Difference between revisions of "Reconciliation FHIR Resource Proposal"
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Latest revision as of 17:48, 19 February 2015
This page documents a Approved FHIR Resource Proposal
Contents
- 1 Reconciliation
- 1.1 Owning committee name
- 1.2 Contributing or Reviewing Work Groups
- 1.3 FHIR Resource Development Project Insight ID
- 1.4 Scope of coverage
- 1.5 RIM scope
- 1.6 Resource appropriateness
- 1.7 Expected implementations
- 1.8 Content sources
- 1.9 Example Scenarios
- 1.10 Resource Relationships
- 1.11 Timelines
- 1.12 gForge Users
Reconciliation
Owning committee name
Contributing or Reviewing Work Groups
- Patient Administration
FHIR Resource Development Project Insight ID
994
Scope of coverage
The Reconciliation resource provides application level error information or the bulk payment details associated with a payment by the payor for goods and services rendered by a provider to patients covered by insurance plans offered by that payor. These are the payment reconciliation details which align to the individual payment amounts indicated on discrete ClaimResponses.
RIM scope
Payment (classClode=XACT, moodCode=EVN))
Resource appropriateness
Bulk payments need to provide a means to associate the amounts paid again specific Claims to the bulk payment itself in order to reconcile provider accounts receivable.
Expected implementations
This is a key resource expected by most Healthcare billing implementations where Health care products and services are provided.
Content sources
Existing normative V3 and V2 specifications, Canadian Specifications, X12, NCPDP
Example Scenarios
Resource Relationships
Refers to a ReconciliationRequest.
Timelines
Ready for DSTU 2
gForge Users
paulknapp
