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ChargeItemDefinition FHIR Resource Proposal

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ChargeItemDefinition

Owning committee name

Financial Management

Committee Approval Date:

7 Feb 2018 (Simone Heckman, Brian Postlethwaite 2-0-1)

Contributing or Reviewing Work Groups

Patient Administration


FHIR Resource Development Project Insight ID

pending

Scope of coverage

The existing ChargeItem Resource specifies the instance of a charge item that documents billable codes for items and services rendered. The details, prices and rules associated with billing codes exist however, independent from these instances. Following up on the discussion in Zulip, such details should be kept in separate Resources and not as properties of the codes, as such things as prices may change over time and independently from the CodeSystem lifecycle.


RIM scope

-none-

Resource appropriateness

Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. This resource provides the properties that apply to the (billing) codes necessary to calculate costs and prices. The properties may differ largely depending on type and realm, therefore this resource gives only a rough structure and requires profiling for each type of billing code system.

Expected implementations

  • Any solution that tracks billing information and needs to calculate prices and cost
  • Private Insurance Providers who want to deliver structured information to patients to increase cost tranparency
  • Patient apps that want to include information on the amount and reason of the charged costs for the healthcare services a patient received
  • Interested parties: SAP, IBM, Association of Private Insurers in Germany

Content sources

• German statutory health services billing catalogue: http://www.kbv.de/html/online-ebm.php

Please note that all such catalog definitions will be realm specific and need profiles for the ChargeItemDefinition in order to be useful.

Example Scenarios

  • Invoicing

In order to determine the actual price of a ChargeItem (when becoming an Invoice.lineItem) a billing engine needs to know base/unit prices, applicable surcharges and discounts and the rules associated with their application. The ChargeItemDefinition provides this information in an exchangeable and standardized form.

Resource Relationships

Referenced by:

  • ChargeItem.definition


Timelines

The aim is to have a draft (Maturity 0) ready for 4.0 timeline.

gForge Users

brianpos simoneheckmann

When Resource Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org