Resource type: invoice

Description

Invoice containing collected ChargeItems from an Account with calculated individual and total price for Billing purpose.

Elements

PathShortDefinitionComments
Invoice containing ChargeItems from an AccountInvoice containing collected ChargeItems from an Account with calculated individual and total price for Billing purpose.
identifierBusiness Identifier for itemIdentifier of this Invoice, often used for reference in corresponcence about this invoice or for tracking of payments.
statusdraft | issued | balanced | cancelled | entered-in-errorThe current state of the Invoice.
cancelledReasonReason for cancellation of this InvoiceIn case of Invoice cancellation a reason must be given (entered in error, superseded by corrected invoice etc.).Derived Profiles may chose to add invariants requiring this field to be populated if either priceOverride or factorOverride have been filled.
typeType of InvoiceType of Invoice depending on domain, realm an usage (eg. internal/external, dental, preliminary).
subjectRecipient(s) of goods and servicesThe individual or set of individuals receiving the goods and services billed in this invoice.
recipientRecipient of this invoiceThe individual or Organization responsible for balancing of this invoice.
dateInvoice date / posting dateDate/time(s) of when this Invoice was posted.The list of types may be constrained as appropriate for the type of charge item.
participantParticipant in creation of this InvoiceIndicates who or what performed or participated in the charged service.
participant.idUnique id for inter-element referencingUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
participant.extensionAdditional content defined by implementationsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
participant.modifierExtensionExtensions that cannot be ignored even if unrecognizedMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
participant.roleType of involevent in creation of this InvoiceDescribes the type of involvement (e.g. transcriptionist, creator etc.). If the invoice has been created automatically, the Participant may be a billing engine or another kind of device.
participant.actorIndividual who was involvedThe device, practitioner, etc. who performed or participated in the service.
issuerIssuing Organization of InvoiceThe organizationissuing the Invoice.Practitioners and Devices can be associated with multiple organizations. It has to be made clear, on behalf of which Organization the services have been rendered.
accountAccount that is being balancedAccount which is supposed to be balanced with this Invoice.Systems posting the ChargeItems might not always be able to determine, which accounts the Items need to be places into. It is up to the potprocessing Financial System to apply internal rules to decide based on the Encounter/EpisodeOfCare/Patient/Coverage context and the type of ChargeItem, which Account is appropriate.
lineItemLine items of this InvoiceEach line item represents one charge for goods ond services rendered. Details such as date, code and amount are found in the referenced ChargeItem resource.
lineItem.idUnique id for inter-element referencingUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
lineItem.extensionAdditional content defined by implementationsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
lineItem.modifierExtensionExtensions that cannot be ignored even if unrecognizedMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
lineItem.sequenceSequence number of line itemSequence in which the items appear on the invoice.
lineItem.chargeItem[x]Reference to ChargeItem containing details of this line item or an inline billing codeThe ChargeItem contains information such as the billing code, date, amount etc. Of no further details are required for the lineItem, inline billing codes can be added using the CodeableConcept data type instead of the Reference.
lineItem.priceComponentComponents of total line item priceThe price for a ChargeItem may be calculated as a base price with surcharges/deductions that apply in certain conditions. A ChargeItemDefinition resource that defines the prices, factors and conditions that apply to a billing code is currently under developement. The priceComponent element can be used to offer transparency to the recipient of the Invoice of how the prices have been calculated.
lineItem.priceComponent.idUnique id for inter-element referencingUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
lineItem.priceComponent.extensionAdditional content defined by implementationsMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
lineItem.priceComponent.modifierExtensionExtensions that cannot be ignored even if unrecognizedMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
lineItem.priceComponent.typebase | surcharge | deduction | discount | tax | informationalThis code identifies the type of the component.
lineItem.priceComponent.codeCode identifying the specific componentA code that identifies the component. Codes may be used to differentiate between kinds of taxes, surcharges, discounts etc.
lineItem.priceComponent.factorFactor used for calculating this componentThe factor that has been applied on the base price for calculating this component.There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.
lineItem.priceComponent.amountMonetary amount associated with this componentThe amount calculated for this component.There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.
totalPriceComponentComponents of Invoice totalThe total amount for the Invoice may be calculated as the sum of the line items with surcharges/deductions that apply in certain conditions. The priceComponent element can be used to offer transparency to the recipient of the Invoice of how the total price was calculated.
totalNetNet total of this InvoiceInvoice total , taxes excluded.There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.
totalGrossGross total of this InvoiceInvoice total, tax included.There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overriden.
paymentTermsPayment detailsPayment details such as banking details, period of payment, deductables, methods of payment.Derived Profiles may chose to add invariants requiring this field to be populated if either priceOverride or factorOverride have been filled.
noteComments made about the invoiceComments made about the invoice by the issuer, subject or other participants.


Scope and Usage

Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. An invoice is a financial document issued by a healthcare provider to a patient or a payer indicating the goods and services (ChargeItems) performed with their quantities and prices.

Example implementations:

Boundaries and Relationships

The existing Claim resource is constricted to use cases where Claims are sent to insurances for reimbursement, in a message-like style. It neither references ChargeItems nor Accounts.

Competing invoicing standards such as EDIFACT or X12 are aiming at inter-organisational exchange and do not offer human readable representations or traceable links to services rendered which is a requirement for invoicing towards patients. This resource is used where existing ChargeItems in an Account are collected to create an Invoice to be sent out to Individuals or Organizations in a structured way. The invoice is the hospital’s view, whereas the Claim is the payer’s view on the performed services.

Since the indiviual ChargeItem resources that make the line items of the Invoice do not carry any pricing information, ChargeItemDefinitions will have to be applied to the ChargeItems in order to calculate the price components for the Invoice depending on the context of the ChargeItem



Search Parameters

accountAccount that is being balancedInvoice.account
dateInvoice date / posting dateInvoice.date
identifierBusiness Identifier for itemInvoice.identifier
issuerIssuing Organization of InvoiceInvoice.issuer
participantIndividual who was involvedInvoice.participant.actor
participant-roleType of involevent in creation of this InvoiceInvoice.participant.role
patientRecipient(s) of goods and servicesInvoice.subject.where(resolve() is Patient)
recipientRecipient of this invoiceInvoice.recipient
statusdraft | issued | balanced | cancelled | entered-in-errorInvoice.status
subjectRecipient(s) of goods and servicesInvoice.subject
totalgrossGross total of this InvoiceInvoice.totalGross
totalnetNet total of this InvoiceInvoice.totalNet
typeType of InvoiceInvoice.type

Extension Definitions

These are extension definitions for this resource defined by the spec