ISO/HL7 10781 - Electronic Health Record System Functional Model, Release 2.1
2.1.0 - local
ISO/HL7 10781 - Electronic Health Record System Functional Model, Release 2.1
2.1.0 - local
Publish Box goes here
| Active as of 2024-11-26 |
<Requirements xmlns="http://hl7.org/fhir">
<id value="EHRSFMR2.1-AS.9.5"/>
<meta>
<profile value="http://hl7.org/ehrs/StructureDefinition/FMFunction"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<span id="description"><b>Statement <a href="https://hl7.org/fhir/versions.html#std-process" title="Normative Content" class="normative-flag">N</a>:</b> <div><p>Support interactions with other systems, applications, and modules to enable the creation of claims and encounter reports for reimbursement.</p>
</div></span>
<span id="purpose"><b>Description <a href="https://hl7.org/fhir/versions.html#std-process" title="Informative Content" class="informative-flag">I</a>:</b> <div><p>Retrieves information needed to support claims and encounter reporting. This reporting occurs at the appropriate juncture in the encounter workflow in a manual or automated fashion. For example this could occur at an initial, interim or final billing. The system may also present the information that is provided for audit and review.</p>
</div></span>
<span id="requirements"><b>Criteria <a href="https://hl7.org/fhir/versions.html#std-process" title="Normative Content" class="normative-flag">N</a>:</b></span>
<table id="statements" class="grid dict">
<tr>
<td style="padding-left: 4px;">
<span>AS.9.5#01</span>
</td>
<td style="padding-left: 4px;">
<span>SHALL</span>
</td>
<td style="padding-left: 4px;" class="requirement">
<span><div><p>The system SHALL provide the ability to render available information needed to enable the creation of claims and encounter reports for reimbursement.</p>
</div></span>
</td>
</tr>
<tr>
<td style="padding-left: 4px;">
<span>AS.9.5#02</span>
</td>
<td style="padding-left: 4px;">
<i>dependent</i>
<span>SHALL</span>
</td>
<td style="padding-left: 4px;" class="requirement">
<span><div><p>The system SHALL provide the ability to capture and render available data as required for audit and review according to scope of practice, organizational policy, and/or jurisdictional law.</p>
</div></span>
</td>
</tr>
<tr>
<td style="padding-left: 4px;">
<span>AS.9.5#03</span>
</td>
<td style="padding-left: 4px;">
<span>MAY</span>
</td>
<td style="padding-left: 4px;" class="requirement">
<span><div><p>The system MAY provide the ability to render available data in a computer readable form when needed to enable the creation of claims and encounter reports for reimbursement.</p>
</div></span>
</td>
</tr>
<tr>
<td style="padding-left: 4px;">
<span>AS.9.5#04</span>
</td>
<td style="padding-left: 4px;">
<span>MAY</span>
</td>
<td style="padding-left: 4px;" class="requirement">
<span><div><p>The system MAY provide the ability to render data, using either internal or external reporting tools, to support coding of diagnosis, procedure and outcomes.</p>
</div></span>
</td>
</tr>
</table>
</div>
</text>
<url value="http://hl7.org/ehrs/Requirements/EHRSFMR2.1-AS.9.5"/>
<version value="2.1.0"/>
<name value="AS_9_5_Support_Financial_Claims___Encounter_Reports"/>
<title
value="AS.9.5 Support Financial Claims & Encounter Reports (Function)"/>
<status value="active"/>
<date value="2024-11-26T16:30:50+00:00"/>
<publisher value="EHR WG"/>
<contact>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/ehr"/>
</telecom>
</contact>
<description
value="Support interactions with other systems, applications, and modules to enable the creation of claims and encounter reports for reimbursement."/>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
<display value="World"/>
</coding>
</jurisdiction>
<purpose
value="Retrieves information needed to support claims and encounter reporting. This reporting occurs at the appropriate juncture in the encounter workflow in a manual or automated fashion. For example this could occur at an initial, interim or final billing. The system may also present the information that is provided for audit and review."/>
<statement>
<extension
url="http://hl7.org/ehrs/StructureDefinition/requirements-dependent">
<valueBoolean value="false"/>
</extension>
<key value="EHRSFMR2.1-AS.9.5-01"/>
<label value="AS.9.5#01"/>
<conformance value="SHALL"/>
<conditionality value="false"/>
<requirement
value="The system SHALL provide the ability to render available information needed to enable the creation of claims and encounter reports for reimbursement."/>
<derivedFrom value="EHR-S_FM_R1.1 S.3.3.5#1"/>
</statement>
<statement>
<extension
url="http://hl7.org/ehrs/StructureDefinition/requirements-dependent">
<valueBoolean value="true"/>
</extension>
<key value="EHRSFMR2.1-AS.9.5-02"/>
<label value="AS.9.5#02"/>
<conformance value="SHALL"/>
<conditionality value="false"/>
<requirement
value="The system SHALL provide the ability to capture and render available data as required for audit and review according to scope of practice, organizational policy, and/or jurisdictional law."/>
<derivedFrom value="EHR-S_FM_R1.1 S.3.3.5#2"/>
</statement>
<statement>
<extension
url="http://hl7.org/ehrs/StructureDefinition/requirements-dependent">
<valueBoolean value="false"/>
</extension>
<key value="EHRSFMR2.1-AS.9.5-03"/>
<label value="AS.9.5#03"/>
<conformance value="MAY"/>
<conditionality value="false"/>
<requirement
value="The system MAY provide the ability to render available data in a computer readable form when needed to enable the creation of claims and encounter reports for reimbursement."/>
<derivedFrom value="EHR-S_FM_R1.1 S.3.3.5#3"/>
</statement>
<statement>
<extension
url="http://hl7.org/ehrs/StructureDefinition/requirements-dependent">
<valueBoolean value="false"/>
</extension>
<key value="EHRSFMR2.1-AS.9.5-04"/>
<label value="AS.9.5#04"/>
<conformance value="MAY"/>
<conditionality value="false"/>
<requirement
value="The system MAY provide the ability to render data, using either internal or external reporting tools, to support coding of diagnosis, procedure and outcomes."/>
</statement>
</Requirements>