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| − | <div style="float: left;">[[Image:OpenHotTopic.GIF|35px| ]]</div> | + | Current version: https://confluence.hl7.org/display/FHIR/Invoice+FHIR+Resource+Proposal<div style="float: left;">[[Image:OpenHotTopic.GIF|35px| ]]</div> |
<div style="background:#F0F0F0"> | <div style="background:#F0F0F0"> | ||
This page documents a [[:category:Pending FHIR Resource Proposal|Pending]] [[:category:FHIR Resource Proposal|FHIR Resource Proposal]] | This page documents a [[:category:Pending FHIR Resource Proposal|Pending]] [[:category:FHIR Resource Proposal|FHIR Resource Proposal]] | ||
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==Committee Approval Date:== | ==Committee Approval Date:== | ||
| − | + | FM Approval (17 Jan 2019 Paul Knapp/Brian Postlethwaite 10-0-0) | |
| + | PA Approval (4 April 2018 Brian Postlethwaite/Simone Heckmann 3-0-0) | ||
==Contributing or Reviewing Work Groups== | ==Contributing or Reviewing Work Groups== | ||
| Line 43: | Line 44: | ||
==Scope of coverage== | ==Scope of coverage== | ||
| − | + | In cases where the provider bills another party directly for products and/or services, an Invoice is used. | |
| − | + | An invoice is a financial instrument issued by a Healthcare provider to a patient or other party indicating the goods and services performed with their quantities and prices. | |
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | An invoice is a financial | ||
| − | |||
| + | The Claim resource is constricted to use cases where a request for reimbursement is sent on behalf of the insured to an insurance for reimbursement under a specified policy. | ||
| + | An Invoice can use ChargeItems in an Account to provide the details to support the creation of an Invoice. | ||
==RIM scope== | ==RIM scope== | ||
| − | + | FinancialTransaction[MoodCode=RQO] | |
| − | |||
| − | |||
==Resource appropriateness== | ==Resource appropriateness== | ||
| − | + | Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. This resource provides the details of the invoice, and which items are allocated to it. | |
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | |||
| − | + | Competing invoicing standards such as EDIFACT or X12 are aiming at inter-organisational exchange and do not offer traceable links in FHIR to the services rendered. | |
==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 tracks billing information and needs to issue invoices | + | *Any solution that tracks billing information and needs to issue invoices |
| − | * | + | *Providers who want to deliver structured information to patients to increase cost transparency |
| − | * Patient | + | *A Patient facing application that handles healthcare invoice information, such as costs, amounts and reasons of the charged costs for the healthcare services a patient received |
| − | * Interested | + | *Interested implementing organizations: SAP, IBM, Association of Private Insurers in Germany |
| + | *more interested parties: https://chat.fhir.org/#narrow/stream/4-implementers/topic/Invoices | ||
==Content sources== | ==Content sources== | ||
| Line 105: | Line 89: | ||
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? --> | ||
| − | + | Content for the resource has considered the existing normative V3 and V2 specifications and other knowledge of invoicing in general | |
==Example Scenarios== | ==Example Scenarios== | ||
| Line 111: | Line 95: | ||
<!-- 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.) --> | ||
| − | * Invoicing between systems that primarily interact using FHIR API | + | *Invoicing between systems that primarily interact using FHIR API |
| + | |||
| + | *Patient Apps | ||
| − | |||
Patient apps may chose to not only give patients access to their health data but also to the charges assoicated with them (e.g. provide insight into the cost for medications, treatments and immunizations). Such apps will require structured invoices to allow association between the charges and the services rendered. | Patient apps may chose to not only give patients access to their health data but also to the charges assoicated with them (e.g. provide insight into the cost for medications, treatments and immunizations). Such apps will require structured invoices to allow association between the charges and the services rendered. | ||
Apps can provide abilities to trace and compare costs or deliver additional information as to the meaning of specific billing codes. | Apps can provide abilities to trace and compare costs or deliver additional information as to the meaning of specific billing codes. | ||
| + | |||
| + | These internally provider created and processed FHIR based invoices may be mapped to other standards such as X12 for posting in external systems. | ||
==Resource Relationships== | ==Resource Relationships== | ||
| Line 128: | Line 115: | ||
Reference to resources is really only relevant at the "same or higher level" (Bo – fix this wording) | Reference to resources is really only relevant at the "same or higher level" (Bo – fix this wording) | ||
--> | --> | ||
| − | * Reference to Account (account) | + | *Reference to Account (account) |
| − | * Reference to ChargeItems (items) | + | *Reference to ChargeItems (items) |
| − | * Reference to Encounter/EpisodeOfCare (via Account) (context) | + | *Reference to Encounter/EpisodeOfCare (via Account) (context) |
| − | * Reference to Patient|Group (subject) | + | *Reference to Patient|Group (subject) |
| − | * Reference to any type of Request/Referal (basedOn) (via Account) | + | *Reference to any type of Request/Referal (basedOn) (via Account) |
| − | * Reference to any type of Event (service) | + | *Reference to any type of Event (service) |
| − | * Payor (Organization|Patient|RelatedPerson) | + | *Payor (Organization|Patient|RelatedPerson) |
Referenced by: | Referenced by: | ||
| − | * Claim | + | |
| + | *Claim | ||
| Line 143: | Line 131: | ||
<!-- 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 --> | ||
| − | + | A draft is included in R4. | |
==gForge Users== | ==gForge Users== | ||
| Line 150: | Line 138: | ||
brianpos | brianpos | ||
simoneheckmann | simoneheckmann | ||
| + | paulknapp | ||
==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 15:08, 31 October 2019
Current version: https://confluence.hl7.org/display/FHIR/Invoice+FHIR+Resource+Proposal
This page documents a Pending FHIR Resource Proposal
Contents
- 1 Invoice
- 1.1 Owning committee name
- 1.2 Committee Approval Date:
- 1.3 Contributing or Reviewing Work Groups
- 1.4 FHIR Resource Development Project Insight ID
- 1.5 Scope of coverage
- 1.6 RIM scope
- 1.7 Resource appropriateness
- 1.8 Expected implementations
- 1.9 Content sources
- 1.10 Example Scenarios
- 1.11 Resource Relationships
- 1.12 Timelines
- 1.13 gForge Users
- 1.14 When Resource Proposal Is Complete
Invoice
Owning committee name
Committee Approval Date:
FM Approval (17 Jan 2019 Paul Knapp/Brian Postlethwaite 10-0-0) PA Approval (4 April 2018 Brian Postlethwaite/Simone Heckmann 3-0-0)
Contributing or Reviewing Work Groups
FHIR Resource Development Project Insight ID
pending
Scope of coverage
In cases where the provider bills another party directly for products and/or services, an Invoice is used. An invoice is a financial instrument issued by a Healthcare provider to a patient or other party indicating the goods and services performed with their quantities and prices.
The Claim resource is constricted to use cases where a request for reimbursement is sent on behalf of the insured to an insurance for reimbursement under a specified policy.
An Invoice can use ChargeItems in an Account to provide the details to support the creation of an Invoice.
RIM scope
FinancialTransaction[MoodCode=RQO]
Resource appropriateness
Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. This resource provides the details of the invoice, and which items are allocated to it.
Competing invoicing standards such as EDIFACT or X12 are aiming at inter-organisational exchange and do not offer traceable links in FHIR to the services rendered.
Expected implementations
- Any solution that tracks billing information and needs to issue invoices
- Providers who want to deliver structured information to patients to increase cost transparency
- A Patient facing application that handles healthcare invoice information, such as costs, amounts and reasons of the charged costs for the healthcare services a patient received
- Interested implementing organizations: SAP, IBM, Association of Private Insurers in Germany
- more interested parties: https://chat.fhir.org/#narrow/stream/4-implementers/topic/Invoices
Content sources
Content for the resource has considered the existing normative V3 and V2 specifications and other knowledge of invoicing in general
Example Scenarios
- Invoicing between systems that primarily interact using FHIR API
- Patient Apps
Patient apps may chose to not only give patients access to their health data but also to the charges assoicated with them (e.g. provide insight into the cost for medications, treatments and immunizations). Such apps will require structured invoices to allow association between the charges and the services rendered.
Apps can provide abilities to trace and compare costs or deliver additional information as to the meaning of specific billing codes.
These internally provider created and processed FHIR based invoices may be mapped to other standards such as X12 for posting in external systems.
Resource Relationships
- Reference to Account (account)
- Reference to ChargeItems (items)
- Reference to Encounter/EpisodeOfCare (via Account) (context)
- Reference to Patient|Group (subject)
- Reference to any type of Request/Referal (basedOn) (via Account)
- Reference to any type of Event (service)
- Payor (Organization|Patient|RelatedPerson)
Referenced by:
- Claim
Timelines
A draft is included in R4.
gForge Users
brianpos simoneheckmann paulknapp
When Resource Proposal Is Complete
When you have completed your proposal, please send an email to FMGcontact@HL7.org
