Healthcare Financial Services IG Edition 1
0.3.0 - STU-Ballot 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

Resource Profile: NphiesPaymentReconciliation - Detailed Descriptions

Draft as of 2025-07-30

Definitions for the payment-reconciliation resource profile.

Guidance on how to interpret the contents of this table can be foundhere

0. PaymentReconciliation
Definition

This resource provides the details including amount of a payment and allocates the payment items being paid.

ShortPaymentReconciliation resource
Control0..*
Is Modifierfalse
Summaryfalse
Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
BV-00053: PaymentReconciliation period end date is after PaymentReconciliation created date. (period.exists() implies created.exists() implies period.end >= created)
BV-00191: The PaymentReconciliation identifier does not exist. (identifier.exists())
BV-00194: The PaymentReconciliation identifier does not exist. (identifier.exists() implies identifier.value.exists())
BV-00337: PaymentReconciliation status is not using the specified value 'active'. (status.exists() implies status='active')
BV-00338: PaymentReconciliation outcome is not using the specified value 'complete'. (outcome.exists() implies outcome='complete')
BV-00361: PaymentReconciliation created date cannot be in the future. (created.exists() implies created <= now())
2. PaymentReconciliation.id
Definition

The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

ShortLogical id of this artifact
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Control10..1
Typeidstring
Is Modifierfalse
Summarytrue
Max Length:64
4. PaymentReconciliation.meta
Definition

The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

ShortMetadata about the resource
Control10..1
TypeMeta
Is Modifierfalse
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
6. PaymentReconciliation.meta.profile
Definition

A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.


A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

ShortProfiles this resource claims to conform to
Comments

It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

Control10..*
Typecanonical(DP_canonical)(StructureDefinition)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
8. PaymentReconciliation.implicitRules
Definition

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

ShortA set of rules under which this content was created
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Control0..1
Typeuri
Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. PaymentReconciliation.modifierExtension
Definition

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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).

ShortExtensions that cannot be ignored
Comments

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.

Control0..*
TypeExtension
Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Summaryfalse
Requirements

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
12. PaymentReconciliation.identifier
Definition

A unique identifier assigned to this payment reconciliation.

ShortBusiness Identifier for a payment reconciliation
NoteThis is a business identifier, not a resource identifier (see discussion)
Control10..1*
TypeIdentifier(DP_Identifier_A)
Is Modifierfalse
Summaryfalse
Requirements

Allows payment reconciliations to be distinguished and referenced.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. PaymentReconciliation.status
Definition

The status of the resource instance.

Shortactive | cancelled | draft | entered-in-error
Comments

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

Control1..1
BindingThe codes SHALL be taken from FinancialResourceStatusCodeshttp://hl7.org/fhir/ValueSet/fm-status|4.0.1
(required to http://hl7.org/fhir/ValueSet/fm-status|4.0.1)

A code specifying the state of the resource instance.

Typecode
Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.

Pattern Valueactive
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. PaymentReconciliation.period
Definition

The period of time for which payments have been gathered into this bulk payment for settlement.

ShortPeriod covered
Control10..1
TypePeriod(DP_Period_2)
Is Modifierfalse
Summarytrue
Requirements

Needed to allow receivers to monitor and reconcile payment issuer schedules.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. PaymentReconciliation.created
Definition

The date when the resource was created.

ShortCreation date
Control1..1
TypedateTime(DP_dateTime)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Need to record a timestamp for use by both the recipient and the issuer.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. PaymentReconciliation.paymentIssuer
Definition

The party who generated the payment.

ShortParty generating payment
Comments

This party is also responsible for the reconciliation.

Control10..1
TypeReference(DP_Reference_1or2a)(Nphies Insurer Organization, Organization)
Is Modifierfalse
Summarytrue
Requirements

Need to identify the party resonsible for the payment and this resource.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. PaymentReconciliation.requestor
Definition

The practitioner who is responsible for the services rendered to the patient.

ShortResponsible practitioner
Control10..1
TypeReference(DP_Reference_1or2a)(Nphies Provider Organization, Practitioner, PractitionerRole, Organization)
Is Modifierfalse
Summaryfalse
Requirements

Need to identify the party responsible for the request.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. PaymentReconciliation.outcome
Definition

The outcome of a request for a reconciliation.

Shortqueued | complete | error | partial
Comments

The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).

Control10..1
BindingThe codes SHALL be taken from ClaimProcessingCodeshttp://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1
(required to http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1)

The outcome of the processing.

Typecode
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

To advise the requestor of an overall processing outcome.

Pattern Valuecomplete
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. PaymentReconciliation.disposition
Definition

A human readable description of the status of the request for the reconciliation.

ShortDisposition message
Control0..1
Typestring(DP_string)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summaryfalse
Requirements

Provided for user display.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. PaymentReconciliation.paymentDate
Definition

The date of payment as indicated on the financial instrument.

ShortWhen payment issued
Control1..1
Typedate(DP_date)
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

To advise the payee when payment can be expected.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. PaymentReconciliation.paymentAmount
Definition

Total payment amount as indicated on the financial instrument.

ShortTotal amount of Payment
Control1..1
TypeMoney(DP_Money_SAR)
Is Modifierfalse
Summarytrue
Requirements

Needed to provide the actual payment amount.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
BV-00083: PaymentReconciliation paymentAmount currency is not SAR. (currency = 'SAR')
32. PaymentReconciliation.paymentIdentifier
Definition

Issuer's unique identifier for the payment instrument.

ShortBusiness identifier for the payment
Comments

For example: EFT number or check number.

Control0..1
TypeIdentifier(DP_Identifier_C)
Is Modifierfalse
Summaryfalse
Requirements

Enable the receiver to reconcile when payment is received.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. PaymentReconciliation.paymentIdentifier.use
Definition

The purpose of this identifier.

Shortusual | official | temp | secondary | old (If known)
Comments

Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

Control0..1
BindingThe codes SHALL be taken from IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
(required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

Identifies the purpose for this identifier, if known .

Typecode
Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Requirements

Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. PaymentReconciliation.paymentIdentifier.type
Definition

A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

ShortDescription of identifier
Comments

This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

Control10..1
BindingThe codes SHALL be taken from Unless not suitable, these codes SHALL be taken from Payment Methodhttp://hl7.org/fhir/ValueSet/identifier-type
(required to http://nphies.sa/terminology/ValueSet/payment-method)
TypeCodeableConcept(DP_CodeableConcept)
Is Modifierfalse
Summarytrue
Requirements

Allows users to make use of identifiers when the identifier system is not known.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. PaymentReconciliation.paymentIdentifier.system
Definition

Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

ShortThe namespace for the identifier value
Comments

Identifier.system is always case sensitive.

Control0..1
Typeuri
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Must Supporttrue
Summarytrue
Requirements

There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. PaymentReconciliation.paymentIdentifier.value
Definition

The portion of the identifier typically relevant to the user and which is unique within the context of the system.

ShortThe value that is unique
Comments

If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

Control10..1
Typestring
Is Modifierfalse
Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
Summarytrue
Max Length:50
Example<br/><b>General</b>:123456
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. PaymentReconciliation.detail
Definition

Distribution of the payment amount for a previously acknowledged payable.

ShortSettlement particulars
Control10..*
TypeBackboneElement
Is Modifierfalse
Summaryfalse
Requirements

Needed to show how the payment amount is distributed across the payables.

Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. PaymentReconciliation.detail.extension
Definition

An Extension


May 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.

ShortExtensionAdditional content defined by implementations
Comments

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.

Control10..*
TypeExtension
Is Modifierfalse
Summaryfalse
Alternate Namesextensions, user content
Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingThis element introduces a set of slices on PaymentReconciliation.detail.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
  • value @ url
  • 46. PaymentReconciliation.detail.extension:component-payment
    Slice Namecomponent-payment
    Definition

    The amount of the payment.

    ShortComponent - Payment
    Control1..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Component - Payment) (Extension Type: Money(DP_Money_SAR))
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    48. PaymentReconciliation.detail.extension:component-early-fee
    Slice Namecomponent-early-fee
    Definition

    The charge for early settlement of the payment.

    ShortComponent - Early Fee
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Component - Early Fee) (Extension Type: Money(DP_Money_SAR))
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    50. PaymentReconciliation.detail.extension:component-nphies-fee
    Slice Namecomponent-nphies-fee
    Definition

    The charge for nphies services.

    ShortComponent - nphies Fee
    Control0..1
    This element is affected by the following invariants: ele-1
    TypeExtension(Component - nphies Fee) (Extension Type: Money(DP_Money_SAR))
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    52. PaymentReconciliation.detail.modifierExtension
    Definition

    May 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).

    ShortExtensions that cannot be ignored even if unrecognized
    Comments

    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.

    Control0..*
    TypeExtension
    Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
    Summarytrue
    Requirements

    Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

    Alternate Namesextensions, user content, modifiers
    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    54. PaymentReconciliation.detail.identifier
    Definition

    Unique identifier for the current payment item for the referenced payable.

    ShortBusiness identifier of the payment detail
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control0..1
    TypeIdentifier(DP_Identifier_A)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    Needed for reconciliation of payments.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    56. PaymentReconciliation.detail.predecessor
    Definition

    Unique identifier for the prior payment item for the referenced payable.

    ShortBusiness identifier of the prior payment detail
    Control0..1
    TypeIdentifier(DP_Identifier_A)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    Needed for reconciliation of payments.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    58. PaymentReconciliation.detail.type
    Definition

    Code to indicate the nature of the payment.

    ShortCategory of payment
    Comments

    For example: payment, adjustment, funds advance, etc.

    Control1..1
    BindingThe codes SHALL be taken from For example codes, see PaymentTypeCodeshttp://hl7.org/fhir/ValueSet/payment-type
    (required to http://hl7.org/fhir/ValueSet/payment-type)
    TypeCodeableConcept(DP_CodeableConcept)
    Is Modifierfalse
    Summaryfalse
    Requirements

    Needed to provide context for the amount.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    60. PaymentReconciliation.detail.request
    Definition

    A resource, such as a Claim, the evaluation of which could lead to payment.

    ShortRequest giving rise to the payment
    Control0..1
    TypeReference(DP_Reference_3a)(Nphies Claim Institutional, Nphies Claim Oral, Nphies Claim Pharmacy, Nphies Claim Professional, Nphies Claim Vision, Resource)
    Is Modifierfalse
    Must Supporttrue
    Must Support TypesNo must-support rules about the choice of types/profiles
    Summaryfalse
    Requirements

    Needed to provide a linkage to the original request.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    62. PaymentReconciliation.detail.submitter
    Definition

    The party which submitted the claim or financial transaction.

    ShortSubmitter of the request
    Control0..1
    TypeReference(DP_Reference_1or2a)(Nphies Provider Organization, Practitioner, PractitionerRole, Organization)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    Needed for audit and validation.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    64. PaymentReconciliation.detail.response
    Definition

    A resource, such as a ClaimResponse, which contains a commitment to payment.

    ShortResponse committing to a payment
    Control0..1
    TypeReference(DP_Reference_3a)(Nphies Claim Response, Resource)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    Needed to provide a linkage to the payment commitment.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    66. PaymentReconciliation.detail.date
    Definition

    The date from the response resource containing a commitment to pay.

    ShortDate of commitment to pay
    Control10..1
    Typedate(DP_date)
    Is Modifierfalse
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    Summaryfalse
    Requirements

    Needed for audit and validation.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    68. PaymentReconciliation.detail.payee
    Definition

    The party which is receiving the payment.

    ShortRecipient of the payment
    Control0..1
    TypeReference(DP_Reference_1or2a)(Nphies Provider Organization, Practitioner, PractitionerRole, Organization)
    Is Modifierfalse
    Must Supporttrue
    Summaryfalse
    Requirements

    Needed for audit and validation.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    70. PaymentReconciliation.detail.amount
    Definition

    The monetary amount allocated from the total payment to the payable.

    ShortAmount allocated to this payable
    Control10..1
    TypeMoney(DP_Money_SAR)
    Is Modifierfalse
    Summaryfalse
    Requirements

    Needed to explain the distribution of the payment to the payables.

    Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    BV-00082: PaymentReconciliation detail amount currency is not SAR. (currency = 'SAR')

    Guidance on how to interpret the contents of this table can be foundhere

    0. PaymentReconciliation
    InvariantsBV-00053: PaymentReconciliation period end date is after PaymentReconciliation created date. (period.exists() implies created.exists() implies period.end >= created)
    BV-00191: The PaymentReconciliation identifier does not exist. (identifier.exists())
    BV-00194: The PaymentReconciliation identifier does not exist. (identifier.exists() implies identifier.value.exists())
    BV-00337: PaymentReconciliation status is not using the specified value 'active'. (status.exists() implies status='active')
    BV-00338: PaymentReconciliation outcome is not using the specified value 'complete'. (outcome.exists() implies outcome='complete')
    BV-00361: PaymentReconciliation created date cannot be in the future. (created.exists() implies created <= now())
    2. PaymentReconciliation.id
    Control1..?
    Max Length:64
    4. PaymentReconciliation.meta
    Control1..?
    6. PaymentReconciliation.meta.profile
    Control1..?
    Typecanonical(DP_canonical)(StructureDefinition)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    8. PaymentReconciliation.identifier
    NoteThis is a business identifier, not a resource identifier (see discussion)
    Control1..1
    TypeIdentifier(DP_Identifier_A)
    10. PaymentReconciliation.status
    Pattern Valueactive
    12. PaymentReconciliation.period
    Control1..?
    TypePeriod(DP_Period_2)
    14. PaymentReconciliation.created
    TypedateTime(DP_dateTime)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    16. PaymentReconciliation.paymentIssuer
    Control1..?
    TypeReference(DP_Reference_1or2a)(Nphies Insurer Organization)
    18. PaymentReconciliation.requestor
    Control1..?
    TypeReference(DP_Reference_1or2a)(Nphies Provider Organization)
    20. PaymentReconciliation.outcome
    Control1..?
    Pattern Valuecomplete
    22. PaymentReconciliation.disposition
    Typestring(DP_string)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    24. PaymentReconciliation.paymentDate
    Typedate(DP_date)
    Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
    26. PaymentReconciliation.paymentAmount
    TypeMoney(DP_Money_SAR)
    InvariantsBV-00083: PaymentReconciliation paymentAmount currency is not SAR. (currency = 'SAR')
    28. PaymentReconciliation.paymentIdentifier
    TypeIdentifier(DP_Identifier_C)
    30. PaymentReconciliation.paymentIdentifier.type
    BindingThe codes SHALL be taken from Payment Method
    (required to http://nphies.sa/terminology/ValueSet/payment-method)
    32. PaymentReconciliation.detail
    Control1..?
    34. PaymentReconciliation.detail.extension
    Control1..?
    SlicingThis element introduces a set of slices on PaymentReconciliation.detail.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
    • value @ url
    • 36. PaymentReconciliation.detail.extension:component-payment
      Slice Namecomponent-payment
      Control1..1
      TypeExtension(Component - Payment) (Extension Type: Money(DP_Money_SAR))
      Must Supporttrue
      38. PaymentReconciliation.detail.extension:component-early-fee
      Slice Namecomponent-early-fee
      Control0..1
      TypeExtension(Component - Early Fee) (Extension Type: Money(DP_Money_SAR))
      Must Supporttrue
      40. PaymentReconciliation.detail.extension:component-nphies-fee
      Slice Namecomponent-nphies-fee
      Control0..1
      TypeExtension(Component - nphies Fee) (Extension Type: Money(DP_Money_SAR))
      Must Supporttrue
      42. PaymentReconciliation.detail.identifier
      NoteThis is a business identifier, not a resource identifier (see discussion)
      TypeIdentifier(DP_Identifier_A)
      Must Supporttrue
      44. PaymentReconciliation.detail.predecessor
      TypeIdentifier(DP_Identifier_A)
      Must Supporttrue
      46. PaymentReconciliation.detail.type
      BindingThe codes SHALL be taken from PaymentTypeCodes
      (required to http://hl7.org/fhir/ValueSet/payment-type)
      TypeCodeableConcept(DP_CodeableConcept)
      48. PaymentReconciliation.detail.request
      TypeReference(DP_Reference_3a)(Nphies Claim Institutional, Nphies Claim Oral, Nphies Claim Pharmacy, Nphies Claim Professional, Nphies Claim Vision)
      Must Supporttrue
      Must Support TypesNo must-support rules about the choice of types/profiles
      50. PaymentReconciliation.detail.submitter
      TypeReference(DP_Reference_1or2a)(Nphies Provider Organization)
      Must Supporttrue
      52. PaymentReconciliation.detail.response
      TypeReference(DP_Reference_3a)(Nphies Claim Response)
      Must Supporttrue
      54. PaymentReconciliation.detail.date
      Control1..?
      Typedate(DP_date)
      Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
      56. PaymentReconciliation.detail.payee
      TypeReference(DP_Reference_1or2a)(Nphies Provider Organization)
      Must Supporttrue
      58. PaymentReconciliation.detail.amount
      Control1..?
      TypeMoney(DP_Money_SAR)
      InvariantsBV-00082: PaymentReconciliation detail amount currency is not SAR. (currency = 'SAR')

      Guidance on how to interpret the contents of this table can be foundhere

      0. PaymentReconciliation
      Definition

      This resource provides the details including amount of a payment and allocates the payment items being paid.

      ShortPaymentReconciliation resource
      Control0..*
      Is Modifierfalse
      Summaryfalse
      Invariantsdom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
      dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
      dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
      dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
      dom-6: A resource should have narrative for robust management (text.`div`.exists())
      BV-00053: PaymentReconciliation period end date is after PaymentReconciliation created date. (period.exists() implies created.exists() implies period.end >= created)
      BV-00191: The PaymentReconciliation identifier does not exist. (identifier.exists())
      BV-00194: The PaymentReconciliation identifier does not exist. (identifier.exists() implies identifier.value.exists())
      BV-00337: PaymentReconciliation status is not using the specified value 'active'. (status.exists() implies status='active')
      BV-00338: PaymentReconciliation outcome is not using the specified value 'complete'. (outcome.exists() implies outcome='complete')
      BV-00361: PaymentReconciliation created date cannot be in the future. (created.exists() implies created <= now())
      2. PaymentReconciliation.id
      Definition

      The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

      ShortLogical id of this artifact
      Comments

      The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

      Control1..1
      Typeid
      Is Modifierfalse
      Summarytrue
      Max Length:64
      4. PaymentReconciliation.meta
      Definition

      The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

      ShortMetadata about the resource
      Control1..1
      TypeMeta
      Is Modifierfalse
      Summarytrue
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      6. PaymentReconciliation.meta.id
      Definition

      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

      ShortUnique id for inter-element referencing
      Control0..1
      Typestring
      Is Modifierfalse
      XML FormatIn the XML format, this property is represented as an attribute.
      Summaryfalse
      8. PaymentReconciliation.meta.extension
      Definition

      May 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.

      ShortAdditional content defined by implementations
      Comments

      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.

      Control0..*
      TypeExtension
      Is Modifierfalse
      Summaryfalse
      Alternate Namesextensions, user content
      Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      SlicingThis element introduces a set of slices on PaymentReconciliation.meta.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
      • value @ url
      • 10. PaymentReconciliation.meta.versionId
        Definition

        The version specific identifier, as it appears in the version portion of the URL. This value changes when the resource is created, updated, or deleted.

        ShortVersion specific identifier
        Comments

        The server assigns this value, and ignores what the client specifies, except in the case that the server is imposing version integrity on updates/deletes.

        Control0..1
        Typeid
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        12. PaymentReconciliation.meta.lastUpdated
        Definition

        When the resource last changed - e.g. when the version changed.

        ShortWhen the resource version last changed
        Comments

        This value is always populated except when the resource is first being created. The server / resource manager sets this value; what a client provides is irrelevant. This is equivalent to the HTTP Last-Modified and SHOULD have the same value on a read interaction.

        Control0..1
        Typeinstant
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        14. PaymentReconciliation.meta.source
        Definition

        A uri that identifies the source system of the resource. This provides a minimal amount of Provenance information that can be used to track or differentiate the source of information in the resource. The source may identify another FHIR server, document, message, database, etc.

        ShortIdentifies where the resource comes from
        Comments

        In the provenance resource, this corresponds to Provenance.entity.what[x]. The exact use of the source (and the implied Provenance.entity.role) is left to implementer discretion. Only one nominated source is allowed; for additional provenance details, a full Provenance resource should be used.

        This element can be used to indicate where the current master source of a resource that has a canonical URL if the resource is no longer hosted at the canonical URL.

        Control0..1
        Typeuri
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        16. PaymentReconciliation.meta.profile
        Definition

        A list of profiles (references to StructureDefinition resources) that this resource claims to conform to. The URL is a reference to StructureDefinition.url.

        ShortProfiles this resource claims to conform to
        Comments

        It is up to the server and/or other infrastructure of policy to determine whether/how these claims are verified and/or updated over time. The list of profile URLs is a set.

        Control1..*
        Typecanonical(DP_canonical)(StructureDefinition)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        18. PaymentReconciliation.meta.security
        Definition

        Security labels applied to this resource. These tags connect specific resources to the overall security policy and infrastructure.

        ShortSecurity Labels applied to this resource
        Comments

        The security labels can be updated without changing the stated version of the resource. The list of security labels is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..*
        BindingUnless not suitable, these codes SHALL be taken from All Security Labels
        (extensible to http://hl7.org/fhir/ValueSet/security-labels)

        Security Labels from the Healthcare Privacy and Security Classification System.

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        20. PaymentReconciliation.meta.tag
        Definition

        Tags applied to this resource. Tags are intended to be used to identify and relate resources to process and workflow, and applications are not required to consider the tags when interpreting the meaning of a resource.

        ShortTags applied to this resource
        Comments

        The tags can be updated without changing the stated version of the resource. The list of tags is a set. Uniqueness is based the system/code, and version and display are ignored.

        Control0..*
        BindingFor example codes, see CommonTags
        (example to http://hl7.org/fhir/ValueSet/common-tags)

        Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".

        TypeCoding
        Is Modifierfalse
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        22. PaymentReconciliation.implicitRules
        Definition

        A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

        ShortA set of rules under which this content was created
        Comments

        Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

        Control0..1
        Typeuri
        Is Modifiertrue because This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        24. PaymentReconciliation.language
        Definition

        The base language in which the resource is written.

        ShortLanguage of the resource content
        Comments

        Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

        Control0..1
        BindingThe codes SHOULD be taken from CommonLanguages
        (preferred to http://hl7.org/fhir/ValueSet/languages)

        A human language.

        Additional BindingsPurpose
        AllLanguagesMax Binding
        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        26. PaymentReconciliation.text
        Definition

        A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

        ShortText summary of the resource, for human interpretation
        Comments

        Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

        Control0..1
        TypeNarrative
        Is Modifierfalse
        Summaryfalse
        Alternate Namesnarrative, html, xhtml, display
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        28. PaymentReconciliation.contained
        Definition

        These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

        ShortContained, inline Resources
        Comments

        This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

        Control0..*
        TypeResource
        Is Modifierfalse
        Summaryfalse
        Alternate Namesinline resources, anonymous resources, contained resources
        30. PaymentReconciliation.extension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource. 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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        32. PaymentReconciliation.modifierExtension
        Definition

        May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it 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 is allowed to 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).

        ShortExtensions that cannot be ignored
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
        Summaryfalse
        Requirements

        Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        34. PaymentReconciliation.identifier
        Definition

        A unique identifier assigned to this payment reconciliation.

        ShortBusiness Identifier for a payment reconciliation
        NoteThis is a business identifier, not a resource identifier (see discussion)
        Control1..1
        TypeIdentifier(DP_Identifier_A)
        Is Modifierfalse
        Summaryfalse
        Requirements

        Allows payment reconciliations to be distinguished and referenced.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        36. PaymentReconciliation.status
        Definition

        The status of the resource instance.

        Shortactive | cancelled | draft | entered-in-error
        Comments

        This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

        Control1..1
        BindingThe codes SHALL be taken from FinancialResourceStatusCodes
        (required to http://hl7.org/fhir/ValueSet/fm-status|4.0.1)

        A code specifying the state of the resource instance.

        Typecode
        Is Modifiertrue because This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.

        Pattern Valueactive
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        38. PaymentReconciliation.period
        Definition

        The period of time for which payments have been gathered into this bulk payment for settlement.

        ShortPeriod covered
        Control1..1
        TypePeriod(DP_Period_2)
        Is Modifierfalse
        Summarytrue
        Requirements

        Needed to allow receivers to monitor and reconcile payment issuer schedules.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        40. PaymentReconciliation.created
        Definition

        The date when the resource was created.

        ShortCreation date
        Control1..1
        TypedateTime(DP_dateTime)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        Need to record a timestamp for use by both the recipient and the issuer.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        42. PaymentReconciliation.paymentIssuer
        Definition

        The party who generated the payment.

        ShortParty generating payment
        Comments

        This party is also responsible for the reconciliation.

        Control1..1
        TypeReference(DP_Reference_1or2a)(Nphies Insurer Organization)
        Is Modifierfalse
        Summarytrue
        Requirements

        Need to identify the party resonsible for the payment and this resource.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        44. PaymentReconciliation.request
        Definition

        Original request resource reference.

        ShortReference to requesting resource
        Control0..1
        TypeReference(Task)
        Is Modifierfalse
        Summaryfalse
        Requirements

        Needed to allow the response to be linked to the request.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        46. PaymentReconciliation.requestor
        Definition

        The practitioner who is responsible for the services rendered to the patient.

        ShortResponsible practitioner
        Control1..1
        TypeReference(DP_Reference_1or2a)(Nphies Provider Organization)
        Is Modifierfalse
        Summaryfalse
        Requirements

        Need to identify the party responsible for the request.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        48. PaymentReconciliation.outcome
        Definition

        The outcome of a request for a reconciliation.

        Shortqueued | complete | error | partial
        Comments

        The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).

        Control1..1
        BindingThe codes SHALL be taken from ClaimProcessingCodes
        (required to http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1)

        The outcome of the processing.

        Typecode
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        To advise the requestor of an overall processing outcome.

        Pattern Valuecomplete
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        50. PaymentReconciliation.disposition
        Definition

        A human readable description of the status of the request for the reconciliation.

        ShortDisposition message
        Control0..1
        Typestring(DP_string)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summaryfalse
        Requirements

        Provided for user display.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        52. PaymentReconciliation.paymentDate
        Definition

        The date of payment as indicated on the financial instrument.

        ShortWhen payment issued
        Control1..1
        Typedate(DP_date)
        Is Modifierfalse
        Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
        Summarytrue
        Requirements

        To advise the payee when payment can be expected.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        54. PaymentReconciliation.paymentAmount
        Definition

        Total payment amount as indicated on the financial instrument.

        ShortTotal amount of Payment
        Control1..1
        TypeMoney(DP_Money_SAR)
        Is Modifierfalse
        Summarytrue
        Requirements

        Needed to provide the actual payment amount.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        BV-00083: PaymentReconciliation paymentAmount currency is not SAR. (currency = 'SAR')
        56. PaymentReconciliation.paymentIdentifier
        Definition

        Issuer's unique identifier for the payment instrument.

        ShortBusiness identifier for the payment
        Comments

        For example: EFT number or check number.

        Control0..1
        TypeIdentifier(DP_Identifier_C)
        Is Modifierfalse
        Summaryfalse
        Requirements

        Enable the receiver to reconcile when payment is received.

        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        58. PaymentReconciliation.paymentIdentifier.id
        Definition

        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

        ShortUnique id for inter-element referencing
        Control0..1
        Typestring
        Is Modifierfalse
        XML FormatIn the XML format, this property is represented as an attribute.
        Summaryfalse
        60. PaymentReconciliation.paymentIdentifier.extension
        Definition

        May 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.

        ShortAdditional content defined by implementations
        Comments

        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.

        Control0..*
        TypeExtension
        Is Modifierfalse
        Summaryfalse
        Alternate Namesextensions, user content
        Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
        SlicingThis element introduces a set of slices on PaymentReconciliation.paymentIdentifier.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
        • value @ url
        • 62. PaymentReconciliation.paymentIdentifier.use
          Definition

          The purpose of this identifier.

          Shortusual | official | temp | secondary | old (If known)
          Comments

          Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

          Control0..1
          BindingThe codes SHALL be taken from IdentifierUse
          (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

          Identifies the purpose for this identifier, if known .

          Typecode
          Is Modifiertrue because This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Requirements

          Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          64. PaymentReconciliation.paymentIdentifier.type
          Definition

          A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

          ShortDescription of identifier
          Comments

          This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

          Control1..1
          BindingThe codes SHALL be taken from Payment Method
          (required to http://nphies.sa/terminology/ValueSet/payment-method)
          TypeCodeableConcept(DP_CodeableConcept)
          Is Modifierfalse
          Summarytrue
          Requirements

          Allows users to make use of identifiers when the identifier system is not known.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          66. PaymentReconciliation.paymentIdentifier.system
          Definition

          Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

          ShortThe namespace for the identifier value
          Comments

          Identifier.system is always case sensitive.

          Control0..1
          Typeuri
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Must Supporttrue
          Summarytrue
          Requirements

          There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

          Example<br/><b>General</b>:http://www.acme.com/identifiers/patient
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          68. PaymentReconciliation.paymentIdentifier.value
          Definition

          The portion of the identifier typically relevant to the user and which is unique within the context of the system.

          ShortThe value that is unique
          Comments

          If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

          Control1..1
          Typestring
          Is Modifierfalse
          Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
          Summarytrue
          Max Length:50
          Example<br/><b>General</b>:123456
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          70. PaymentReconciliation.paymentIdentifier.period
          Definition

          Time period during which identifier is/was valid for use.

          ShortTime period when id is/was valid for use
          Control0..1
          TypePeriod
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          72. PaymentReconciliation.paymentIdentifier.assigner
          Definition

          Organization that issued/manages the identifier.

          ShortOrganization that issued id (may be just text)
          Comments

          The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

          Control0..1
          TypeReference(Organization)
          Is Modifierfalse
          Summarytrue
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          74. PaymentReconciliation.detail
          Definition

          Distribution of the payment amount for a previously acknowledged payable.

          ShortSettlement particulars
          Control1..*
          TypeBackboneElement
          Is Modifierfalse
          Summaryfalse
          Requirements

          Needed to show how the payment amount is distributed across the payables.

          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          76. PaymentReconciliation.detail.id
          Definition

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          ShortUnique id for inter-element referencing
          Control0..1
          Typestring
          Is Modifierfalse
          XML FormatIn the XML format, this property is represented as an attribute.
          Summaryfalse
          78. PaymentReconciliation.detail.extension
          Definition

          An Extension

          ShortExtension
          Control1..*
          TypeExtension
          Is Modifierfalse
          Summaryfalse
          Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingThis element introduces a set of slices on PaymentReconciliation.detail.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators:
          • value @ url
          • 80. PaymentReconciliation.detail.extension:component-payment
            Slice Namecomponent-payment
            Definition

            The amount of the payment.

            ShortComponent - Payment
            Control1..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Component - Payment) (Extension Type: Money(DP_Money_SAR))
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            82. PaymentReconciliation.detail.extension:component-early-fee
            Slice Namecomponent-early-fee
            Definition

            The charge for early settlement of the payment.

            ShortComponent - Early Fee
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Component - Early Fee) (Extension Type: Money(DP_Money_SAR))
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            84. PaymentReconciliation.detail.extension:component-nphies-fee
            Slice Namecomponent-nphies-fee
            Definition

            The charge for nphies services.

            ShortComponent - nphies Fee
            Control0..1
            This element is affected by the following invariants: ele-1
            TypeExtension(Component - nphies Fee) (Extension Type: Money(DP_Money_SAR))
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            86. PaymentReconciliation.detail.modifierExtension
            Definition

            May 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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            88. PaymentReconciliation.detail.identifier
            Definition

            Unique identifier for the current payment item for the referenced payable.

            ShortBusiness identifier of the payment detail
            NoteThis is a business identifier, not a resource identifier (see discussion)
            Control0..1
            TypeIdentifier(DP_Identifier_A)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Needed for reconciliation of payments.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            90. PaymentReconciliation.detail.predecessor
            Definition

            Unique identifier for the prior payment item for the referenced payable.

            ShortBusiness identifier of the prior payment detail
            Control0..1
            TypeIdentifier(DP_Identifier_A)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Needed for reconciliation of payments.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            92. PaymentReconciliation.detail.type
            Definition

            Code to indicate the nature of the payment.

            ShortCategory of payment
            Comments

            For example: payment, adjustment, funds advance, etc.

            Control1..1
            BindingThe codes SHALL be taken from PaymentTypeCodes
            (required to http://hl7.org/fhir/ValueSet/payment-type)
            TypeCodeableConcept(DP_CodeableConcept)
            Is Modifierfalse
            Summaryfalse
            Requirements

            Needed to provide context for the amount.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            94. PaymentReconciliation.detail.request
            Definition

            A resource, such as a Claim, the evaluation of which could lead to payment.

            ShortRequest giving rise to the payment
            Control0..1
            TypeReference(DP_Reference_3a)(Nphies Claim Institutional, Nphies Claim Oral, Nphies Claim Pharmacy, Nphies Claim Professional, Nphies Claim Vision)
            Is Modifierfalse
            Must Supporttrue
            Must Support TypesNo must-support rules about the choice of types/profiles
            Summaryfalse
            Requirements

            Needed to provide a linkage to the original request.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            96. PaymentReconciliation.detail.submitter
            Definition

            The party which submitted the claim or financial transaction.

            ShortSubmitter of the request
            Control0..1
            TypeReference(DP_Reference_1or2a)(Nphies Provider Organization)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Needed for audit and validation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            98. PaymentReconciliation.detail.response
            Definition

            A resource, such as a ClaimResponse, which contains a commitment to payment.

            ShortResponse committing to a payment
            Control0..1
            TypeReference(DP_Reference_3a)(Nphies Claim Response)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Needed to provide a linkage to the payment commitment.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            100. PaymentReconciliation.detail.date
            Definition

            The date from the response resource containing a commitment to pay.

            ShortDate of commitment to pay
            Control1..1
            Typedate(DP_date)
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            Needed for audit and validation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            102. PaymentReconciliation.detail.responsible
            Definition

            A reference to the individual who is responsible for inquiries regarding the response and its payment.

            ShortContact for the response
            Control0..1
            TypeReference(PractitionerRole)
            Is Modifierfalse
            Summaryfalse
            Requirements

            To provide contact information.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            104. PaymentReconciliation.detail.payee
            Definition

            The party which is receiving the payment.

            ShortRecipient of the payment
            Control0..1
            TypeReference(DP_Reference_1or2a)(Nphies Provider Organization)
            Is Modifierfalse
            Must Supporttrue
            Summaryfalse
            Requirements

            Needed for audit and validation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            106. PaymentReconciliation.detail.amount
            Definition

            The monetary amount allocated from the total payment to the payable.

            ShortAmount allocated to this payable
            Control1..1
            TypeMoney(DP_Money_SAR)
            Is Modifierfalse
            Summaryfalse
            Requirements

            Needed to explain the distribution of the payment to the payables.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            BV-00082: PaymentReconciliation detail amount currency is not SAR. (currency = 'SAR')
            108. PaymentReconciliation.formCode
            Definition

            A code for the form to be used for printing the content.

            ShortPrinted form identifier
            Comments

            May be needed to identify specific jurisdictional forms.

            Control0..1
            BindingFor example codes, see Form Codes
            (example to http://hl7.org/fhir/ValueSet/forms)

            The forms codes.

            TypeCodeableConcept
            Is Modifierfalse
            Summaryfalse
            Requirements

            Needed to specify the specific form used for producing output for this response.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            110. PaymentReconciliation.processNote
            Definition

            A note that describes or explains the processing in a human readable form.

            ShortNote concerning processing
            Control0..*
            TypeBackboneElement
            Is Modifierfalse
            Summaryfalse
            Requirements

            Provides the specific textual explanations associated with the processing.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            112. PaymentReconciliation.processNote.id
            Definition

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            ShortUnique id for inter-element referencing
            Control0..1
            Typestring
            Is Modifierfalse
            XML FormatIn the XML format, this property is represented as an attribute.
            Summaryfalse
            114. PaymentReconciliation.processNote.extension
            Definition

            May 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.

            ShortAdditional content defined by implementations
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifierfalse
            Summaryfalse
            Alternate Namesextensions, user content
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            116. PaymentReconciliation.processNote.modifierExtension
            Definition

            May 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).

            ShortExtensions that cannot be ignored even if unrecognized
            Comments

            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.

            Control0..*
            TypeExtension
            Is Modifiertrue because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
            Summarytrue
            Requirements

            Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

            Alternate Namesextensions, user content, modifiers
            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            118. PaymentReconciliation.processNote.type
            Definition

            The business purpose of the note text.

            Shortdisplay | print | printoper
            Control0..1
            BindingThe codes SHALL be taken from NoteType
            (required to http://hl7.org/fhir/ValueSet/note-type|4.0.1)

            The presentation types of notes.

            Typecode
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            To convey the expectation for when the text is used.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            120. PaymentReconciliation.processNote.text
            Definition

            The explanation or description associated with the processing.

            ShortNote explanatory text
            Control0..1
            Typestring
            Is Modifierfalse
            Primitive ValueThis primitive element may be present, or absent, or replaced by an extension
            Summaryfalse
            Requirements

            Required to provide human readable explanation.

            Invariantsele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))