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Financial Management icon Work GroupMaturity Level: 2 Trial UseSecurity Category: Patient Compartments: Practitioner

Detailed Descriptions for the elements in the PaymentReconciliation resource.

PaymentReconciliation
Element IdPaymentReconciliation
Definition

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

Short DisplayPaymentReconciliation resource
Cardinality0..*
TypeDomainResource
Summaryfalse
PaymentReconciliation.identifier
Element IdPaymentReconciliation.identifier
Definition

A unique identifier assigned to this payment reconciliation.

Short DisplayBusiness Identifier for a payment reconciliation
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..*
TypeIdentifier
Requirements

Allows payment reconciliations to be distinguished and referenced.

Summaryfalse
PaymentReconciliation.type
Element IdPaymentReconciliation.type
Definition

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

Short DisplayCategory of payment
Cardinality1..1
Terminology BindingPayment Type Codes (Extensible)
TypeCodeableConcept
Summarytrue
PaymentReconciliation.status
Element IdPaymentReconciliation.status
Definition

The status of the resource instance.

Short Displayactive | cancelled | draft | entered-in-error
Cardinality1..1
Terminology BindingFinancial Resource Status Codes (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)
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'.

Summarytrue
Comments

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

PaymentReconciliation.kind
Element IdPaymentReconciliation.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 DisplayWorkflow originating payment
Cardinality0..1
Terminology BindingPayment Kind (Extensible)
TypeCodeableConcept
Summaryfalse
PaymentReconciliation.period
Element IdPaymentReconciliation.period
Definition

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

Short DisplayPeriod covered
Cardinality0..1
TypePeriod
Requirements

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

Summarytrue
PaymentReconciliation.created
Element IdPaymentReconciliation.created
Definition

The date when the resource was created.

Short DisplayCreation date
Cardinality1..1
TypedateTime
Requirements

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

Summarytrue
PaymentReconciliation.enterer
Element IdPaymentReconciliation.enterer
Definition

Payment enterer if not the actual payment issuer.

Short DisplayWho entered the payment
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization)
Summaryfalse
PaymentReconciliation.issuerType
Element IdPaymentReconciliation.issuerType
Definition

The type of the source such as patient or insurance.

Short DisplayNature of the source
Cardinality0..1
Terminology BindingPayment Issuer Type (Extensible)
TypeCodeableConcept
Requirements

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

Summaryfalse
PaymentReconciliation.paymentIssuer
Element IdPaymentReconciliation.paymentIssuer
Definition

The party who generated the payment.

Short DisplayParty generating payment
Cardinality0..1
TypeReference(Organization | Patient | Person | RelatedPerson)
Requirements

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

Summarytrue
Comments

This party is also responsible for the reconciliation.

PaymentReconciliation.request
Element IdPaymentReconciliation.request
Definition

Original request resource reference.

Short DisplayReference to requesting resource
Cardinality0..1
TypeReference(Task)
Requirements

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

Summaryfalse
PaymentReconciliation.requestor
Element IdPaymentReconciliation.requestor
Definition

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

Short DisplayResponsible practitioner
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization)
Requirements

Need to identify the party responsible for the request.

Summaryfalse
PaymentReconciliation.outcome
Element IdPaymentReconciliation.outcome
Definition

The outcome of a request for a reconciliation.

Short Displayqueued | complete | error | partial
Cardinality0..1
Terminology BindingPaymentOutcome (Required)
Typecode
Requirements

To advise the requestor of an overall processing outcome.

Summaryfalse
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 IdPaymentReconciliation.disposition
Definition

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

Short DisplayDisposition message
Cardinality0..1
Typestring
Requirements

Provided for user display.

Summaryfalse
PaymentReconciliation.date
Element IdPaymentReconciliation.date
Definition

The date of payment as indicated on the financial instrument.

Short DisplayWhen payment issued
Cardinality1..1
Typedate
Requirements

To advise the payee when payment can be expected.

Summarytrue
PaymentReconciliation.location
Element IdPaymentReconciliation.location
Definition

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

Short DisplayWhere payment collected
Cardinality0..1
TypeReference(Location)
Summaryfalse
PaymentReconciliation.method
Element IdPaymentReconciliation.method
Definition

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

Short DisplayPayment instrument
Cardinality0..1
Terminology Bindinghl7VS-paymentMethodCode icon (Extensible)
TypeCodeableConcept
Summaryfalse
PaymentReconciliation.cardBrand
Element IdPaymentReconciliation.cardBrand
Definition

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

Short DisplayType of card
Cardinality0..1
Typestring
Summaryfalse
PaymentReconciliation.accountNumber
Element IdPaymentReconciliation.accountNumber
Definition

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

Short DisplayDigits for verification
Cardinality0..1
Typestring
Summaryfalse
PaymentReconciliation.expirationDate
Element IdPaymentReconciliation.expirationDate
Definition

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

Short DisplayExpiration year-month
Cardinality0..1
Typedate
Summaryfalse
PaymentReconciliation.processor
Element IdPaymentReconciliation.processor
Definition

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

Short DisplayProcessor name
Cardinality0..1
Typestring
Summaryfalse
PaymentReconciliation.referenceNumber
Element IdPaymentReconciliation.referenceNumber
Definition

The check number, eft reference, car processor reference.

Short DisplayCheck number or payment reference
Cardinality0..1
Typestring
Summaryfalse
PaymentReconciliation.authorization
Element IdPaymentReconciliation.authorization
Definition

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

Short DisplayAuthorization number
Cardinality0..1
Typestring
Summaryfalse
PaymentReconciliation.tenderedAmount
Element IdPaymentReconciliation.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 DisplayAmount offered by the issuer
Cardinality0..1
TypeMoney
Summaryfalse
PaymentReconciliation.returnedAmount
Element IdPaymentReconciliation.returnedAmount
Definition

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

Short DisplayAmount returned by the receiver
Cardinality0..1
TypeMoney
Summaryfalse
PaymentReconciliation.amount
Element IdPaymentReconciliation.amount
Definition

Total payment amount as indicated on the financial instrument.

Short DisplayTotal amount of Payment
Cardinality1..1
TypeMoney
Requirements

Needed to provide the actual payment amount.

Summarytrue
PaymentReconciliation.paymentIdentifier
Element IdPaymentReconciliation.paymentIdentifier
Definition

Issuer's unique identifier for the payment instrument.

Short DisplayBusiness identifier for the payment
Cardinality0..1
TypeIdentifier
Requirements

Enable the receiver to reconcile when payment is received.

Summaryfalse
Comments

For example: EFT number or check number.

PaymentReconciliation.allocation
Element IdPaymentReconciliation.allocation
Definition

Distribution of the payment amount for a previously acknowledged payable.

Short DisplaySettlement particulars
Cardinality0..*
Requirements

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

Summaryfalse
PaymentReconciliation.allocation.identifier
Element IdPaymentReconciliation.allocation.identifier
Definition

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

Short DisplayBusiness identifier of the payment detail
NoteThis is a business identifier, not a resource identifier (see discussion)
Cardinality0..1
TypeIdentifier
Requirements

Needed for reconciliation of payments.

Summaryfalse
PaymentReconciliation.allocation.predecessor
Element IdPaymentReconciliation.allocation.predecessor
Definition

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

Short DisplayBusiness identifier of the prior payment detail
Cardinality0..1
TypeIdentifier
Requirements

Needed for reconciliation of payments.

Summaryfalse
PaymentReconciliation.allocation.target
Element IdPaymentReconciliation.allocation.target
Definition

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

Short DisplaySubject of the payment
Cardinality0..1
TypeReference(Claim | Account | Invoice | ChargeItem | Encounter | Contract)
Summaryfalse
PaymentReconciliation.allocation.targetItem[x]
Element IdPaymentReconciliation.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 DisplaySub-element of the subject
Cardinality0..1
Typestring|Identifier|positiveInt
[x] NoteSee Choice of Datatypes for further information about how to use [x]
Summaryfalse
PaymentReconciliation.allocation.encounter
Element IdPaymentReconciliation.allocation.encounter
Definition

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

Short DisplayApplied-to encounter
Cardinality0..1
TypeReference(Encounter)
Summaryfalse
PaymentReconciliation.allocation.account
Element IdPaymentReconciliation.allocation.account
Definition

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

Short DisplayApplied-to account
Cardinality0..1
TypeReference(Account)
Summaryfalse
PaymentReconciliation.allocation.type
Element IdPaymentReconciliation.allocation.type
Definition

Code to indicate the nature of the payment.

Short DisplayCategory of payment
Cardinality0..1
Terminology BindingPayment Type Codes (Extensible)
TypeCodeableConcept
Requirements

Needed to provide context for the amount.

Summaryfalse
Comments

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

PaymentReconciliation.allocation.submitter
Element IdPaymentReconciliation.allocation.submitter
Definition

The party which submitted the claim or financial transaction.

Short DisplaySubmitter of the request
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization)
Requirements

Needed for audit and validation.

Summaryfalse
PaymentReconciliation.allocation.response
Element IdPaymentReconciliation.allocation.response
Definition

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

Short DisplayResponse committing to a payment
Cardinality0..1
TypeReference(ClaimResponse)
Requirements

Needed to provide a linkage to the payment commitment.

Summaryfalse
PaymentReconciliation.allocation.date
Element IdPaymentReconciliation.allocation.date
Definition

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

Short DisplayDate of commitment to pay
Cardinality0..1
Typedate
Requirements

Needed for audit and validation.

Summaryfalse
PaymentReconciliation.allocation.responsible
Element IdPaymentReconciliation.allocation.responsible
Definition

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

Short DisplayContact for the response
Cardinality0..1
TypeReference(PractitionerRole)
Requirements

To provide contact information.

Summaryfalse
PaymentReconciliation.allocation.payee
Element IdPaymentReconciliation.allocation.payee
Definition

The party which is receiving the payment.

Short DisplayRecipient of the payment
Cardinality0..1
TypeReference(Practitioner | PractitionerRole | Organization)
Requirements

Needed for audit and validation.

Summaryfalse
PaymentReconciliation.allocation.amount
Element IdPaymentReconciliation.allocation.amount
Definition

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

Short DisplayAmount allocated to this payable
Cardinality0..1
TypeMoney
Requirements

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

Summaryfalse
PaymentReconciliation.formCode
Element IdPaymentReconciliation.formCode
Definition

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

Short DisplayPrinted form identifier
Cardinality0..1
Terminology BindingForm Codes (Example)
TypeCodeableConcept
Requirements

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

Summaryfalse
Comments

May be needed to identify specific jurisdictional forms.

PaymentReconciliation.processNote
Element IdPaymentReconciliation.processNote
Definition

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

Short DisplayNote concerning processing
Cardinality0..*
Requirements

Provides the specific textual explanations associated with the processing.

Summaryfalse
PaymentReconciliation.processNote.type
Element IdPaymentReconciliation.processNote.type
Definition

The business purpose of the note text.

Short Displaydisplay | print | printoper
Cardinality0..1
Terminology BindingNoteType (Required)
Typecode
Requirements

To convey the expectation for when the text is used.

Summaryfalse
PaymentReconciliation.processNote.text
Element IdPaymentReconciliation.processNote.text
Definition

The explanation or description associated with the processing.

Short DisplayNote explanatory text
Cardinality0..1
Typestring
Requirements

Required to provide human readable explanation.

Summaryfalse