In HL7 we use to have 3 basics types for financial class (PV1): Client, Patient and Insurance in order to specify the entity who pay for the services. Now in FHIR we are unable to find the right ResourceType or field in Coverage to put that information. What we are missing?? Thanks
In Coverage the Coverage.Type would indicate the type of insurance or ‘pay’ indicating self or other paying and the payor would identify the insurer, person or organization which is the party potentially paying for services.
We saw that field but the values specified in the value set doesn’t match exactly what we were expecting. Maybe we can just use a custom
valueset for this field matching our needs
T -> ThirdParty Bill P -> Patient Bill C -> Client Bill
No, you can’t replace terminologies in that way and retain any hope for interoperability - what are you using for the ‘bill’?
We use the bill to specify who will pay for the order. We were able to achieve what we want using
Coverage and the standard terminology.
Understood, but if you are using Account (a ‘master’ resource where the ‘bills’ could be ‘details’ as the amounts of the bills are accumulated into the account) and Coverage (the instruments available for payment excluding credit cards) then you still need something else to represent the Bill - the Invoice resource would be used for that purpose and in it you could indicate who is responsible for payment if it is not addressed at the Account level. The account may be for all bills for a patient or just for certain bills for the patient, for example just those paid exclusively by the patient or some other party on their behalf.