HL7.TERMINOLOGY\ActInvoiceAdjudicationPaymentGroupCode

HL7 Terminology (THO)
3.0.0 - Publication

This page is part of the HL7 Terminology (v3.0.0: 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

ValueSet: ActInvoiceAdjudicationPaymentGroupCode

Summary

Defining URL:

http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentGroupCode

Version:

2.0.0

Name:

ActInvoiceAdjudicationPaymentGroupCode

Status:

Active as of 3/26/14

Definition:

Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.

OID:

2.16.840.1.113883.1.11.19414 (for OID based terminology systems)

Source Resource:

XML / JSON / Turtle

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

Include codes from http://terminology.hl7.org/CodeSystem/v3-ActCode where concept descends from _ActInvoicePaymentCode

Expansion

This value set contains 13 concepts

Expansion based on ActCode v6.0.0 (CodeSystem)

All codes in this table are from the system http://terminology.hl7.org/CodeSystem/v3-ActCode

Code	Display	Definition
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.

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