This page is part of the HL7 Terminology (v1.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions
Summary
Defining URL: | http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentCode |
Version: | 2.0.0 |
Name: | ActInvoiceAdjudicationPaymentCode |
Status: | Active |
Title: | ActInvoiceAdjudicationPaymentCode |
Definition: | Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees. |
OID: | 2.16.840.1.113883.1.11.19412 (for OID based terminology systems) |
Source Resource: | XML / JSON / Turtle |
References
This value set includes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/v3-ActCode
where concept is-a _ActInvoiceAdjudicationPaymentCodehttp://terminology.hl7.org/CodeSystem/v3-ActCode
Code | Display | |
_ActInvoiceAdjudicationPaymentCode | ActInvoiceAdjudicationPaymentCode | Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees. |
This value set contains 25 concepts
Expansion based on ActCode v2.0.0 (CodeSystem)
All codes from system http://terminology.hl7.org/CodeSystem/v3-ActCode
Code | Display | Definition |
_ActInvoiceAdjudicationPaymentGroupCode | ActInvoiceAdjudicationPaymentGroupCode | Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc. |
ALEC | alternate electronic | Payment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission). |
BONUS | bonus | Bonus payments based on performance, volume, etc. as agreed to by the payor. |
CFWD | carry forward adjusment | An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made. |
EDU | education fees | Fees deducted on behalf of a payee for tuition and continuing education. |
EPYMT | early payment fee | Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments. |
GARN | garnishee | Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. |
INVOICE | submitted invoice | Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results.. |
PINV | paper invoice | Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice. |
PPRD | prior period adjustment | An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice |
PROA | professional association deduction | Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association |
RECOV | recovery | Retroactive adjustment such as fee rate adjustment due to contract negotiations. |
RETRO | retro adjustment | Bonus payments based on performance, volume, etc. as agreed to by the payor. |
TRAN | transaction fee | Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. |
_ActInvoicePaymentCode | ActInvoiceAdjudicationPaymentGroupCode | Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc. |
_ActInvoiceAdjudicationPaymentSummaryCode | ActInvoiceAdjudicationPaymentSummaryCode | Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc. |
CONT | contract | Transaction counts and value totals by Contract Identifier. |
DAY | day | Transaction counts and value totals for each calendar day within the date range specified. |
LOC | location | Transaction counts and value totals by service location (e.g clinic). |
MONTH | month | Transaction counts and value totals for each calendar month within the date range specified. |
PERIOD | period | Transaction counts and value totals for the date range specified. |
PROV | provider | Transaction counts and value totals by Provider Identifier. |
WEEK | week | Transaction counts and value totals for each calendar week within the date range specified. |
YEAR | year | Transaction counts and value totals for each calendar year within the date range specified. |
INVTYPE | invoice type | Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense) |
PAYEE | payee | Transaction counts and value totals by each instance of an invoice payee. |
PAYOR | payor | Transaction counts and value totals by each instance of an invoice payor. |
SENDAPP | sending application | Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers. |
Explanation of the columns that may appear on this page:
Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies |
Source | The source of the definition of the code (when the value set draws in codes defined elsewhere) |
Code | The code (used as the code in the resource instance) |
Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application |
Definition | An explanation of the meaning of the concept |
Comments | Additional notes about how to use the code |
History
Date | Action | Author | Custodian | Comment |
2020-05-06 | revise | Ted Klein | Vocabulary WG | Migrated to the UTG maintenance environment and publishing tooling. |
2014-03-26 | revise | Vocabulary (Woody Beeler) (no record of original request) | 2014T1_2014-03-26_001283 (RIM release ID) | Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26 |