HL7 Terminology (THO)
2.1.33 - Continuous Process Integration (ci build)

HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This is not an authorized publication; it is the continuous build for version 2.1.33). This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions

ValueSet: ActInvoiceAdjudicationPaymentGroupCode

Summary

Defining URL:http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentGroupCode
Version:2.0.0
Name:ActInvoiceAdjudicationPaymentGroupCode
Status:Active as of 2014-03-26
Definition:

Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.

OID:2.16.840.1.113883.1.11.19414 (for OID based terminology systems)
Source Resource:XML / JSON / Turtle

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

 

Expansion

This value set contains 13 concepts

Expansion based on ActCode v6.0.0 (CodeSystem)

All codes in this table are from the system http://terminology.hl7.org/CodeSystem/v3-ActCode

CodeDisplayDefinition
ALECalternate electronicPayment 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).
BONUSbonusBonus payments based on performance, volume, etc. as agreed to by the payor.
CFWDcarry forward adjusmentAn amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made.
EDUeducation feesFees deducted on behalf of a payee for tuition and continuing education.
EPYMTearly payment feeFees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments.
GARNgarnisheeFees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.
INVOICEsubmitted invoicePayment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results..
PINVpaper invoicePayment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice.
PPRDprior period adjustmentAn amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice
PROAprofessional association deductionProfessional association fee that is collected by the payor from the practitioner/provider on behalf of the association
RECOVrecoveryRetroactive adjustment such as fee rate adjustment due to contract negotiations.
RETROretro adjustmentBonus payments based on performance, volume, etc. as agreed to by the payor.
TRANtransaction feeFees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.

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
Source 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

DateActionCustodianAuthorComment
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26revise2014T1_2014-03-26_001283 (RIM release ID)Vocabulary (Woody Beeler) (no record of original request)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26