HL7 Terminology (THO)
7.0.1 - Continuous Process Integration (ci build) International flag

This page is part of the HL7 Terminology (v7.0.1: Release) based on FHIR (HL7® FHIR® Standard) v5.0.0. 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

ValueSet: ActInvoiceAdjudicationPaymentGroupCode

Official URL: http://terminology.hl7.org/ValueSet/v3-ActInvoiceAdjudicationPaymentGroupCode Version: 3.0.0
Active as of 2014-03-26 Responsible: Health Level Seven International Computable Name: ActInvoiceAdjudicationPaymentGroupCode
Other Identifiers: OID:2.16.840.1.113883.1.11.19414

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.html

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

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)

Language: en

 

Expansion

Expansion performed internally based on codesystem ActCode v9.0.0 (CodeSystem)

This value set contains 13 concepts

SystemCodeDisplay (en)DefinitionJSONXML
http://terminology.hl7.org/CodeSystem/v3-ActCode  ALECalternate 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).

http://terminology.hl7.org/CodeSystem/v3-ActCode  BONUSbonus

Bonus payments based on performance, volume, etc. as agreed to by the payor.

http://terminology.hl7.org/CodeSystem/v3-ActCode  CFWDcarry 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.

http://terminology.hl7.org/CodeSystem/v3-ActCode  EDUeducation fees

Fees deducted on behalf of a payee for tuition and continuing education.

http://terminology.hl7.org/CodeSystem/v3-ActCode  EPYMTearly payment fee

Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments.

http://terminology.hl7.org/CodeSystem/v3-ActCode  GARNgarnishee

Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.

http://terminology.hl7.org/CodeSystem/v3-ActCode  INVOICEsubmitted invoice

Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results..

http://terminology.hl7.org/CodeSystem/v3-ActCode  PINVpaper invoice

Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice.

http://terminology.hl7.org/CodeSystem/v3-ActCode  PPRDprior period adjustment

An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice

http://terminology.hl7.org/CodeSystem/v3-ActCode  PROAprofessional association deduction

Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association

http://terminology.hl7.org/CodeSystem/v3-ActCode  RECOVrecovery

Retroactive adjustment such as fee rate adjustment due to contract negotiations.

http://terminology.hl7.org/CodeSystem/v3-ActCode  RETROretro adjustment

Bonus payments based on performance, volume, etc. as agreed to by the payor.

http://terminology.hl7.org/CodeSystem/v3-ActCode  TRANtransaction 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
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

DateActionCustodianAuthorComment
2023-11-14reviseTSMGMarc DuteauAdd standard copyright and contact to internal content; up-476
2022-10-18reviseTSMGMarc DuteauFixing missing metadata; up-349
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26revise2014T1_2014-03-26_001283 (RIM release ID)Vocabulary (Woody Beeler) (no record of original request)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26