Healthcare Financial Services IG Edition 1
0.3.0 - ci-build Saudi Arabia flag

Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Example PaymentReconciliation: Payment Reconciliation Example

Generated Narrative: PaymentReconciliation 90581

identifier: http://sni.com.sa/identifiers/paymentreconciliation/90581

status: Active

period: 2023-12-01 --> 2023-12-06

created: 2023-12-06

paymentIssuer: Bundle: type = message; timestamp = 2023-12-19 08:20:29+0000

requestor: Bundle: type = message; timestamp = 2023-12-02 19:36:29+0000

outcome: Processing Complete

disposition: Payment made for the month of December, 2023

paymentDate: 2023-12-06

PaymentAmounts

-ValueCurrency
*239.55Saudi riyal

paymentIdentifier: EFT/URN-987590432322

detail

Component - Payment: SAR241.50 (SAR)

Component - Early Fee: SAR0.00 (SAR)

Component - Payment: SAR-1.95 (SAR)

type: Payment

request: Identifier: http://saudidentalclinic.com.sa/identifiers/claim/req_29309905401

submitter: Bundle: type = message; timestamp = 2023-12-02 19:36:29+0000

response: Identifier: http://sni.com.sa/identifiers/claimresponse/res_10411448401

date: 2023-12-06

payee: Bundle: type = message; timestamp = 2023-12-02 19:36:29+0000

Amounts

-ValueCurrency
*239.55Saudi riyal