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

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

Specification

All implementations of this specification SHALL be conformant to the definitional Artifacts and business exchange guidance provided throughout this implementation guide.

Conformance Expectations

This implementation guide uses specific terminology such as SHALL, SHOULD, MAY to flag statements that have relevance for the evaluation of conformance with the guide. As well, profiles in this implementation guide make use of the mustSupport concept. Base expectations for the interpretations of these terms are set in the FHIR core specification.

MustSupport

MustSupport, indicated by the S symbol, on any profile data element SHALL be interpreted as follows:

  1. Financial Service Message Senders, those: Healthcare providers; insurers; parties acting on behalf of providers and insurers; and, nphies itself, which are implementing the message exchanges defined in the guide; SHALL be capable of populating all data elements which are marked as Must Support within the messages supported by those implementations.
  2. Message Receivers SHALL be capable of processing resource instances containing the data elements without generating an error or causing the application to fail. In other words Message Receivers SHOULD be capable of displaying the data elements for human use or storing it for other purposes. In situations where information on a particular data element is not present and the reason for absence is unknown, Message Receivers SHALL NOT include the data elements in the resource instance returned as part of the response message.
  3. Message Receivers SHALL interpret missing data elements within resource instances as data not present in the Sender’s system. In situations where information on a particular data element is missing and the Message Sender knows the precise reason for the absence of data and the profile permits inclusion of a data absent reason then Message Senders SHALL send the reason for the missing information using values (such as nullFlavors) from the value set where they exist or using the dataAbsentReason extension if that is supporting in the relevant profile.
  4. Message Receivers SHALL be able to process resource instances containing data elements asserting missing information.

Additional information about MustSupport can be found in the FHIR Must Support page.

Out-of-Scope Data Elements

Resource data elements marked as required, cardinality 1.., and MustSupport are the in-scope part of the resources which are expected to be exchanged between systems conforming to this guide. All other data elements are not subject to this guide and sending systems should avoid populating these elements or including extensions not specifically identified in the respective profiles defined in this guide as receivers are not obligated to retain or process that information and may reject instances containing out-of-scope elements if the receivers data retention policies do not permit them to accept liability for those data elements.

Dependencies

This guide is based on the HL7 FHIR R4 Specification only.

IGPackageFHIRComment
.. Healthcare Financial Services IG Edition 1nphies-fs#0.3.0R4
... HL7 Terminology (THO)hl7.terminology.r4#6.4.0R4Automatically added as a dependency - all IGs depend on HL7 Terminology
... FHIR Extensions Packhl7.fhir.uv.extensions.r4#5.2.0R4Automatically added as a dependency - all IGs depend on the HL7 Extension Pack

Intellectual Property Considerations

This HL7 specification contains and references intellectual property owned by third parties (“Third Party IP”). Implementers and testers of this specification SHALL abide by the license requirements for each terminology content artifact utilized within a functioning implementation. Terminology licenses SHALL be obtained from the Third-Party IP owner for each code system and/or other specified artifact used. It is the sole responsibility of each organization deploying or testing this specification to ensure their implementations comply with licensing requirements of each Third-Party IP.

This publication includes IP covered under the following statements.

Change History

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (nphies-fs.r4) and R4B (nphies-fs.r4b) are available.

Globals

There are no Global profiles defined

License

Copyright (c) 2025, HL7

This document is licensed under the terms of HL7’s FHIR license.

Creative Commons “No Rights Reserved” (CC0)