ChargeItem FHIR Resource Proposal

ChargeItem

Owning committee name

Patient Administration

Committee Approval Date:

24 Jan 2017

Contributing or Reviewing Work Groups

Financial Management

FHIR Resource Development Project Insight ID

pending

Scope of coverage

ChargeItem is used to communicate statistical or billing relevant information associated with services (planned or actual). ChargeItems are placed into Patient Account resources. Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. This resource provides the individual items to track.

This resource is not an actual financial transaction (such as an item on an invoice), but is the base administrative data that may be used by a billing engine to create the financial transactions (which may be done outside FHIR).

The FHIR Claim resource does contain line items, and this ChargeItem resource provides the source material for the billing engine to create the items on the claim (which may be different due to business rules).

RIM scope

Financial Transaction

Resource appropriateness

Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. This resource provides the individual items to track.

Expected implementations

• Any solution that requires tracking billing information

Content sources

Existing normative V3 and V2 specifications

Example Scenarios

• Identify Encounters that may be billed for time spent in a facility
• Lab system sends ChargeItems containing billing codes for administered services to the patient's account
• Billing System queries patient account for all billable ChargeItems to create an Invoice/Claim
• Hospital maintains internal catalogue of statistically relevant services. All systems providing these services post ChargeItems into the Accounts of the Patients for whom these services have been provided. Customized queries can be used to analyze distribution of services among patient cohorts or developement of services provisions over time

Resource Relationships

• Reference to Account (account)
• Reference to Encounter/EpisodeOfCare (context)
• Reference to Patient|Group (subject)
• Reference to any type of Request (basedOn)
• Reference to any type of Event (service)
• Self reference to permit grouping of charges
• (May also need a reference from the Claim back to these Items)

Timelines

We have built a draft placeholder for this resource, and working with the Finance WG to refine it during the 3.0/4.0 timeline.

gForge Users

brianpos simoneheckmann

When Resource Proposal Is Complete

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