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Financial Management icon Work GroupMaturity Level: 4 Trial UseSecurity Category: Patient Compartments: Practitioner

Detailed Descriptions for the elements in the PaymentReconciliation resource.

PaymentReconciliation
Element Id PaymentReconciliation
Definition

This resource provides the details including amount of a payment and allocates the payment items being paid.

Short Display PaymentReconciliation resource
Cardinality 0..*
Type DomainResource
Summary false
PaymentReconciliation.identifier
Element Id PaymentReconciliation.identifier
Definition

A unique identifier assigned to this payment reconciliation.

Short Display Business Identifier for a payment reconciliation
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..*
Type Identifier
Requirements

Allows payment reconciliations to be distinguished and referenced.

Summary false
PaymentReconciliation.type
Element Id PaymentReconciliation.type
Definition

Code to indicate the nature of the payment such as payment, adjustment.

Short Display Category of payment
Cardinality 1..1
Terminology Binding Payment Type Codes (Extensible)
Type CodeableConcept
Summary true
PaymentReconciliation.status
Element Id PaymentReconciliation.status
Definition

The status of the resource instance.

Short Display active | cancelled | draft | entered-in-error
Cardinality 1..1
Terminology Binding Financial Resource Status Codes (Required)
Type code
Is Modifier true (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)
Requirements

Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.

Summary true
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

PaymentReconciliation.kind
Element Id PaymentReconciliation.kind
Definition

The workflow or activity which gave rise to or during which the payment ocurred such as a kiosk, deposit on account, periodic payment etc.

Short Display Workflow originating payment
Cardinality 0..1
Terminology Binding Payment Kind (Extensible)
Type CodeableConcept
Summary false
PaymentReconciliation.period
Element Id PaymentReconciliation.period
Definition

The period of time for which payments have been gathered into this bulk payment for settlement.

Short Display Period covered
Cardinality 0..1
Type Period
Requirements

Needed to allow receivers to monitor and reconcile payment issuer schedules.

Summary true
PaymentReconciliation.created
Element Id PaymentReconciliation.created
Definition

The date when the resource was created.

Short Display Creation date
Cardinality 1..1
Type dateTime
Requirements

Need to record a timestamp for use by both the recipient and the issuer.

Summary true
PaymentReconciliation.enterer
Element Id PaymentReconciliation.enterer
Definition

Payment enterer if not the actual payment issuer.

Short Display Who entered the payment
Cardinality 0..1
Type Reference(Practitioner | PractitionerRole | Organization)
Summary false
PaymentReconciliation.issuerType
Element Id PaymentReconciliation.issuerType
Definition

The type of the source such as patient or insurance.

Short Display Nature of the source
Cardinality 0..1
Terminology Binding Payment Issuer Type (Extensible)
Type CodeableConcept
Requirements

Providers may need to identify the source to know to which sub-ledger to apply the payment.

Summary false
PaymentReconciliation.paymentIssuer
Element Id PaymentReconciliation.paymentIssuer
Definition

The party who generated the payment.

Short Display Party generating payment
Cardinality 0..1
Type Reference(Organization | Patient | RelatedPerson)
Requirements

Need to identify the party resonsible for the payment and this resource.

Summary true
Comments

This party is also responsible for the reconciliation.

PaymentReconciliation.request
Element Id PaymentReconciliation.request
Definition

Original request resource reference.

Short Display Reference to requesting resource
Cardinality 0..1
Type Reference(Task)
Requirements

Needed to allow the response to be linked to the request.

Summary false
PaymentReconciliation.requestor
Element Id PaymentReconciliation.requestor
Definition

The practitioner who is responsible for the services rendered to the patient.

Short Display Responsible practitioner
Cardinality 0..1
Type Reference(Practitioner | PractitionerRole | Organization)
Requirements

Need to identify the party responsible for the request.

Summary false
PaymentReconciliation.outcome
Element Id PaymentReconciliation.outcome
Definition

The outcome of a request for a reconciliation.

Short Display queued | complete | error | partial
Cardinality 0..1
Terminology Binding Payment Outcome (Required)
Type code
Requirements

To advise the requestor of an overall processing outcome.

Summary false
Comments

The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).

PaymentReconciliation.disposition
Element Id PaymentReconciliation.disposition
Definition

A human readable description of the status of the request for the reconciliation.

Short Display Disposition message
Cardinality 0..1
Type string
Requirements

Provided for user display.

Summary false
PaymentReconciliation.date
Element Id PaymentReconciliation.date
Definition

The date of payment as indicated on the financial instrument.

Short Display When payment issued
Cardinality 1..1
Type date
Requirements

To advise the payee when payment can be expected.

Summary true
PaymentReconciliation.location
Element Id PaymentReconciliation.location
Definition

The location of the site or device for electronic transfers or physical location for cash payments.

Short Display Where payment collected
Cardinality 0..1
Type Reference(Location)
Summary false
PaymentReconciliation.method
Element Id PaymentReconciliation.method
Definition

The means of payment such as check, card cash, or electronic funds transfer.

Short Display Payment instrument
Cardinality 0..1
Terminology Binding hl7VS-paymentMethodCode icon (Extensible)
Type CodeableConcept
Summary false
PaymentReconciliation.cardBrand
Element Id PaymentReconciliation.cardBrand
Definition

The card brand such as debit, Visa, Amex etc. used if a card is the method of payment.

Short Display Type of card
Cardinality 0..1
Type string
Summary false
PaymentReconciliation.accountNumber
Element Id PaymentReconciliation.accountNumber
Definition

A portion of the account number, often the last 4 digits, used for verification not charging purposes.

Short Display Digits for verification
Cardinality 0..1
Type string
Summary false
PaymentReconciliation.expirationDate
Element Id PaymentReconciliation.expirationDate
Definition

The year and month (YYYY-MM) when the instrument, typically card, expires.

Short Display Expiration year-month
Cardinality 0..1
Type date
Summary false
PaymentReconciliation.processor
Element Id PaymentReconciliation.processor
Definition

The name of the card processor, etf processor, bank for checks.

Short Display Processor name
Cardinality 0..1
Type string
Summary false
PaymentReconciliation.referenceNumber
Element Id PaymentReconciliation.referenceNumber
Definition

The check number, eft reference, car processor reference.

Short Display Check number or payment reference
Cardinality 0..1
Type string
Summary false
PaymentReconciliation.authorization
Element Id PaymentReconciliation.authorization
Definition

An alphanumeric issued by the processor to confirm the successful issuance of payment.

Short Display Authorization number
Cardinality 0..1
Type string
Summary false
PaymentReconciliation.tenderedAmount
Element Id PaymentReconciliation.tenderedAmount
Definition

The amount offered by the issuer, typically applies to cash when the issuer provides an amount in bank note denominations equal to or excess of the amount actually being paid.

Short Display Amount offered by the issuer
Cardinality 0..1
Type Money
Summary false
PaymentReconciliation.returnedAmount
Element Id PaymentReconciliation.returnedAmount
Definition

The amount returned by the receiver which is excess to the amount payable, often referred to as 'change'.

Short Display Amount returned by the receiver
Cardinality 0..1
Type Money
Summary false
PaymentReconciliation.amount
Element Id PaymentReconciliation.amount
Definition

Total payment amount as indicated on the financial instrument.

Short Display Total amount of Payment
Cardinality 1..1
Type Money
Requirements

Needed to provide the actual payment amount.

Summary true
PaymentReconciliation.paymentIdentifier
Element Id PaymentReconciliation.paymentIdentifier
Definition

Issuer's unique identifier for the payment instrument.

Short Display Business identifier for the payment
Cardinality 0..1
Type Identifier
Requirements

Enable the receiver to reconcile when payment is received.

Summary false
Comments

For example: EFT number or check number.

PaymentReconciliation.allocation
Element Id PaymentReconciliation.allocation
Definition

Distribution of the payment amount for a previously acknowledged payable.

Short Display Settlement particulars
Cardinality 0..*
Requirements

Needed to show how the payment amount is distributed across the payables.

Summary false
PaymentReconciliation.allocation.identifier
Element Id PaymentReconciliation.allocation.identifier
Definition

Unique identifier for the current payment item for the referenced payable.

Short Display Business identifier of the payment detail
Note This is a business identifier, not a resource identifier (see discussion)
Cardinality 0..1
Type Identifier
Requirements

Needed for reconciliation of payments.

Summary false
PaymentReconciliation.allocation.predecessor
Element Id PaymentReconciliation.allocation.predecessor
Definition

Unique identifier for the prior payment item for the referenced payable.

Short Display Business identifier of the prior payment detail
Cardinality 0..1
Type Identifier
Requirements

Needed for reconciliation of payments.

Summary false
PaymentReconciliation.allocation.target
Element Id PaymentReconciliation.allocation.target
Definition

Specific resource to which the payment/adjustment/advance applies.

Short Display Subject of the payment
Cardinality 0..1
Type Reference(Claim | Account | Invoice | ChargeItem | Encounter | Contract)
Summary false
PaymentReconciliation.allocation.targetItem[x]
Element Id PaymentReconciliation.allocation.targetItem[x]
Definition

Identifies the claim line item, encounter or other sub-element being paid. Note payment may be partial, that is not match the then outstanding balance or amount incurred.

Short Display Sub-element of the subject
Cardinality 0..1
Type string|Identifier|positiveInt
[x] Note See Choice of Datatypes for further information about how to use [x]
Summary false
PaymentReconciliation.allocation.encounter
Element Id PaymentReconciliation.allocation.encounter
Definition

The Encounter to which this payment applies, may be completed by the receiver, used for search.

Short Display Applied-to encounter
Cardinality 0..1
Type Reference(Encounter)
Summary false
PaymentReconciliation.allocation.account
Element Id PaymentReconciliation.allocation.account
Definition

The Account to which this payment applies, may be completed by the receiver, used for search.

Short Display Applied-to account
Cardinality 0..1
Type Reference(Account)
Summary false
PaymentReconciliation.allocation.type
Element Id PaymentReconciliation.allocation.type
Definition

Code to indicate the nature of the payment.

Short Display Category of payment
Cardinality 0..1
Terminology Binding Payment Type Codes (Extensible)
Type CodeableConcept
Requirements

Needed to provide context for the amount.

Summary false
Comments

For example: payment, adjustment, funds advance, etc.

PaymentReconciliation.allocation.submitter
Element Id PaymentReconciliation.allocation.submitter
Definition

The party which submitted the claim or financial transaction.

Short Display Submitter of the request
Cardinality 0..1
Type Reference(Practitioner | PractitionerRole | Organization)
Requirements

Needed for audit and validation.

Summary false
PaymentReconciliation.allocation.response
Element Id PaymentReconciliation.allocation.response
Definition

A resource, such as a ClaimResponse, which contains a commitment to payment.

Short Display Response committing to a payment
Cardinality 0..1
Type Reference(ClaimResponse)
Requirements

Needed to provide a linkage to the payment commitment.

Summary false
PaymentReconciliation.allocation.date
Element Id PaymentReconciliation.allocation.date
Definition

The date from the response resource containing a commitment to pay.

Short Display Date of commitment to pay
Cardinality 0..1
Type date
Requirements

Needed for audit and validation.

Summary false
PaymentReconciliation.allocation.responsible
Element Id PaymentReconciliation.allocation.responsible
Definition

A reference to the individual who is responsible for inquiries regarding the response and its payment.

Short Display Contact for the response
Cardinality 0..1
Type Reference(PractitionerRole)
Requirements

To provide contact information.

Summary false
PaymentReconciliation.allocation.payee
Element Id PaymentReconciliation.allocation.payee
Definition

The party which is receiving the payment.

Short Display Recipient of the payment
Cardinality 0..1
Type Reference(Practitioner | PractitionerRole | Organization)
Requirements

Needed for audit and validation.

Summary false
PaymentReconciliation.allocation.amount
Element Id PaymentReconciliation.allocation.amount
Definition

The monetary amount allocated from the total payment to the payable.

Short Display Amount allocated to this payable
Cardinality 0..1
Type Money
Requirements

Needed to explain the distribution of the payment to the payables.

Summary false
PaymentReconciliation.formCode
Element Id PaymentReconciliation.formCode
Definition

A code for the form to be used for printing the content.

Short Display Printed form identifier
Cardinality 0..1
Terminology Binding Form Codes (Example)
Type CodeableConcept
Requirements

Needed to specify the specific form used for producing output for this response.

Summary false
Comments

May be needed to identify specific jurisdictional forms.

PaymentReconciliation.processNote
Element Id PaymentReconciliation.processNote
Definition

A note that describes or explains the processing in a human readable form.

Short Display Note concerning processing
Cardinality 0..*
Requirements

Provides the specific textual explanations associated with the processing.

Summary false
PaymentReconciliation.processNote.type
Element Id PaymentReconciliation.processNote.type
Definition

The business purpose of the note text.

Short Display display | print | printoper
Cardinality 0..1
Terminology Binding NoteType (Required)
Type code
Requirements

To convey the expectation for when the text is used.

Summary false
PaymentReconciliation.processNote.text
Element Id PaymentReconciliation.processNote.text
Definition

The explanation or description associated with the processing.

Short Display Note explanatory text
Cardinality 0..1
Type string
Requirements

Required to provide human readable explanation.

Summary false