HL7 Terminology (THO)
4.0.0 - Publication World

This page is part of the HL7 Terminology (v4.0.0: Release) based on FHIR R4. This is the current published version. 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: 2.0.0
Active as of 2014-03-26 Computable Name: ActInvoiceAdjudicationPaymentGroupCode
Other Identifiers: : urn:oid:2.16.840.1.113883.1.11.19414

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)

 

Expansion

This value set contains 13 concepts

Expansion based on ActCode v6.1.0 (CodeSystem)

CodeSystemDisplayDefinition
  ALEChttp://terminology.hl7.org/CodeSystem/v3-ActCodealternate 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).

  BONUShttp://terminology.hl7.org/CodeSystem/v3-ActCodebonus

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

  CFWDhttp://terminology.hl7.org/CodeSystem/v3-ActCodecarry 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.

  EDUhttp://terminology.hl7.org/CodeSystem/v3-ActCodeeducation fees

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

  EPYMThttp://terminology.hl7.org/CodeSystem/v3-ActCodeearly payment fee

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

  GARNhttp://terminology.hl7.org/CodeSystem/v3-ActCodegarnishee

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

  INVOICEhttp://terminology.hl7.org/CodeSystem/v3-ActCodesubmitted invoice

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

  PINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodepaper invoice

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

  PPRDhttp://terminology.hl7.org/CodeSystem/v3-ActCodeprior period adjustment

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

  PROAhttp://terminology.hl7.org/CodeSystem/v3-ActCodeprofessional association deduction

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

  RECOVhttp://terminology.hl7.org/CodeSystem/v3-ActCoderecovery

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

  RETROhttp://terminology.hl7.org/CodeSystem/v3-ActCoderetro adjustment

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

  TRANhttp://terminology.hl7.org/CodeSystem/v3-ActCodetransaction 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
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