FHIR Implementation Guide for ABDM
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FHIR Implementation Guide for ABDM - Local Development build (v7.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: PaymentReconciliation

Official URL: https://nrces.in/ndhm/fhir/r4/StructureDefinition/PaymentReconciliation Version: 7.0.0
Draft as of 2025-03-18 Computable Name: PaymentReconciliation

This profile provides the bulk payment details associated with a payment for goods and services rendered by a provider to patients covered by insurance plans offered by that payor.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PaymentReconciliation 0..* PaymentReconciliation PaymentReconciliation resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... paymentIssuer Σ 0..1 Reference(Organization) Party generating payment
... request 0..1 Reference(Task) Reference to requesting resource
... requestor 0..1 Reference(Practitioner | PractitionerRole | Organization) Responsible practitioner
... paymentDate Σ 1..1 date When payment issued
... paymentAmount Σ 1..1 Money Total amount of Payment

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
PaymentReconciliation.​status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

This structure is derived from PaymentReconciliation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PaymentReconciliation 0..* PaymentReconciliation PaymentReconciliation resource
... paymentIssuer 0..1 Reference(Organization) Party generating payment
... request 0..1 Reference(Task) Reference to requesting resource
... requestor 0..1 Reference(Practitioner | PractitionerRole | Organization) Responsible practitioner
.... type 1..1 CodeableConcept Category of payment
Binding: Payment Type (example): The reason for the amount: payment, adjustment, advance,tds.
.... submitter 0..1 Reference(Practitioner | PractitionerRole | Organization) Submitter of the request
.... responsible 0..1 Reference(PractitionerRole) Contact for the response
.... payee 0..1 Reference(Practitioner | PractitionerRole | Organization) Recipient of the payment

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
PaymentReconciliation.​detail.type Base example Payment Type 📦7.0.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PaymentReconciliation 0..* PaymentReconciliation PaymentReconciliation resource
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... 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 0..* Identifier 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.
... period Σ 0..1 Period Period covered
... created Σ 1..1 dateTime Creation date
... paymentIssuer Σ 0..1 Reference(Organization) Party generating payment
... request 0..1 Reference(Task) Reference to requesting resource
... requestor 0..1 Reference(Practitioner | PractitionerRole | Organization) Responsible practitioner
... outcome 0..1 code queued | complete | error | partial
Binding: ClaimProcessingCodes (required): The outcome of the processing.
... disposition 0..1 string Disposition message
... paymentDate Σ 1..1 date When payment issued
... paymentAmount Σ 1..1 Money Total amount of Payment
... paymentIdentifier 0..1 Identifier Business identifier for the payment
... detail 0..* BackboneElement Settlement particulars
.... 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
.... identifier 0..1 Identifier Business identifier of the payment detail
.... predecessor 0..1 Identifier Business identifier of the prior payment detail
.... type 1..1 CodeableConcept Category of payment
Binding: Payment Type (example): The reason for the amount: payment, adjustment, advance,tds.
.... request 0..1 Reference(Resource) Request giving rise to the payment
.... submitter 0..1 Reference(Practitioner | PractitionerRole | Organization) Submitter of the request
.... response 0..1 Reference(Resource) Response committing to a payment
.... date 0..1 date Date of commitment to pay
.... responsible 0..1 Reference(PractitionerRole) Contact for the response
.... payee 0..1 Reference(Practitioner | PractitionerRole | Organization) Recipient of the payment
.... amount 0..1 Money Amount allocated to this payable
... 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
PaymentReconciliation.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
PaymentReconciliation.​status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
PaymentReconciliation.​outcome Base required Claim Processing Codes 📍4.0.1 FHIR Std.
PaymentReconciliation.​detail.type Base example Payment Type 📦7.0.0 This IG
PaymentReconciliation.​formCode Base example Forms 📍4.0.1 FHIR Std.
PaymentReconciliation.​processNote.type Base required NoteType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PaymentReconciliation 0..* PaymentReconciliation PaymentReconciliation resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... paymentIssuer Σ 0..1 Reference(Organization) Party generating payment
... request 0..1 Reference(Task) Reference to requesting resource
... requestor 0..1 Reference(Practitioner | PractitionerRole | Organization) Responsible practitioner
... paymentDate Σ 1..1 date When payment issued
... paymentAmount Σ 1..1 Money Total amount of Payment

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
PaymentReconciliation.​status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

Differential View

This structure is derived from PaymentReconciliation

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PaymentReconciliation 0..* PaymentReconciliation PaymentReconciliation resource
... paymentIssuer 0..1 Reference(Organization) Party generating payment
... request 0..1 Reference(Task) Reference to requesting resource
... requestor 0..1 Reference(Practitioner | PractitionerRole | Organization) Responsible practitioner
.... type 1..1 CodeableConcept Category of payment
Binding: Payment Type (example): The reason for the amount: payment, adjustment, advance,tds.
.... submitter 0..1 Reference(Practitioner | PractitionerRole | Organization) Submitter of the request
.... responsible 0..1 Reference(PractitionerRole) Contact for the response
.... payee 0..1 Reference(Practitioner | PractitionerRole | Organization) Recipient of the payment

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
PaymentReconciliation.​detail.type Base example Payment Type 📦7.0.0 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. PaymentReconciliation 0..* PaymentReconciliation PaymentReconciliation resource
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... 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 0..* Identifier 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.
... period Σ 0..1 Period Period covered
... created Σ 1..1 dateTime Creation date
... paymentIssuer Σ 0..1 Reference(Organization) Party generating payment
... request 0..1 Reference(Task) Reference to requesting resource
... requestor 0..1 Reference(Practitioner | PractitionerRole | Organization) Responsible practitioner
... outcome 0..1 code queued | complete | error | partial
Binding: ClaimProcessingCodes (required): The outcome of the processing.
... disposition 0..1 string Disposition message
... paymentDate Σ 1..1 date When payment issued
... paymentAmount Σ 1..1 Money Total amount of Payment
... paymentIdentifier 0..1 Identifier Business identifier for the payment
... detail 0..* BackboneElement Settlement particulars
.... 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
.... identifier 0..1 Identifier Business identifier of the payment detail
.... predecessor 0..1 Identifier Business identifier of the prior payment detail
.... type 1..1 CodeableConcept Category of payment
Binding: Payment Type (example): The reason for the amount: payment, adjustment, advance,tds.
.... request 0..1 Reference(Resource) Request giving rise to the payment
.... submitter 0..1 Reference(Practitioner | PractitionerRole | Organization) Submitter of the request
.... response 0..1 Reference(Resource) Response committing to a payment
.... date 0..1 date Date of commitment to pay
.... responsible 0..1 Reference(PractitionerRole) Contact for the response
.... payee 0..1 Reference(Practitioner | PractitionerRole | Organization) Recipient of the payment
.... amount 0..1 Money Amount allocated to this payable
... 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

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
PaymentReconciliation.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
PaymentReconciliation.​status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
PaymentReconciliation.​outcome Base required Claim Processing Codes 📍4.0.1 FHIR Std.
PaymentReconciliation.​detail.type Base example Payment Type 📦7.0.0 This IG
PaymentReconciliation.​formCode Base example Forms 📍4.0.1 FHIR Std.
PaymentReconciliation.​processNote.type Base required NoteType 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
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()

 

Other representations of profile: CSV, Excel, Schematron