Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
PaymentReconciliation	C	0..*	PaymentReconciliation	PaymentReconciliation resource Constraints: BV-00053, BV-00191, BV-00194, BV-00337, BV-00338, BV-00361
id	Σ	1..1	id	Logical id of this artifact Max Length:64
meta	Σ	1..1	Meta	Metadata about the resource
profile	Σ	1..*	DP_canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	DP_Identifier_A	Business Identifier for a payment reconciliation
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active
period	Σ	1..1	DP_Period_2	Period covered
created	Σ	1..1	DP_dateTime	Creation date
paymentIssuer	Σ	1..1	DP_Reference_1or2a(Nphies Insurer Organization)	Party generating payment
requestor		1..1	DP_Reference_1or2a(Nphies Provider Organization)	Responsible practitioner
outcome		1..1	code	queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. Required Pattern: complete
disposition		0..1	DP_string	Disposition message
paymentDate	Σ	1..1	DP_date	When payment issued
paymentAmount	ΣC	1..1	DP_Money_SAR	Total amount of Payment Constraints: BV-00083
paymentIdentifier		0..1	DP_Identifier_C	Business identifier for the payment
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Payment Method (required)
system	SΣ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
detail		1..*	BackboneElement	Settlement particulars
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:component-payment	S	1..1	DP_Money_SAR	Component - Payment URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-payment
extension:component-early-fee	S	0..1	DP_Money_SAR	Component - Early Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-early-fee
extension:component-nphies-fee	S	0..1	DP_Money_SAR	Component - nphies Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-nphies-fee
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier	S	0..1	DP_Identifier_A	Business identifier of the payment detail
predecessor	S	0..1	DP_Identifier_A	Business identifier of the prior payment detail
type		1..1	DP_CodeableConcept	Category of payment Binding: PaymentTypeCodes (required)
request	S	0..1	DP_Reference_3a(Nphies Claim Institutional | Nphies Claim Oral | Nphies Claim Pharmacy | Nphies Claim Professional | Nphies Claim Vision)	Request giving rise to the payment
submitter	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Submitter of the request
response	S	0..1	DP_Reference_3a(Nphies Claim Response)	Response committing to a payment
date		1..1	DP_date	Date of commitment to pay
payee	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Recipient of the payment
amount	C	1..1	DP_Money_SAR	Amount allocated to this payable Constraints: BV-00082
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
PaymentReconciliation.status	required	Pattern Value: active http://hl7.org/fhir/ValueSet/fm-status|4.0.1 From the FHIR Standard
PaymentReconciliation.outcome	required	Pattern Value: complete http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 From the FHIR Standard
PaymentReconciliation.paymentIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
PaymentReconciliation.paymentIdentifier.type	required	PaymentMethod(a valid code from Payment Method) http://nphies.sa/terminology/ValueSet/payment-method From this IG
PaymentReconciliation.detail.type	required	PaymentTypeCodes http://hl7.org/fhir/ValueSet/payment-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00053	error	PaymentReconciliation	PaymentReconciliation period end date is after PaymentReconciliation created date. : period.exists() implies created.exists() implies period.end >= created
BV-00082	error	PaymentReconciliation.detail.amount	PaymentReconciliation detail amount currency is not SAR. : currency = 'SAR'
BV-00083	error	PaymentReconciliation.paymentAmount	PaymentReconciliation paymentAmount currency is not SAR. : currency = 'SAR'
BV-00191	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists()
BV-00194	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists() implies identifier.value.exists()
BV-00337	error	PaymentReconciliation	PaymentReconciliation status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00338	error	PaymentReconciliation	PaymentReconciliation outcome is not using the specified value 'complete'. : outcome.exists() implies outcome='complete'
BV-00361	error	PaymentReconciliation	PaymentReconciliation created date cannot be in the future. : created.exists() implies created <= now()
dom-2	error	PaymentReconciliation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	PaymentReconciliation	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	error	PaymentReconciliation	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	error	PaymentReconciliation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	PaymentReconciliation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
PaymentReconciliation	C	0..*	PaymentReconciliation	PaymentReconciliation resource Constraints: BV-00053, BV-00191, BV-00194, BV-00337, BV-00338, BV-00361
id		1..1	id	Logical id of this artifact Max Length:64
meta		1..1	Meta	Metadata about the resource
profile		1..*	DP_canonical(StructureDefinition)	Profiles this resource claims to conform to
identifier		1..1	DP_Identifier_A	Business Identifier for a payment reconciliation
status		1..1	code	active | cancelled | draft | entered-in-error Required Pattern: active
period		1..1	DP_Period_2	Period covered
created		1..1	DP_dateTime	Creation date
paymentIssuer		1..1	DP_Reference_1or2a(Nphies Insurer Organization)	Party generating payment
requestor		1..1	DP_Reference_1or2a(Nphies Provider Organization)	Responsible practitioner
outcome		1..1	code	queued | complete | error | partial Required Pattern: complete
disposition		0..1	DP_string	Disposition message
paymentDate		1..1	DP_date	When payment issued
paymentAmount	C	1..1	DP_Money_SAR	Total amount of Payment Constraints: BV-00083
paymentIdentifier		0..1	DP_Identifier_C	Business identifier for the payment
type		1..1	DP_CodeableConcept	Description of identifier Binding: Payment Method (required)
detail		1..*	BackboneElement	Settlement particulars
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:component-payment	S	1..1	DP_Money_SAR	Component - Payment URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-payment
extension:component-early-fee	S	0..1	DP_Money_SAR	Component - Early Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-early-fee
extension:component-nphies-fee	S	0..1	DP_Money_SAR	Component - nphies Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-nphies-fee
identifier	S	0..1	DP_Identifier_A	Business identifier of the payment detail
predecessor	S	0..1	DP_Identifier_A	Business identifier of the prior payment detail
type		1..1	DP_CodeableConcept	Category of payment Binding: PaymentTypeCodes (required)
request	S	0..1	DP_Reference_3a(Nphies Claim Institutional | Nphies Claim Oral | Nphies Claim Pharmacy | Nphies Claim Professional | Nphies Claim Vision)	Request giving rise to the payment
submitter	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Submitter of the request
response	S	0..1	DP_Reference_3a(Nphies Claim Response)	Response committing to a payment
date		1..1	DP_date	Date of commitment to pay
payee	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Recipient of the payment
amount	C	1..1	DP_Money_SAR	Amount allocated to this payable Constraints: BV-00082
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
PaymentReconciliation.paymentIdentifier.type	required	PaymentMethod(a valid code from Payment Method) http://nphies.sa/terminology/ValueSet/payment-method From this IG
PaymentReconciliation.detail.type	required	PaymentTypeCodes http://hl7.org/fhir/ValueSet/payment-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00053	error	PaymentReconciliation	PaymentReconciliation period end date is after PaymentReconciliation created date. : period.exists() implies created.exists() implies period.end >= created
BV-00082	error	PaymentReconciliation.detail.amount	PaymentReconciliation detail amount currency is not SAR. : currency = 'SAR'
BV-00083	error	PaymentReconciliation.paymentAmount	PaymentReconciliation paymentAmount currency is not SAR. : currency = 'SAR'
BV-00191	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists()
BV-00194	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists() implies identifier.value.exists()
BV-00337	error	PaymentReconciliation	PaymentReconciliation status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00338	error	PaymentReconciliation	PaymentReconciliation outcome is not using the specified value 'complete'. : outcome.exists() implies outcome='complete'
BV-00361	error	PaymentReconciliation	PaymentReconciliation created date cannot be in the future. : created.exists() implies created <= now()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
PaymentReconciliation	C	0..*	PaymentReconciliation	PaymentReconciliation resource Constraints: BV-00053, BV-00191, BV-00194, BV-00337, BV-00338, BV-00361
id	Σ	1..1	id	Logical id of this artifact Max Length:64
meta	Σ	1..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	1..*	DP_canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	DP_Identifier_A	Business Identifier for a payment reconciliation
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active
period	Σ	1..1	DP_Period_2	Period covered
created	Σ	1..1	DP_dateTime	Creation date
paymentIssuer	Σ	1..1	DP_Reference_1or2a(Nphies Insurer Organization)	Party generating payment
request		0..1	Reference(Task)	Reference to requesting resource
requestor		1..1	DP_Reference_1or2a(Nphies Provider Organization)	Responsible practitioner
outcome		1..1	code	queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. Required Pattern: complete
disposition		0..1	DP_string	Disposition message
paymentDate	Σ	1..1	DP_date	When payment issued
paymentAmount	ΣC	1..1	DP_Money_SAR	Total amount of Payment Constraints: BV-00083
paymentIdentifier		0..1	DP_Identifier_C	Business identifier for the payment
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Payment Method (required)
system	SΣ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
detail		1..*	BackboneElement	Settlement particulars
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:component-payment	S	1..1	DP_Money_SAR	Component - Payment URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-payment
extension:component-early-fee	S	0..1	DP_Money_SAR	Component - Early Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-early-fee
extension:component-nphies-fee	S	0..1	DP_Money_SAR	Component - nphies Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-nphies-fee
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier	S	0..1	DP_Identifier_A	Business identifier of the payment detail
predecessor	S	0..1	DP_Identifier_A	Business identifier of the prior payment detail
type		1..1	DP_CodeableConcept	Category of payment Binding: PaymentTypeCodes (required)
request	S	0..1	DP_Reference_3a(Nphies Claim Institutional | Nphies Claim Oral | Nphies Claim Pharmacy | Nphies Claim Professional | Nphies Claim Vision)	Request giving rise to the payment
submitter	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Submitter of the request
response	S	0..1	DP_Reference_3a(Nphies Claim Response)	Response committing to a payment
date		1..1	DP_date	Date of commitment to pay
responsible		0..1	Reference(PractitionerRole)	Contact for the response
payee	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Recipient of the payment
amount	C	1..1	DP_Money_SAR	Amount allocated to this payable Constraints: BV-00082
formCode		0..1	CodeableConcept	Printed form identifier Binding: Form Codes (example): The forms codes.
processNote		0..*	BackboneElement	Note concerning processing
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		0..1	code	display | print | printoper Binding: NoteType (required): The presentation types of notes.
text		0..1	string	Note explanatory text
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
PaymentReconciliation.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
PaymentReconciliation.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags From the FHIR Standard
PaymentReconciliation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
PaymentReconciliation.status	required	Pattern Value: active http://hl7.org/fhir/ValueSet/fm-status|4.0.1 From the FHIR Standard
PaymentReconciliation.outcome	required	Pattern Value: complete http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 From the FHIR Standard
PaymentReconciliation.paymentIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
PaymentReconciliation.paymentIdentifier.type	required	PaymentMethod(a valid code from Payment Method) http://nphies.sa/terminology/ValueSet/payment-method From this IG
PaymentReconciliation.detail.type	required	PaymentTypeCodes http://hl7.org/fhir/ValueSet/payment-type From the FHIR Standard
PaymentReconciliation.formCode	example	Form Codes http://hl7.org/fhir/ValueSet/forms From the FHIR Standard
PaymentReconciliation.processNote.type	required	NoteType http://hl7.org/fhir/ValueSet/note-type|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00053	error	PaymentReconciliation	PaymentReconciliation period end date is after PaymentReconciliation created date. : period.exists() implies created.exists() implies period.end >= created
BV-00082	error	PaymentReconciliation.detail.amount	PaymentReconciliation detail amount currency is not SAR. : currency = 'SAR'
BV-00083	error	PaymentReconciliation.paymentAmount	PaymentReconciliation paymentAmount currency is not SAR. : currency = 'SAR'
BV-00191	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists()
BV-00194	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists() implies identifier.value.exists()
BV-00337	error	PaymentReconciliation	PaymentReconciliation status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00338	error	PaymentReconciliation	PaymentReconciliation outcome is not using the specified value 'complete'. : outcome.exists() implies outcome='complete'
BV-00361	error	PaymentReconciliation	PaymentReconciliation created date cannot be in the future. : created.exists() implies created <= now()
dom-2	error	PaymentReconciliation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	PaymentReconciliation	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	error	PaymentReconciliation	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	error	PaymentReconciliation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	PaymentReconciliation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Summary

Mandatory: 13 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• DP_canonical (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-canonical)
• DP_Identifier_A (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Identifier-A)
• DP_Period_2 (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Period-2)
• DP_dateTime (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-dateTime)
• DP_Reference_1or2a (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Reference-1or2a)
• Nphies Insurer Organization (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization)
• Nphies Provider Organization (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization)
• DP_string (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-string)
• DP_date (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-date)
• DP_Money_SAR (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Money-SAR)
• DP_Identifier_C (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Identifier-C)
• DP_CodeableConcept (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-CodeableConcept)
• DP_Reference_3a (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Reference-3a)
• Nphies Claim Institutional (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/institutional-claim)
• Nphies Claim Oral (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/oral-claim)
• Nphies Claim Pharmacy (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/pharmacy-claim)
• Nphies Claim Professional (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/professional-claim)
• Nphies Claim Vision (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/vision-claim)
• Nphies Claim Response (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/claim-response)

Extensions

This structure refers to these extensions:

• http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-payment
• http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-early-fee
• http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-nphies-fee

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
PaymentReconciliation	C	0..*	PaymentReconciliation	PaymentReconciliation resource Constraints: BV-00053, BV-00191, BV-00194, BV-00337, BV-00338, BV-00361
id	Σ	1..1	id	Logical id of this artifact Max Length:64
meta	Σ	1..1	Meta	Metadata about the resource
profile	Σ	1..*	DP_canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	DP_Identifier_A	Business Identifier for a payment reconciliation
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active
period	Σ	1..1	DP_Period_2	Period covered
created	Σ	1..1	DP_dateTime	Creation date
paymentIssuer	Σ	1..1	DP_Reference_1or2a(Nphies Insurer Organization)	Party generating payment
requestor		1..1	DP_Reference_1or2a(Nphies Provider Organization)	Responsible practitioner
outcome		1..1	code	queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. Required Pattern: complete
disposition		0..1	DP_string	Disposition message
paymentDate	Σ	1..1	DP_date	When payment issued
paymentAmount	ΣC	1..1	DP_Money_SAR	Total amount of Payment Constraints: BV-00083
paymentIdentifier		0..1	DP_Identifier_C	Business identifier for the payment
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Payment Method (required)
system	SΣ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
detail		1..*	BackboneElement	Settlement particulars
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:component-payment	S	1..1	DP_Money_SAR	Component - Payment URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-payment
extension:component-early-fee	S	0..1	DP_Money_SAR	Component - Early Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-early-fee
extension:component-nphies-fee	S	0..1	DP_Money_SAR	Component - nphies Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-nphies-fee
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier	S	0..1	DP_Identifier_A	Business identifier of the payment detail
predecessor	S	0..1	DP_Identifier_A	Business identifier of the prior payment detail
type		1..1	DP_CodeableConcept	Category of payment Binding: PaymentTypeCodes (required)
request	S	0..1	DP_Reference_3a(Nphies Claim Institutional | Nphies Claim Oral | Nphies Claim Pharmacy | Nphies Claim Professional | Nphies Claim Vision)	Request giving rise to the payment
submitter	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Submitter of the request
response	S	0..1	DP_Reference_3a(Nphies Claim Response)	Response committing to a payment
date		1..1	DP_date	Date of commitment to pay
payee	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Recipient of the payment
amount	C	1..1	DP_Money_SAR	Amount allocated to this payable Constraints: BV-00082
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
PaymentReconciliation.status	required	Pattern Value: active http://hl7.org/fhir/ValueSet/fm-status|4.0.1 From the FHIR Standard
PaymentReconciliation.outcome	required	Pattern Value: complete http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 From the FHIR Standard
PaymentReconciliation.paymentIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
PaymentReconciliation.paymentIdentifier.type	required	PaymentMethod(a valid code from Payment Method) http://nphies.sa/terminology/ValueSet/payment-method From this IG
PaymentReconciliation.detail.type	required	PaymentTypeCodes http://hl7.org/fhir/ValueSet/payment-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00053	error	PaymentReconciliation	PaymentReconciliation period end date is after PaymentReconciliation created date. : period.exists() implies created.exists() implies period.end >= created
BV-00082	error	PaymentReconciliation.detail.amount	PaymentReconciliation detail amount currency is not SAR. : currency = 'SAR'
BV-00083	error	PaymentReconciliation.paymentAmount	PaymentReconciliation paymentAmount currency is not SAR. : currency = 'SAR'
BV-00191	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists()
BV-00194	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists() implies identifier.value.exists()
BV-00337	error	PaymentReconciliation	PaymentReconciliation status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00338	error	PaymentReconciliation	PaymentReconciliation outcome is not using the specified value 'complete'. : outcome.exists() implies outcome='complete'
BV-00361	error	PaymentReconciliation	PaymentReconciliation created date cannot be in the future. : created.exists() implies created <= now()
dom-2	error	PaymentReconciliation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	PaymentReconciliation	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	error	PaymentReconciliation	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	error	PaymentReconciliation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	PaymentReconciliation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
PaymentReconciliation	C	0..*	PaymentReconciliation	PaymentReconciliation resource Constraints: BV-00053, BV-00191, BV-00194, BV-00337, BV-00338, BV-00361
id		1..1	id	Logical id of this artifact Max Length:64
meta		1..1	Meta	Metadata about the resource
profile		1..*	DP_canonical(StructureDefinition)	Profiles this resource claims to conform to
identifier		1..1	DP_Identifier_A	Business Identifier for a payment reconciliation
status		1..1	code	active | cancelled | draft | entered-in-error Required Pattern: active
period		1..1	DP_Period_2	Period covered
created		1..1	DP_dateTime	Creation date
paymentIssuer		1..1	DP_Reference_1or2a(Nphies Insurer Organization)	Party generating payment
requestor		1..1	DP_Reference_1or2a(Nphies Provider Organization)	Responsible practitioner
outcome		1..1	code	queued | complete | error | partial Required Pattern: complete
disposition		0..1	DP_string	Disposition message
paymentDate		1..1	DP_date	When payment issued
paymentAmount	C	1..1	DP_Money_SAR	Total amount of Payment Constraints: BV-00083
paymentIdentifier		0..1	DP_Identifier_C	Business identifier for the payment
type		1..1	DP_CodeableConcept	Description of identifier Binding: Payment Method (required)
detail		1..*	BackboneElement	Settlement particulars
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:component-payment	S	1..1	DP_Money_SAR	Component - Payment URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-payment
extension:component-early-fee	S	0..1	DP_Money_SAR	Component - Early Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-early-fee
extension:component-nphies-fee	S	0..1	DP_Money_SAR	Component - nphies Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-nphies-fee
identifier	S	0..1	DP_Identifier_A	Business identifier of the payment detail
predecessor	S	0..1	DP_Identifier_A	Business identifier of the prior payment detail
type		1..1	DP_CodeableConcept	Category of payment Binding: PaymentTypeCodes (required)
request	S	0..1	DP_Reference_3a(Nphies Claim Institutional | Nphies Claim Oral | Nphies Claim Pharmacy | Nphies Claim Professional | Nphies Claim Vision)	Request giving rise to the payment
submitter	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Submitter of the request
response	S	0..1	DP_Reference_3a(Nphies Claim Response)	Response committing to a payment
date		1..1	DP_date	Date of commitment to pay
payee	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Recipient of the payment
amount	C	1..1	DP_Money_SAR	Amount allocated to this payable Constraints: BV-00082
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
PaymentReconciliation.paymentIdentifier.type	required	PaymentMethod(a valid code from Payment Method) http://nphies.sa/terminology/ValueSet/payment-method From this IG
PaymentReconciliation.detail.type	required	PaymentTypeCodes http://hl7.org/fhir/ValueSet/payment-type From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00053	error	PaymentReconciliation	PaymentReconciliation period end date is after PaymentReconciliation created date. : period.exists() implies created.exists() implies period.end >= created
BV-00082	error	PaymentReconciliation.detail.amount	PaymentReconciliation detail amount currency is not SAR. : currency = 'SAR'
BV-00083	error	PaymentReconciliation.paymentAmount	PaymentReconciliation paymentAmount currency is not SAR. : currency = 'SAR'
BV-00191	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists()
BV-00194	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists() implies identifier.value.exists()
BV-00337	error	PaymentReconciliation	PaymentReconciliation status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00338	error	PaymentReconciliation	PaymentReconciliation outcome is not using the specified value 'complete'. : outcome.exists() implies outcome='complete'
BV-00361	error	PaymentReconciliation	PaymentReconciliation created date cannot be in the future. : created.exists() implies created <= now()

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
PaymentReconciliation	C	0..*	PaymentReconciliation	PaymentReconciliation resource Constraints: BV-00053, BV-00191, BV-00194, BV-00337, BV-00338, BV-00361
id	Σ	1..1	id	Logical id of this artifact Max Length:64
meta	Σ	1..1	Meta	Metadata about the resource
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
versionId	Σ	0..1	id	Version specific identifier
lastUpdated	Σ	0..1	instant	When the resource version last changed
source	Σ	0..1	uri	Identifies where the resource comes from
profile	Σ	1..*	DP_canonical(StructureDefinition)	Profiles this resource claims to conform to
security	Σ	0..*	Coding	Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System.
tag	Σ	0..*	Coding	Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones".
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	DP_Identifier_A	Business Identifier for a payment reconciliation
status	?!Σ	1..1	code	active | cancelled | draft | entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active
period	Σ	1..1	DP_Period_2	Period covered
created	Σ	1..1	DP_dateTime	Creation date
paymentIssuer	Σ	1..1	DP_Reference_1or2a(Nphies Insurer Organization)	Party generating payment
request		0..1	Reference(Task)	Reference to requesting resource
requestor		1..1	DP_Reference_1or2a(Nphies Provider Organization)	Responsible practitioner
outcome		1..1	code	queued | complete | error | partial Binding: ClaimProcessingCodes (required): The outcome of the processing. Required Pattern: complete
disposition		0..1	DP_string	Disposition message
paymentDate	Σ	1..1	DP_date	When payment issued
paymentAmount	ΣC	1..1	DP_Money_SAR	Total amount of Payment Constraints: BV-00083
paymentIdentifier		0..1	DP_Identifier_C	Business identifier for the payment
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Payment Method (required)
system	SΣ	0..1	uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
detail		1..*	BackboneElement	Settlement particulars
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:component-payment	S	1..1	DP_Money_SAR	Component - Payment URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-payment
extension:component-early-fee	S	0..1	DP_Money_SAR	Component - Early Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-early-fee
extension:component-nphies-fee	S	0..1	DP_Money_SAR	Component - nphies Fee URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-nphies-fee
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier	S	0..1	DP_Identifier_A	Business identifier of the payment detail
predecessor	S	0..1	DP_Identifier_A	Business identifier of the prior payment detail
type		1..1	DP_CodeableConcept	Category of payment Binding: PaymentTypeCodes (required)
request	S	0..1	DP_Reference_3a(Nphies Claim Institutional | Nphies Claim Oral | Nphies Claim Pharmacy | Nphies Claim Professional | Nphies Claim Vision)	Request giving rise to the payment
submitter	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Submitter of the request
response	S	0..1	DP_Reference_3a(Nphies Claim Response)	Response committing to a payment
date		1..1	DP_date	Date of commitment to pay
responsible		0..1	Reference(PractitionerRole)	Contact for the response
payee	S	0..1	DP_Reference_1or2a(Nphies Provider Organization)	Recipient of the payment
amount	C	1..1	DP_Money_SAR	Amount allocated to this payable Constraints: BV-00082
formCode		0..1	CodeableConcept	Printed form identifier Binding: Form Codes (example): The forms codes.
processNote		0..*	BackboneElement	Note concerning processing
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		0..1	code	display | print | printoper Binding: NoteType (required): The presentation types of notes.
text		0..1	string	Note explanatory text
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
PaymentReconciliation.meta.security	extensible	All Security Labels http://hl7.org/fhir/ValueSet/security-labels From the FHIR Standard
PaymentReconciliation.meta.tag	example	CommonTags http://hl7.org/fhir/ValueSet/common-tags From the FHIR Standard
PaymentReconciliation.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages From the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
PaymentReconciliation.status	required	Pattern Value: active http://hl7.org/fhir/ValueSet/fm-status|4.0.1 From the FHIR Standard
PaymentReconciliation.outcome	required	Pattern Value: complete http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1 From the FHIR Standard
PaymentReconciliation.paymentIdentifier.use	required	IdentifierUse http://hl7.org/fhir/ValueSet/identifier-use|4.0.1 From the FHIR Standard
PaymentReconciliation.paymentIdentifier.type	required	PaymentMethod(a valid code from Payment Method) http://nphies.sa/terminology/ValueSet/payment-method From this IG
PaymentReconciliation.detail.type	required	PaymentTypeCodes http://hl7.org/fhir/ValueSet/payment-type From the FHIR Standard
PaymentReconciliation.formCode	example	Form Codes http://hl7.org/fhir/ValueSet/forms From the FHIR Standard
PaymentReconciliation.processNote.type	required	NoteType http://hl7.org/fhir/ValueSet/note-type|4.0.1 From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00053	error	PaymentReconciliation	PaymentReconciliation period end date is after PaymentReconciliation created date. : period.exists() implies created.exists() implies period.end >= created
BV-00082	error	PaymentReconciliation.detail.amount	PaymentReconciliation detail amount currency is not SAR. : currency = 'SAR'
BV-00083	error	PaymentReconciliation.paymentAmount	PaymentReconciliation paymentAmount currency is not SAR. : currency = 'SAR'
BV-00191	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists()
BV-00194	error	PaymentReconciliation	The PaymentReconciliation identifier does not exist. : identifier.exists() implies identifier.value.exists()
BV-00337	error	PaymentReconciliation	PaymentReconciliation status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00338	error	PaymentReconciliation	PaymentReconciliation outcome is not using the specified value 'complete'. : outcome.exists() implies outcome='complete'
BV-00361	error	PaymentReconciliation	PaymentReconciliation created date cannot be in the future. : created.exists() implies created <= now()
dom-2	error	PaymentReconciliation	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	PaymentReconciliation	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	error	PaymentReconciliation	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	error	PaymentReconciliation	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	PaymentReconciliation	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Summary

Mandatory: 13 elements
Must-Support: 9 elements

Structures

This structure refers to these other structures:

• DP_canonical (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-canonical)
• DP_Identifier_A (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Identifier-A)
• DP_Period_2 (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Period-2)
• DP_dateTime (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-dateTime)
• DP_Reference_1or2a (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Reference-1or2a)
• Nphies Insurer Organization (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization)
• Nphies Provider Organization (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization)
• DP_string (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-string)
• DP_date (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-date)
• DP_Money_SAR (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Money-SAR)
• DP_Identifier_C (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Identifier-C)
• DP_CodeableConcept (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-CodeableConcept)
• DP_Reference_3a (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/DP-Reference-3a)
• Nphies Claim Institutional (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/institutional-claim)
• Nphies Claim Oral (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/oral-claim)
• Nphies Claim Pharmacy (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/pharmacy-claim)
• Nphies Claim Professional (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/professional-claim)
• Nphies Claim Vision (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/vision-claim)
• Nphies Claim Response (http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/claim-response)

Extensions

This structure refers to these extensions:

• http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-payment
• http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-early-fee
• http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-component-nphies-fee