Current Build
Financial Management Work GroupMaturity Level: 2 Trial Use Compartments: Practitioner

Detailed Descriptions for the elements in the PaymentReconciliation resource.

PaymentReconciliation
Element IdPaymentReconciliation
Definition

This resource provides payment details and claim references supporting a bulk payment.

Control1..1
PaymentReconciliation.identifier
Element IdPaymentReconciliation.identifier
Definition

The Response business identifier.

NoteThis is a business identifer, not a resource identifier (see discussion)
Control0..*
TypeIdentifier
PaymentReconciliation.status
Element IdPaymentReconciliation.status
Definition

The status of the resource instance.

Control0..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)
Summarytrue
Comments

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

PaymentReconciliation.period
Element IdPaymentReconciliation.period
Definition

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

Control0..1
TypePeriod
PaymentReconciliation.created
Element IdPaymentReconciliation.created
Definition

The date when the resource was created.

Control0..1
TypedateTime
PaymentReconciliation.organization
Element IdPaymentReconciliation.organization
Definition

The Insurer who produced this adjudicated response.

Control0..1
TypeReference(Organization)
PaymentReconciliation.request
Element IdPaymentReconciliation.request
Definition

Original request resource reference.

Control0..1
TypeReference(ProcessRequest)
PaymentReconciliation.outcome
Element IdPaymentReconciliation.outcome
Definition

Transaction status: error, complete.

Control0..1
Terminology BindingRemittanceOutcome (Required)
Typecode
PaymentReconciliation.disposition
Element IdPaymentReconciliation.disposition
Definition

A description of the status of the adjudication.

Control0..1
Typestring
PaymentReconciliation.requestProvider
Element IdPaymentReconciliation.requestProvider
Definition

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

Control0..1
TypeReference(Practitioner | PractitionerRole | Organization)
PaymentReconciliation.detail
Element IdPaymentReconciliation.detail
Definition

List of individual settlement amounts and the corresponding transaction.

Control0..*
PaymentReconciliation.detail.type
Element IdPaymentReconciliation.detail.type
Definition

Code to indicate the nature of the payment, adjustment, funds advance, etc.

Control1..1
Terminology BindingPayment Type Codes (Example)
TypeCodeableConcept
PaymentReconciliation.detail.request
Element IdPaymentReconciliation.detail.request
Definition

The claim or financial resource.

Control0..1
TypeReference(Any)
PaymentReconciliation.detail.response
Element IdPaymentReconciliation.detail.response
Definition

The claim response resource.

Control0..1
TypeReference(Any)
PaymentReconciliation.detail.submitter
Element IdPaymentReconciliation.detail.submitter
Definition

The Organization which submitted the claim or financial transaction.

Control0..1
TypeReference(Organization)
PaymentReconciliation.detail.payee
Element IdPaymentReconciliation.detail.payee
Definition

The organization which is receiving the payment.

Control0..1
TypeReference(Organization)
PaymentReconciliation.detail.date
Element IdPaymentReconciliation.detail.date
Definition

The date of the invoice or financial resource.

Control0..1
Typedate
PaymentReconciliation.detail.amount
Element IdPaymentReconciliation.detail.amount
Definition

Amount paid for this detail.

Control0..1
TypeMoney
PaymentReconciliation.form
Element IdPaymentReconciliation.form
Definition

The form to be used for printing the content.

Control0..1
Terminology BindingForm Codes (Example)
TypeCodeableConcept
PaymentReconciliation.total
Element IdPaymentReconciliation.total
Definition

Total payment amount.

Control0..1
TypeMoney
PaymentReconciliation.processNote
Element IdPaymentReconciliation.processNote
Definition

Suite of notes.

Control0..*
PaymentReconciliation.processNote.type
Element IdPaymentReconciliation.processNote.type
Definition

The note purpose: Print/Display.

Control0..1
Terminology BindingNoteType (Required)
Typecode
PaymentReconciliation.processNote.text
Element IdPaymentReconciliation.processNote.text
Definition

The note text.

Control0..1
Typestring