Abrechnungsfall (Account)
Motivation
Komplementär zum Datenobjekt "Kontakt - Encounter" können Fälle, im Sinne einer Gruppierung von medizinischen Leistungen, innerhalb eines gemeinsamen Kontextes, zu einem Abrechnungsfall zusammengefasst werden. Ein solcher Abrechnungsfall kann mehrere Kontakte umfassen (z.B. vorstationärer Besuch, stationärer Aufenthalt und nachstationärer Besuch).
Gemeinsam mit dem Einrichtungskontakt bildet der Abrechnungsfall einen wichtigen Einstiegspunkt in die Dokumentation der Behandlungsleistungen der Patienten. Als Bindeglied zwischen den Kontakten und dem Versicherungsverhältnis erfolgt eine feingranulare Auflistung, in welchen Zeiträumen ein Behandlungskontext zwischen einer Gesundheitseinrichtung und der Patienten bestand. Zudem werden Diagnosen abschließend / nachträglich dokumentiert, sodass eine Übersicht von relevanten (DRG)-Diagnosen ermöglicht wird, ohne die Gesamtheit aller Kontakte betrachten zu müssen.
Kompatibilität
Seitens der KBV, als auch der Medizininformatik-Initiative wurde zum Zeitpunkt der Veröffentlichung dieser vorliegenden Spezifikation kein Profil für den Ressourcentyp "Account" definiert, sodass kein Abgleich der Kompatibilität durchgeführt werden konnte.
Profil
| Name | Canonical |
|---|---|
| ISiKAbrechnungsfall | https://gematik.de/fhir/isik/v2/Basismodul/StructureDefinition/ISiKAbrechnungsfall |
| ISiKAbrechnungsfall (Account) | C | Account | There are no (further) constraints on this element Element idAccountShort description Tracks balance, charges, for patient or cost center Alternate namesCost center, Record DefinitionA financial tool for tracking value accrued for a particular purpose. In the healthcare field, used to track charges for a patient, cost centers, etc.
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| id | S Σ | 1..1 | id | There are no (further) constraints on this element Element idAccount.idShort description Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idAccount.metaShort description Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idAccount.implicitRulesShort description A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| language | 0..1 | codeBinding | There are no (further) constraints on this element Element idAccount.languageShort description Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Binding extensions
The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| text | 0..1 | Narrative | There are no (further) constraints on this element Element idAccount.textShort description Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| contained | 0..* | Resource | There are no (further) constraints on this element Element idAccount.containedShort description Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
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| extension | S C | 0..* | Extension | There are no (further) constraints on this element Element idAccount.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| AbrechnungsDiagnoseProzedur | S C | 0..1 | Extension(Complex) | Element idAccount.extension:AbrechnungsDiagnoseProzedurShort description Fallbezogene Abrechnungsrelevanz von Diagnosen und Prozeduren Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLExtensionAbrechnungsDiagnoseProzedur ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| modifierExtension | ?! C | 0..* | Extension | There are no (further) constraints on this element Element idAccount.modifierExtensionShort description Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| identifier | S Σ | 1..* | Identifier | Element idAccount.identifierShort description Account number DefinitionUnique identifier used to reference the account. Might or might not be intended for human use (e.g. credit card number). Unordered, Open, by $this(Pattern) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| Aufnahmenummer | S Σ | 1..1 | IdentifierAufnahmenummerPattern | Element idAccount.identifier:AufnahmenummerShort description An identifier intended for computation DefinitionAn identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "VN"
}
]
}
}Mappings
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| id | 0..1 | string | There are no (further) constraints on this element Element idAccount.identifier:Aufnahmenummer.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idAccount.identifier:Aufnahmenummer.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| use | Σ ?! | 0..1 | codeBinding | There are no (further) constraints on this element Element idAccount.identifier:Aufnahmenummer.useShort description usual | official | temp | secondary | old (If known) DefinitionThe purpose of this identifier. Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers. Applications can assume that an identifier is permanent unless it explicitly says that it is temporary. Identifies the purpose for this identifier, if known . ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| type | S Σ | 1..1 | CodeableConceptBindingPattern | There are no (further) constraints on this element Element idAccount.identifier:Aufnahmenummer.typeShort description Description of identifier DefinitionA coded type for the identifier that can be used to determine which identifier to use for a specific purpose. Allows users to make use of identifiers when the identifier system is not known. This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type. A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. IdentifierTypeDeBasis (extensible) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "VN"
}
]
}Mappings
| ||
| system | S Σ | 1..1 | uri | There are no (further) constraints on this element Element idAccount.identifier:Aufnahmenummer.systemShort description The namespace for the identifier value DefinitionEstablishes the namespace for the value - that is, a URL that describes a set values that are unique. There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers. Identifier.system is always case sensitive. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General http://www.acme.com/identifiers/patientMappings
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| value | S Σ | 1..1 | string | There are no (further) constraints on this element Element idAccount.identifier:Aufnahmenummer.valueShort description The value that is unique DefinitionThe portion of the identifier typically relevant to the user and which is unique within the context of the system. If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
General 123456Mappings
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| period | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idAccount.identifier:Aufnahmenummer.periodShort description Time period when id is/was valid for use DefinitionTime period during which identifier is/was valid for use. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| assigner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idAccount.identifier:Aufnahmenummer.assignerShort description Organization that issued id (may be just text) DefinitionOrganization that issued/manages the identifier. The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| status | S Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idAccount.statusShort description active | inactive | entered-in-error | on-hold | unknown DefinitionIndicates whether the account is presently used/usable or not. This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the Account as not currently valid. Indicates whether the account is available to be used. ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| type | S Σ | 1..1 | CodeableConceptBinding | Element idAccount.typeShort description E.g. patient, expense, depreciation DefinitionCategorizes the account for reporting and searching purposes. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. The usage type of this account, permits categorization of accounts. ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| name | Σ | 0..1 | string | There are no (further) constraints on this element Element idAccount.nameShort description Human-readable label Alternate namesTitle DefinitionName used for the account when displaying it to humans in reports, etc. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| subject | S Σ C | 1..* | Reference(Device | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole) | Element idAccount.subjectShort description The entity that caused the expenses Alternate namestarget DefinitionIdentifies the entity which incurs the expenses. While the immediate recipients of services or goods might be entities related to the subject, the expenses were ultimately incurred by the subject of the Account. Accounts can be applied to non-patients for tracking other non-patient related activities, such as group services (patients not tracked, and costs charged to another body), or might not be allocated. Reference(Device | HealthcareService | Location | Organization | Patient | Practitioner | PractitionerRole) SlicingUnordered, Open, by resolve()(Type) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| PatientISiK | S Σ C | 1..1 | Reference(Patient) | Element idAccount.subject:PatientISiKShort description The entity that caused the expenses Alternate namestarget DefinitionIdentifies the entity which incurs the expenses. While the immediate recipients of services or goods might be entities related to the subject, the expenses were ultimately incurred by the subject of the Account. Accounts can be applied to non-patients for tracking other non-patient related activities, such as group services (patients not tracked, and costs charged to another body), or might not be allocated. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| servicePeriod | Σ C | 0..1 | Period | There are no (further) constraints on this element Element idAccount.servicePeriodShort description Transaction window DefinitionThe date range of services associated with this account. It is possible for transactions to be posted outside the service period, as long as the service was provided within the defined service period. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| coverage | S Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idAccount.coverageShort description The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account DefinitionThe party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account. Typically. this may be some form of insurance, internal charges, or self-pay. Local or jurisdictional business rules may determine which coverage covers which types of billable items charged to the account, and in which order. Where the order is important, a local/jurisdictional extension may be defined to specify the order for the type of charge. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAccount.coverage.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | S C | 0..1 | Extension | There are no (further) constraints on this element Element idAccount.coverage.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| Abrechnungsart | S C | 0..1 | Extension(Coding) | Element idAccount.coverage.extension:AbrechnungsartShort description Abrechnungsart Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idAccount.coverage.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| coverage | S Σ C | 1..1 | Reference(Coverage) | There are no (further) constraints on this element Element idAccount.coverage.coverageShort description The party(s), such as insurances, that may contribute to the payment of this account DefinitionThe party(s) that contribute to payment (or part of) of the charges applied to this account (including self-pay). A coverage may only be responsible for specific types of charges, and the sequence of the coverages in the account could be important when processing billing. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| priority | Σ | 0..1 | positiveInt | There are no (further) constraints on this element Element idAccount.coverage.priorityShort description The priority of the coverage in the context of this account Alternate namescoordination of benefit priority DefinitionThe priority of the coverage in the context of this account. It is common in some jurisdictions for there to be multiple coverages allocated to an account, and a sequence is required to order the settling of the account (often with insurance claiming). The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| owner | Σ C | 0..1 | Reference(Organization) | There are no (further) constraints on this element Element idAccount.ownerShort description Entity managing the Account DefinitionIndicates the service area, hospital, department, etc. with responsibility for managing the Account. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| description | Σ | 0..1 | string | There are no (further) constraints on this element Element idAccount.descriptionShort description Explanation of purpose/use DefinitionProvides additional information about what the account tracks and how it is used. Note that FHIR strings SHALL NOT exceed 1MB in size The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| guarantor | 0..* | BackboneElement | There are no (further) constraints on this element Element idAccount.guarantorShort description The parties ultimately responsible for balancing the Account DefinitionThe parties responsible for balancing the account if other payment options fall short. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| id | 0..1 | string | There are no (further) constraints on this element Element idAccount.guarantor.idShort description Unique id for inter-element referencing DefinitionUnique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
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| extension | C | 0..* | Extension | There are no (further) constraints on this element Element idAccount.guarantor.extensionShort description Additional content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
| ||
| modifierExtension | Σ ?! C | 0..* | Extension | There are no (further) constraints on this element Element idAccount.guarantor.modifierExtensionShort description Extensions that cannot be ignored even if unrecognized Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| party | C | 1..1 | Reference(Organization | Patient | RelatedPerson) | There are no (further) constraints on this element Element idAccount.guarantor.partyShort description Responsible entity DefinitionThe entity who is responsible. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Organization | Patient | RelatedPerson) ConditionsThe cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| onHold | 0..1 | boolean | There are no (further) constraints on this element Element idAccount.guarantor.onHoldShort description Credit or other hold applied DefinitionA guarantor may be placed on credit hold or otherwise have their role temporarily suspended. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| period | C | 0..1 | Period | There are no (further) constraints on this element Element idAccount.guarantor.periodShort description Guarantee account during DefinitionThe timeframe during which the guarantor accepts responsibility for the account. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). Period is not used for a duration (a measure of elapsed time). See Duration. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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| partOf | C | 0..1 | Reference(Account) | There are no (further) constraints on this element Element idAccount.partOfShort description Reference to a parent Account DefinitionReference to a parent Account. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. The cardinality or value of this element may be affected by these constraints: ele-1 Constraints
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Weitere Hinweise zu den Abgrenzungen der Begrifflichkeiten Fall und Kontakt finden sie unter Deutsche Basisprofile - Abschnitt Ambulanter/stationärer Fall / Kontakt (Encounter).
Terminology Bindings
| Path | Name | Strength | URL |
|---|---|---|---|
| Account.type | ISiKAccountType | required | https://gematik.de/fhir/isik/v2/Basismodul/ValueSet/ISiKAccountType |
Anmerkungen zu den Must-Support Feldern
Account.extension:Abrechnungsdiagnose
Bedeutung: DRG- und hiervon abweichende Krankenhausdiagnosen sollten im Account zusammenfassend und abschließend angegeben werden. Relevante Prozeduren können ebenfalls aufgelistet werden.
Account.identifier
Bedeutung: Der Account muss die Aufnahmenummer des dazugehörigen Encounters enthalten.
Account.status
Bedeutung: Der Status MUSS insbesondere zur Differenzierung von abgeschlossenen und derzeitig noch aktiven Abrechnungsfällen angegeben werden. Alle in einem System möglichen Status-Werte müssen über FHIR korrekt repräsentiert werden können, mindestens jedoch die Status-Werte "active", "inactive". Deren korrekte Abbildung wird im Rahmen des Bestätigungsverfahrens überprüft.
Hinweise: Siehe Beschreibung in der FHIR Kernspezifikation
Account.type
Bedeutung: Alle Accounts MÜSSEN eindeutig kategorisiert werden können, sodass eine Filterung pro Typ möglich ist.
Hinweise: Verpflichtende Kodierung per HL7 v3 Value Set ActEncounterCode als Äquivalent zu Encounter.class.
Account.subject
Bedeutung: Ein Patientenbezug des Falls MUSS stets zum Zwecke der Nachvollziehbarkeit und Datenintegrität vorliegen.
Account.coverage
Bedeutung: Unter Account.coverage SOLL der Kostenträger referenziert werden, über den der Fall abgerechnet wird. Falls bekannt, SOLL angegeben werden, in welcher Abrechnungsart die Abrechnung erfolgt.
Interaktionen
Für die Ressource Account MUSS die REST-Interaktion "READ" implementiert werden.
Folgende Suchparameter sind für das Bestätigungsverfahren relevant, auch in Kombination:
Der Suchparameter "_id" MUSS unterstützt werden:
Beispiele:
GET [base]/Account?_id=103270Anwendungshinweise: Weitere Informationen zur Suche nach "_id" finden sich in der FHIR-Basisspezifikation - Abschnitt "Parameters for all resources".
Der Suchparameter "identifier" MUSS unterstützt werden:
Beispiele:
GET [base]/Account?identifier=http://test.krankenhaus.de/fhir/sid/fallnr|123456Anwendungshinweise: Weitere Informationen zur Suche nach "Account.identifier" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "status" MUSS unterstützt werden:
Beispiele:
GET [base]/Account?status=activeAnwendungshinweise: Weitere Informationen zur Suche nach "Account.status" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "type" MUSS unterstützt werden:
Beispiele:
GET [base]/Account?type=http://terminology.hl7.org/CodeSystem/v3-ActCode|AMBAnwendungshinweise: Weitere Informationen zur Suche nach "Account.type" finden sich in der FHIR-Basisspezifikation - Abschnitt "Token Search".
Der Suchparameter "patient" MUSS unterstützt werden:
Beispiele:
GET [base]/Account?patient=Patient/123Anwendungshinweise: Weitere Informationen zur Suche nach "Account.subject" finden sich in der FHIR-Basisspezifikation - Abschnitt "Reference Search".
Beispiele
Valides Minimalbeispiel für das Profil ISiKAbrechnungsfall: