the next billing cycle. A patient that is admitted for 6 months, where the billing cycle is monthly, would have 6 episodic accounts each covering one month.

Account.coverage
Element IdAccount.coverage
Definition

The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account.

Short DisplayThe party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account
Cardinality0..*
Summarytrue
Comments

Typically. this may be some form of insurance, internal charges, or self-pay.

Local or jurisdictional business rules may determine which coverage covers which types of billable items charged to the account, and in which order. Where the order is important, a local/jurisdictional extension may be defined to specify the order for the type of charge.

Account.coverage.coverage
Element IdAccount.coverage.coverage
Definition

The party(s) that contribute to payment (or part of) of the charges applied to this account (including self-pay).

A coverage may only be responsible for specific types of charges, and the sequence of the coverages in the account could be important when processing billing.

Short DisplayThe party(s), such as insurances, that may contribute to the payment of this account
Cardinality1..1
TypeReference(Coverage)
Summarytrue
Account.coverage.priority
Element IdAccount.coverage.priority
Definition

The priority of the coverage in the context of this account.

Short DisplayThe priority of the coverage in the context of this account
Cardinality0..1
TypepositiveInt
Alternate Namescoordination of benefit priority
Summarytrue
Comments

It is common in some jurisdictions for there to be multiple coverages allocated to an account, and a sequence is required to order the settling of the account (often with insurance claiming).

Account.owner
Element IdAccount.owner
Definition

Indicates the service area, hospital, department, etc. with responsibility for managing the Account.

Short DisplayEntity managing the Account
Cardinality0..1
TypeReference(Organization)
Summarytrue
Account.description
Element IdAccount.description
Definition

Provides additional information about what the account tracks and how it is used.

Short DisplayExplanation of purpose/use
Cardinality0..1
Typemarkdown
Summarytrue
Account.guarantor
Element IdAccount.guarantor
Definition

The parties responsible for balancing the account if other payment options fall short.

Short DisplayThe parties ultimately responsible for balancing the Account
Cardinality0..*
Summaryfalse
Account.guarantor.party
Element IdAccount.guarantor.party
Definition

The entity who is responsible.

Short DisplayResponsible entity
Cardinality1..1
TypeReference(Patient | RelatedPerson | Organization)
Summaryfalse
Account.guarantor.onHold
Element IdAccount.guarantor.onHold
Definition

A guarantor may be placed on credit hold or otherwise have their role temporarily suspended.

Short DisplayCredit or other hold applied
Cardinality0..1
Typeboolean
Summaryfalse
Account.guarantor.period
Element IdAccount.guarantor.period
Definition

The timeframe during which the guarantor accepts responsibility for the account.

Short DisplayGuarantee account during
Cardinality0..1
TypePeriod
Summaryfalse
Account.diagnosis
Element IdAccount.diagnosis
Definition

When using an account for billing a specific Encounter the set of diagnoses that are relevant for billing are stored here on the account where they are able to be sequenced appropriately prior to processing to produce claim(s).

Short DisplayThe list of diagnoses relevant to this account
Cardinality0..*
Summarytrue
Invariants
Defined on this element
act-1Rule The dateOfDiagnosis is not valid when using a reference to a diagnosiscondition.reference.empty().not() implies dateOfDiagnosis.empty()
Account.diagnosis.sequence
Element IdAccount.diagnosis.sequence
Definition

Ranking of the diagnosis (for each type).

Short DisplayRanking of the diagnosis (for each type)
Cardinality0..1
TypepositiveInt
Summaryfalse
Account.diagnosis.condition
Element IdAccount.diagnosis.condition
Definition

The diagnosis relevant to the account.

Short DisplayThe diagnosis relevant to the account
Cardinality1..1
Terminology BindingCondition/Problem/Diagnosis Codes (Example)
TypeCodeableReference(Condition)
Alternate Namesindication
Summarytrue
Invariants
Affect this element
act-1Rule The dateOfDiagnosis is not valid when using a reference to a diagnosiscondition.reference.empty().not() implies dateOfDiagnosis.empty()
Account.diagnosis.dateOfDiagnosis
Element IdAccount.diagnosis.dateOfDiagnosis
Definition

Ranking of the diagnosis (for each type).

Short DisplayDate of the diagnosis (when coded diagnosis)
Cardinality0..1
TypedateTime
Summaryfalse
Invariants
Affect this element
act-1Rule The dateOfDiagnosis is not valid when using a reference to a diagnosiscondition.reference.empty().not() implies dateOfDiagnosis.empty()
Account.diagnosis.type
Element IdAccount.diagnosis.type
Definition

Type that this diagnosis has relevant to the account (e.g. admission, billing, discharge …).

Short DisplayType that this diagnosis has relevant to the account (e.g. admission, billing, discharge …)
Cardinality0..*
Terminology BindingEncounter Diagnosis Use (Preferred)
TypeCodeableConcept
Summaryfalse
Account.diagnosis.onAdmission
Element IdAccount.diagnosis.onAdmission
Definition

Was the Diagnosis present on Admission in the related Encounter.

Short DisplayDiagnosis present on Admission
Cardinality0..1
Typeboolean
Summaryfalse
Account.diagnosis.packageCode
Element IdAccount.diagnosis.packageCode
Definition

The package code can be used to group diagnoses that may be priced or delivered as a single product. Such as DRGs.

Short DisplayPackage Code specific for billing
Cardinality0..*
Terminology Bindingdiagnosis-package-code:
TypeCodeableConcept
Summaryfalse
Account.procedure
Element IdAccount.procedure
Definition

When using an account for billing a specific Encounter the set of procedures that are relevant for billing are stored here on the account where they are able to be sequenced appropriately prior to processing to produce claim(s).

Short DisplayThe list of procedures relevant to this account
Cardinality0..*
Summarytrue
Invariants
Defined on this element
act-2Rule The dateOfService is not valid when using a reference to a procedurecode.reference.empty().not() implies dateOfService.empty()
Account.procedure.sequence
Element IdAccount.procedure.sequence
Definition

Ranking of the procedure (for each type).

Short DisplayRanking of the procedure (for each type)
Cardinality0..1
TypepositiveInt
Summaryfalse
Account.procedure.code
Element IdAccount.procedure.code
Definition

The procedure relevant to the account.

Short DisplayThe procedure relevant to the account
Cardinality1..1
Terminology BindingProcedure Codes (SNOMED CT) (Example)
TypeCodeableReference(Procedure)
Alternate Namesindication
Summarytrue
Invariants
Affect this element
act-2Rule The dateOfService is not valid when using a reference to a procedurecode.reference.empty().not() implies dateOfService.empty()
Account.procedure.dateOfService
Element IdAccount.procedure.dateOfService
Definition

Date of the procedure when using a coded procedure. If using a reference to a procedure, then the date on the procedure should be used.

Short DisplayDate of the procedure (when coded procedure)
Cardinality0..1
TypedateTime
Summaryfalse
Invariants
Affect this element
act-2Rule The dateOfService is not valid when using a reference to a procedurecode.reference.empty().not() implies dateOfService.empty()
Account.procedure.type
Element IdAccount.procedure.type
Definition

How this procedure value should be used in charging the account.

Short DisplayHow this procedure value should be used in charging the account
Cardinality0..*
Terminology Bindingprocedure-type:
TypeCodeableConcept
Summaryfalse
Account.procedure.packageCode
Element IdAccount.procedure.packageCode
Definition

The package code can be used to group procedures that may be priced or delivered as a single product. Such as DRGs.

Short DisplayPackage Code specific for billing
Cardinality0..*
Terminology Bindingprocedure-package-code:
TypeCodeableConcept
Summaryfalse
Account.procedure.device
Element IdAccount.procedure.device
Definition

Any devices that were associated with the procedure relevant to the account.

Short DisplayAny devices that were associated with the procedure
Cardinality0..*
TypeReference(Device)
Summarytrue
Account.relatedAccount
Element IdAccount.relatedAccount
Definition

Other associated accounts related to this account.

Short DisplayOther associated accounts related to this account
Cardinality0..*
Summaryfalse
Account.relatedAccount.relationship
Element IdAccount.relatedAccount.relationship
Definition

Relationship of the associated Account.

Short DisplayRelationship of the associated Account
Cardinality0..1
Terminology BindingAccount Relationship (Example)
TypeCodeableConcept
Summaryfalse
Account.relatedAccount.account
Element IdAccount.relatedAccount.account
Definition

Reference to an associated Account.

Short DisplayReference to an associated Account
Cardinality1..1
TypeReference(Account)
HierarchyThis reference may point back to the same instance (including transitively)
Summaryfalse
Account.currency
Element IdAccount.currency
Definition

The default currency for the account.

Short DisplayThe base or default currency
Cardinality0..1
Terminology BindingCurrencies (Required)
TypeCodeableConcept
Summaryfalse
Account.balance
Element IdAccount.balance
Definition

The calculated account balances - these are calculated and processed by the finance system.

The balances with a term that is not current are usually generated/updated by an invoicing or similar process.

Short DisplayCalculated account balance(s)
Cardinality0..*
Summaryfalse
Account.balance.aggregate
Element IdAccount.balance.aggregate
Definition

Who is expected to pay this part of the balance.

Short DisplayWho is expected to pay this part of the balance
Cardinality0..1
Terminology BindingAccount Aggregate (Extensible)
TypeCodeableConcept
Summaryfalse
Account.balance.term
Element IdAccount.balance.term
Definition

The term of the account balances - The balance value is the amount that was outstanding for this age.

Short Displaycurrent | 30 | 60 | 90 | 120
Cardinality0..1
Terminology BindingAccount Balance Term (Extensible)
TypeCodeableConcept
Summaryfalse
Account.balance.estimate
Element IdAccount.balance.estimate
Definition

The amount is only an estimated value - this is likely common for current term balances, but not with known terms (that were generated by a backend process).

Short DisplayEstimated balance
Cardinality0..1
Typeboolean
Summaryfalse
Account.balance.amount
Element IdAccount.balance.amount
Definition

The actual balance value calculated for the age defined in the term property.

Short DisplayCalculated amount
Cardinality1..1
TypeMoney
Summaryfalse
Account.calculatedAt
Element IdAccount.calculatedAt
Definition

Time the balance amount was calculated.

Short DisplayTime the balance amount was calculated
Cardinality0..1
Typeinstant
Summaryfalse
Comments

The total(s) are not typically updated using the restful API but more often by back-end processes included in a typical finance system.