HL7 Terminology (THO)
6.0.2 - Continuous Process Integration (ci build)
HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This guide is not an authorized publication; it is the continuous build for version 6.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions
Official URL: http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentCode | Version: 3.0.0 | |||
Active as of 2014-03-26 | Responsible: Health Level Seven International | Computable Name: ActInvoiceAdjudicationPaymentCode | ||
Other Identifiers: OID:2.16.840.1.113883.1.11.19412 | ||||
Copyright/Legal: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html |
Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees.
References
Generated Narrative: ValueSet v3-ActInvoiceAdjudicationPaymentCode
Language: en
This value set includes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/v3-ActCode
where concept is-a _ActInvoiceAdjudicationPaymentCodeThis value set excludes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/v3-ActCode
Code | Display | Definition |
_ActInvoiceAdjudicationPaymentCode | ActInvoiceAdjudicationPaymentCode | Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees. |
Generated Narrative: ValueSet
Language: en
Expansion based on codesystem ActCode v9.0.0 (CodeSystem)
This value set contains 28 concepts
Code | System | Display | Inactive | Definition |
_ActInvoiceAdjudicationPaymentGroupCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | ActInvoiceAdjudicationPaymentGroupCode | Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc. | |
ALEC | http://terminology.hl7.org/CodeSystem/v3-ActCode | alternate electronic | Payment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission). | |
BONUS | http://terminology.hl7.org/CodeSystem/v3-ActCode | bonus | Bonus payments based on performance, volume, etc. as agreed to by the payor. | |
CFWD | http://terminology.hl7.org/CodeSystem/v3-ActCode | carry forward adjusment | An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made. | |
EDU | http://terminology.hl7.org/CodeSystem/v3-ActCode | education fees | Fees deducted on behalf of a payee for tuition and continuing education. | |
EPYMT | http://terminology.hl7.org/CodeSystem/v3-ActCode | early payment fee | Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments. | |
GARN | http://terminology.hl7.org/CodeSystem/v3-ActCode | garnishee | Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. | |
INVOICE | http://terminology.hl7.org/CodeSystem/v3-ActCode | submitted invoice | Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results.. | |
PINV | http://terminology.hl7.org/CodeSystem/v3-ActCode | paper invoice | Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice. | |
PPRD | http://terminology.hl7.org/CodeSystem/v3-ActCode | prior period adjustment | An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice | |
PROA | http://terminology.hl7.org/CodeSystem/v3-ActCode | professional association deduction | Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association | |
RECOV | http://terminology.hl7.org/CodeSystem/v3-ActCode | recovery | Retroactive adjustment such as fee rate adjustment due to contract negotiations. | |
RETRO | http://terminology.hl7.org/CodeSystem/v3-ActCode | retro adjustment | Bonus payments based on performance, volume, etc. as agreed to by the payor. | |
TRAN | http://terminology.hl7.org/CodeSystem/v3-ActCode | transaction fee | Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. | |
_ActInvoicePaymentCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | ActInvoiceAdjudicationPaymentGroupCode | inactive | Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc. |
_ActInvoiceAdjudicationPaymentSummaryCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | ActInvoiceAdjudicationPaymentSummaryCode | Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc. | |
CONT | http://terminology.hl7.org/CodeSystem/v3-ActCode | contract | Transaction counts and value totals by Contract Identifier. | |
DAY | http://terminology.hl7.org/CodeSystem/v3-ActCode | day | Transaction counts and value totals for each calendar day within the date range specified. | |
LOC | http://terminology.hl7.org/CodeSystem/v3-ActCode | location | Transaction counts and value totals by service location (e.g clinic). | |
MONTH | http://terminology.hl7.org/CodeSystem/v3-ActCode | month | Transaction counts and value totals for each calendar month within the date range specified. | |
PERIOD | http://terminology.hl7.org/CodeSystem/v3-ActCode | period | Transaction counts and value totals for the date range specified. | |
PROV | http://terminology.hl7.org/CodeSystem/v3-ActCode | provider | Transaction counts and value totals by Provider Identifier. | |
WEEK | http://terminology.hl7.org/CodeSystem/v3-ActCode | week | Transaction counts and value totals for each calendar week within the date range specified. | |
YEAR | http://terminology.hl7.org/CodeSystem/v3-ActCode | year | Transaction counts and value totals for each calendar year within the date range specified. | |
INVTYPE | http://terminology.hl7.org/CodeSystem/v3-ActCode | invoice type | Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense) | |
PAYEE | http://terminology.hl7.org/CodeSystem/v3-ActCode | payee | Transaction counts and value totals by each instance of an invoice payee. | |
PAYOR | http://terminology.hl7.org/CodeSystem/v3-ActCode | payor | Transaction counts and value totals by each instance of an invoice payor. | |
SENDAPP | http://terminology.hl7.org/CodeSystem/v3-ActCode | sending application | Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers. |
Explanation of the columns that may appear on this page:
Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies |
System | The source of the definition of the code (when the value set draws in codes defined elsewhere) |
Code | The code (used as the code in the resource instance) |
Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application |
Definition | An explanation of the meaning of the concept |
Comments | Additional notes about how to use the code |
History
Date | Action | Author | Custodian | Comment |
2023-11-14 | revise | Marc Duteau | TSMG | Add standard copyright and contact to internal content; up-476 |
2022-10-18 | revise | Marc Duteau | TSMG | Fixing missing metadata; up-349 |
2020-05-06 | revise | Ted Klein | Vocabulary WG | Migrated to the UTG maintenance environment and publishing tooling. |
2014-03-26 | revise | Vocabulary (Woody Beeler) (no record of original request) | 2014T1_2014-03-26_001283 (RIM release ID) | Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26 |