--- type: "resource" title: "Invoice" resource: "Invoice" --- # Invoice ## Introduction ## Scope and Usage Tracking Financial information is vital in Patient Administration and Finance systems in most Healthcare Organizations. An invoice is a financial document issued by a healthcare provider to a patient or a payer indicating the goods and services (ChargeItems) performed with their quantities and prices. Example implementations: - Any solution that tracks billing information and needs to issue invoices - Private Insurance Providers who want to deliver structured information to patients to increase cost transparency - Patient apps that want to include information on the amount and reason of the charged costs for the healthcare services a patient received > **Note to Balloters:** > > This resource is likely to be removed from the specification and moved to being an [Additional Resource](resource#additional) after this ballot due to concerns around it's readiness, and the thin implementation experience. Ballot comments on this subject are welcome. ## Boundaries and Relationships The existing Claim resource is constricted to use cases where Claims are sent to insurances for reimbursement, in a message-like style. It neither references ChargeItems nor Accounts. Competing invoicing standards such as EDIFACT or X12 are aiming at inter-organizational exchange and do not offer human readable representations or traceable links to services rendered which is a requirement for invoicing towards patients. This resource is used where existing ChargeItems in an Account are collected to create an Invoice to be sent out to Individuals or Organizations in a structured way. The invoice is the hospital's view, whereas the Claim is the payer's view on the performed services. Since the individual ChargeItem resources that make up the line items of the Invoice do not carry any pricing information, ChargeItemDefinitions will have to be applied to the ChargeItems in order to calculate the price components for the Invoice depending on the context of the ChargeItem ## Background and Context Provides additional detail on exactly how the resource is to be used ## StructureDefinition ### Elements (Simplified) - **[Invoice](/invoice-definitions#Invoice)** [0..*]: - Invoice containing ChargeItems from an Account - **[Invoice.identifier](/invoice-definitions#Invoice.identifier)** [0..*]: [Identifier](/Identifier) Business Identifier for item - **[Invoice.status](/invoice-definitions#Invoice.status)** [1..1]: [code](/code) required:[invoice-status](/valueset-invoice-status) draft | issued | balanced | cancelled | entered-in-error - **[Invoice.cancelledReason](/invoice-definitions#Invoice.cancelledReason)** [0..1]: [string](/string) Reason for cancellation of this Invoice - **[Invoice.type](/invoice-definitions#Invoice.type)** [0..1]: [CodeableConcept](/CodeableConcept) Type of Invoice - **[Invoice.subject](/invoice-definitions#Invoice.subject)** [0..1]: [Reference(Patient](/Reference(Patient), [Group)](/Group)) Recipient(s) of goods and services - **[Invoice.recipient](/invoice-definitions#Invoice.recipient)** [0..1]: [Reference(Organization](/Reference(Organization), [Patient](/Patient), [RelatedPerson)](/RelatedPerson)) Recipient of this invoice - **[Invoice.creation](/invoice-definitions#Invoice.creation)** [0..1]: [dateTime](/dateTime) When posted - **[Invoice.period[x]](/invoice-definitions#Invoice.period%5Bx%5D)** [0..1]: [date](/date), [Period](/Period) Billing date or period - **[Invoice.participant](/invoice-definitions#Invoice.participant)** [0..*]: [BackboneElement](/BackboneElement) Participant in creation of this Invoice - **[Invoice.participant.role](/invoice-definitions#Invoice.participant.role)** [0..1]: [CodeableConcept](/CodeableConcept) Type of involvement in creation of this Invoice - **[Invoice.participant.actor](/invoice-definitions#Invoice.participant.actor)** [1..1]: [Reference(Practitioner](/Reference(Practitioner), [Organization](/Organization), [Patient](/Patient), [PractitionerRole](/PractitionerRole), [Device](/Device), [RelatedPerson)](/RelatedPerson)) Individual who was involved - **[Invoice.issuer](/invoice-definitions#Invoice.issuer)** [0..1]: [Reference(Organization](/Reference(Organization), [Practitioner](/Practitioner), [PractitionerRole)](/PractitionerRole)) Issuing entity - **[Invoice.account](/invoice-definitions#Invoice.account)** [0..1]: Reference([Account](/Account)) Account that is being balanced - **[Invoice.lineItem](/invoice-definitions#Invoice.lineItem)** [0..*]: [BackboneElement](/BackboneElement) Line items of this Invoice - **[Invoice.lineItem.sequence](/invoice-definitions#Invoice.lineItem.sequence)** [0..1]: [positiveInt](/positiveInt) Sequence number of line item - **[Invoice.lineItem.serviced[x]](/invoice-definitions#Invoice.lineItem.serviced%5Bx%5D)** [0..1]: [date](/date), [Period](/Period) Service data or period - **[Invoice.lineItem.chargeItem[x]](/invoice-definitions#Invoice.lineItem.chargeItem%5Bx%5D)** [1..1]: [Reference](/Reference), [CodeableConcept](/CodeableConcept) Reference to ChargeItem containing details of this line item or an inline billing code - **[Invoice.lineItem.priceComponent](/invoice-definitions#Invoice.lineItem.priceComponent)** [0..*]: [MonetaryComponent](/MonetaryComponent) Components of total line item price - **[Invoice.totalPriceComponent](/invoice-definitions#Invoice.totalPriceComponent)** [0..*]: [MonetaryComponent](/MonetaryComponent) Components of Invoice total - **[Invoice.totalNet](/invoice-definitions#Invoice.totalNet)** [0..1]: [Money](/Money) Net total of this Invoice - **[Invoice.totalGross](/invoice-definitions#Invoice.totalGross)** [0..1]: [Money](/Money) Gross total of this Invoice - **[Invoice.paymentTerms](/invoice-definitions#Invoice.paymentTerms)** [0..1]: [markdown](/markdown) Payment details - **[Invoice.note](/invoice-definitions#Invoice.note)** [0..*]: [Annotation](/Annotation) Comments made about the invoice ## Mappings - [Invoice Mappings](/invoice-mappings) — 42 mapping entries ## Resource Packs ### list-Invoice-packs.xml ```xml ``` ## Search Parameters - [account](/invoice-search#account) — **reference** — Account that is being balanced — `Invoice.account` - [date](/invoice-search#date) — **date** — Invoice date / posting date — `Invoice.creation` - [identifier](/invoice-search#identifier) — **token** — Business Identifier for item — `Invoice.identifier` - [issuer](/invoice-search#issuer) — **reference** — Issuing Organization of Invoice — `Invoice.issuer` - [participant](/invoice-search#participant) — **reference** — Individual who was involved — `Invoice.participant.actor` - [participant-role](/invoice-search#participant-role) — **token** — Type of involvement in creation of this Invoice — `Invoice.participant.role` - [patient](/invoice-search#patient) — **reference** — Recipient(s) of goods and services — `Invoice.subject.where(resolve() is Patient)` - [recipient](/invoice-search#recipient) — **reference** — Recipient of this invoice — `Invoice.recipient` - [status](/invoice-search#status) — **token** — draft | issued | balanced | cancelled | entered-in-error — `Invoice.status` - [subject](/invoice-search#subject) — **reference** — Recipient(s) of goods and services — `Invoice.subject` - [totalgross](/invoice-search#totalgross) — **quantity** — Gross total of this Invoice — `Invoice.totalGross` - [totalnet](/invoice-search#totalnet) — **quantity** — Net total of this Invoice — `Invoice.totalNet` - [type](/invoice-search#type) — **token** — Type of Invoice — `Invoice.type` [Full Search Parameters](/invoice-search) ## Examples - [example](/invoice-example-example) — invoice-example — Example of invoice - [invoice-example](/invoice-example-invoice-example) — invoice-example - [invoice-examples-header](/invoice-example-invoice-examples-header) — invoice-examples-header [Full Examples](/invoice-examples) ## Mapping Exceptions ### invoice-event-mapping-exceptions.xml ### Divergent Elements - **Event.code** → **Invoice.type** - shortUnmatched | reason=Unknown | pattern=What service was done | resource=Type of Invoice - definitionUnmatched | reason=Unknown | pattern=A code that identifies the specific service or action that was or is being performed. | resource=Type of Invoice depending on domain, realm an usage (e.g. internal/external, dental, preliminary). - **Event.subject** → **Invoice.subject** - shortUnmatched | reason=Unknown | pattern=Individual service was done for/to | resource=Recipient(s) of goods and services - definitionUnmatched | reason=Unknown | pattern=The individual or set of individuals the action is being or was performed on. | resource=The individual or set of individuals receiving the goods and services billed in this invoice. - requirementsUnmatched | reason=Unknown | pattern=Links the invoice to the Patient context. May also affect access control. | resource=Links the event to the Patient context. - **Event.note** → **Invoice.note** - shortUnmatched | reason=Unknown | pattern=Comments made about the event | resource=Comments made about the invoice - definitionUnmatched | reason=Unknown | pattern=Comments made about the invoice by the performer, subject or other participants. | resource=Comments made about the invoice by the issuer, subject, or other participants. ### Unmapped Elements - **Event.partOf** — Unknown - **Event.reported** — Unknown - **Event.reason** — Unknown - **Event.relevantHistory** — Unknown - **Event.location** — Unknown - **Event.status** — Unknown - **Event.statusReason** — Unknown - **Event.performer.actor** — Unknown - **Event.performer.function** — Unknown - **Event.category** — Unknown - **Event.encounter** — Unknown - **Event.recorded** — Unknown - **Event.occurrence** — Unknown - **Event.product** — Unknown - **Event.performer** — Unknown - **Event.identifier** — Unknown - **Event.basedOn** — Unknown - **Event.researchStudy** — Unknown ### invoice-fivews-mapping-exceptions.xml ### Unmapped Elements - **FiveWs.recorded** — Unknown - **FiveWs.author** — Unknown - **FiveWs.cause** — Unknown - **FiveWs.version** — Unknown - **FiveWs.witness** — Unknown - **FiveWs.class** — Unknown - **FiveWs.where** — Unknown - **FiveWs.context** — Unknown - **FiveWs.init** — Unknown - **FiveWs.why** — Unknown - **FiveWs.source** — Unknown - **FiveWs.who** — Unknown - **FiveWs.grade** — Unknown - **FiveWs.planned** — Unknown - **FiveWs.done** — Unknown