HL7 Terminology (THO)
5.5.0 - Publication
This page is part of the HL7 Terminology (v5.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Official URL: http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentCode | Version: 3.0.0 | |||
Active as of 2014-03-26 | Responsible: Health Level Seven International | Computable Name: ActInvoiceAdjudicationPaymentCode | ||
Other Identifiers: urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#urn:oid:2.16.840.1.113883.1.11.19412 | ||||
Copyright/Legal: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license |
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.
References
This value set includes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/v3-ActCode
where concept is-a _ActInvoiceAdjudicationPaymentCodeThis value set excludes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/v3-ActCode
Code | Display | Definition |
_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. |
Expansion based on codesystem ActCode v9.0.0 (CodeSystem)
This value set contains 28 concepts.
Code | System | Display | Inactive | Definition |
_ActInvoiceAdjudicationPaymentGroupCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | ActInvoiceAdjudicationPaymentGroupCode | Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc. | |
ALEC | http://terminology.hl7.org/CodeSystem/v3-ActCode | 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 | http://terminology.hl7.org/CodeSystem/v3-ActCode | bonus | Bonus payments based on performance, volume, etc. as agreed to by the payor. | |
CFWD | http://terminology.hl7.org/CodeSystem/v3-ActCode | 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 | http://terminology.hl7.org/CodeSystem/v3-ActCode | education fees | Fees deducted on behalf of a payee for tuition and continuing education. | |
EPYMT | http://terminology.hl7.org/CodeSystem/v3-ActCode | 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 | http://terminology.hl7.org/CodeSystem/v3-ActCode | garnishee | Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. | |
INVOICE | http://terminology.hl7.org/CodeSystem/v3-ActCode | submitted invoice | Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results.. | |
PINV | http://terminology.hl7.org/CodeSystem/v3-ActCode | paper invoice | Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice. | |
PPRD | http://terminology.hl7.org/CodeSystem/v3-ActCode | prior period adjustment | An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice | |
PROA | http://terminology.hl7.org/CodeSystem/v3-ActCode | professional association deduction | Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association | |
RECOV | http://terminology.hl7.org/CodeSystem/v3-ActCode | recovery | Retroactive adjustment such as fee rate adjustment due to contract negotiations. | |
RETRO | http://terminology.hl7.org/CodeSystem/v3-ActCode | retro adjustment | Bonus payments based on performance, volume, etc. as agreed to by the payor. | |
TRAN | http://terminology.hl7.org/CodeSystem/v3-ActCode | transaction fee | Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. | |
_ActInvoicePaymentCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | ActInvoiceAdjudicationPaymentGroupCode | inactive | Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc. |
_ActInvoiceAdjudicationPaymentSummaryCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | 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 | http://terminology.hl7.org/CodeSystem/v3-ActCode | contract | Transaction counts and value totals by Contract Identifier. | |
DAY | http://terminology.hl7.org/CodeSystem/v3-ActCode | day | Transaction counts and value totals for each calendar day within the date range specified. | |
LOC | http://terminology.hl7.org/CodeSystem/v3-ActCode | location | Transaction counts and value totals by service location (e.g clinic). | |
MONTH | http://terminology.hl7.org/CodeSystem/v3-ActCode | month | Transaction counts and value totals for each calendar month within the date range specified. | |
PERIOD | http://terminology.hl7.org/CodeSystem/v3-ActCode | period | Transaction counts and value totals for the date range specified. | |
PROV | http://terminology.hl7.org/CodeSystem/v3-ActCode | provider | Transaction counts and value totals by Provider Identifier. | |
WEEK | http://terminology.hl7.org/CodeSystem/v3-ActCode | week | Transaction counts and value totals for each calendar week within the date range specified. | |
YEAR | http://terminology.hl7.org/CodeSystem/v3-ActCode | year | Transaction counts and value totals for each calendar year within the date range specified. | |
INVTYPE | http://terminology.hl7.org/CodeSystem/v3-ActCode | invoice type | Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense) | |
PAYEE | http://terminology.hl7.org/CodeSystem/v3-ActCode | payee | Transaction counts and value totals by each instance of an invoice payee. | |
PAYOR | http://terminology.hl7.org/CodeSystem/v3-ActCode | payor | Transaction counts and value totals by each instance of an invoice payor. | |
SENDAPP | http://terminology.hl7.org/CodeSystem/v3-ActCode | 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 |
System | 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 |
2023-11-14 | revise | Marc Duteau | TSMG | Add standard copyright and contact to internal content; up-476 |
2022-10-18 | revise | Marc Duteau | TSMG | Fixing missing metadata; up-349 |
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 |