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Difference between revisions of "ChargeItem FHIR Resource Proposal"

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This page documents a [[:category:Pending FHIR Resource Proposal|Pending]] [[:category:FHIR Resource Proposal|FHIR Resource Proposal]]
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This page documents a [[:category:Approved FHIR Resource Proposal|Approved]] [[:category:FHIR Resource Proposal|FHIR Resource Proposal]]
 
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[[Category:FHIR Resource Proposal]]
 
[[Category:FHIR Resource Proposal]]
[[Category:Pending FHIR Resource Proposal]]
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[[Category:Approved FHIR Resource Proposal]]
  
  
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==Owning committee name==
 
==Owning committee name==
Patient Administration
 
  
 
<!-- The name of the committee that is proposed to have responsibility for developing and maintaining the resources. -->
 
<!-- The name of the committee that is proposed to have responsibility for developing and maintaining the resources. -->
[[YourCommitteeName]]
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[[Patient Administration]]
 
==Committee Approval Date:==
 
==Committee Approval Date:==
<i>Please enter the date that the committee approved this Resource proposal</i>
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24 Jan 2017
  
 
==Contributing or Reviewing Work Groups==
 
==Contributing or Reviewing Work Groups==
  
 
<!-- Additional work groups that may have an interest in contributing to, or reviewing  the content of the resource (optional) -->
 
<!-- Additional work groups that may have an interest in contributing to, or reviewing  the content of the resource (optional) -->
* Financial Management
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Financial Management
  
 
==FHIR Resource Development Project Insight ID==
 
==FHIR Resource Development Project Insight ID==
  
 
<!-- Please specify the id of your work group’s PSS for doing FHIR work.  (If submitted but not yet approved, just write “pending”.) The link to the PSS template can be found here: http://gforge.hl7.org/gf/download/docmanfileversion/6832/9398/HL7FHIR_DSTUballotPSS-20120529.doc -->
 
<!-- Please specify the id of your work group’s PSS for doing FHIR work.  (If submitted but not yet approved, just write “pending”.) The link to the PSS template can be found here: http://gforge.hl7.org/gf/download/docmanfileversion/6832/9398/HL7FHIR_DSTUballotPSS-20120529.doc -->
 +
 +
pending
  
 
==Scope of coverage==
 
==Scope of coverage==
  
<!-- Define the full scope of coverage for the resource.  The scope must be clearly delineated such that it does not overlap with any other existing or expected resource. The scope will be used to govern "what is the set of potential applications to consider when evaluating what elements are 'core' – i.e. in the 80%"
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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.
  
Scope should consider numerous aspects of breadth of scope, including:
+
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).
* Subject: Human vs. non-human vs. non-patient (e.g. lab bench medicine)
 
* Disciplines: Environmental Health, Palliative, Respiratory, Psychology, Maternity, Clinical Research
 
* Delivery environment (Community, Geriatric, Home care, Emergency, Inpatient, Intensive, Neonatal, Pediatric, Primary)
 
* Locale: Country, region
 
 
 
As a rule, resources should encompass all of these aspects.
 
-->
 
  
ChargeItem is used to communicate statistical or billing relevant codes that apply to delivered services.
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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).
ChargeItems are associated with an Account resource.  
 
  
 
==RIM scope==
 
==RIM scope==
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* Have the characteristics of high cohesion & low coupling – need to explore whether coupling is good some places, not elsewhere – layers from Bo’s document  
 
* Have the characteristics of high cohesion & low coupling – need to explore whether coupling is good some places, not elsewhere – layers from Bo’s document  
 
  -->
 
  -->
 +
 +
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==
 
==Expected implementations==
  
 
<!--Key resources are justified by CCDA, for resources not deemed "key", what interest is there by implementers in using this particular resource. Provide named implementations if possible - ideally provide multiple independent implementations. -->
 
<!--Key resources are justified by CCDA, for resources not deemed "key", what interest is there by implementers in using this particular resource. Provide named implementations if possible - ideally provide multiple independent implementations. -->
 +
*Any solution that requires tracking billing information
  
 
==Content sources==
 
==Content sources==
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Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider? -->
 
Are there any source specifications that you wish to consult but are concerned about access to or expertise to consider? -->
 +
Existing normative V3 and V2 specifications
  
 
==Example Scenarios==
 
==Example Scenarios==
  
 
<!-- Provide a listing of the types of scenarios to be represented in the examples produced for this resource.  They should demonstrate the full scope of the resource and allow exercising of the resources capabilities (full element coverage, inclusion & omission of optional elements, repeating and singleton repeating elements, etc.) -->
 
<!-- Provide a listing of the types of scenarios to be represented in the examples produced for this resource.  They should demonstrate the full scope of the resource and allow exercising of the resources capabilities (full element coverage, inclusion & omission of optional elements, repeating and singleton repeating elements, etc.) -->
 +
 +
* 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==
 
==Resource Relationships==
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* Reference to any type of Request (basedOn)
 
* Reference to any type of Request (basedOn)
 
* Reference to any type of Event (service)
 
* Reference to any type of Event (service)
 
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* Self reference to permit grouping of charges
 +
* (May also need a reference from the Claim back to these Items)
  
 
==Timelines==
 
==Timelines==
  
 
<!-- Indicate the target date for having the resource complete from a committee perspective and ready for vetting and voting -->
 
<!-- Indicate the target date for having the resource complete from a committee perspective and ready for vetting and voting -->
 +
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==
 
==gForge Users==
  
 
<!-- Identify the userids who will require commit access to gForge to maintain the resource.  (Ensure all users have registered for gForge.) -->
 
<!-- Identify the userids who will require commit access to gForge to maintain the resource.  (Ensure all users have registered for gForge.) -->
 +
brianpos
 +
simoneheckmann
  
 
==When Resource Proposal Is Complete==
 
==When Resource Proposal Is Complete==
 
'''When you have completed your proposal, please send an email to [mailto:FMGcontact@HL7.org FMGcontact@HL7.org]'''
 
'''When you have completed your proposal, please send an email to [mailto:FMGcontact@HL7.org FMGcontact@HL7.org]'''

Latest revision as of 22:11, 13 February 2017



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