Invoice Profile¶
| Canonical | ../StructureDefinition/nexus-emr-core-invoice |
|---|---|
| Status | draft · 1.26.0 |
| Base | Invoice (constraint) |
| CQL primary code path | type — what this means |
| Source | FSH · JSON |
Nexus EMR profile for Invoice representing Canadian provider-side billing records. Aligned with Oscar Pro's billing model: one invoice per claim header, with its line items inline. Phase 1 scope: Ontario OHIP billing via Oscar Pro.
Elements / Differential
What this profile constrains beyond Invoice. Anything not listed is unchanged from the base; muted type/cardinality values are the base's, shown for context.
| Element | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| Invoice | Nexus EMR Invoice Core Invariants: nexus-note-extension-not-where-native |
|||
| id | S | 0..1 | http://hl7.org/fhirpath/System.String | i |
| meta | 0..1 | Meta | ||
| source | S | 0..1 | uri | Identifies EMR instance & pipeline version the resource came from i |
| text | 0..1 | Narrative | Narrative i | |
| extension | 0..* | Extension | i Slicing: value:url (open) |
|
| extension:oscarBillingStatus | S | 0..1 | Extension(Oscar Billing Status Extension) | i |
| extension:shadowBill | S | 0..1 | Extension(Shadow Bill Extension) | i |
| extension:serviceLocation | S | 0..1 | Extension(Invoice Service Location Extension) | i |
| identifier | S | 0..* | Identifier | Invoice identifier(s) (recommended; any system) i |
| system | 1..1 | uri | i | |
| value | 1..1 | string | i | |
| status | S | 1..1 | code | |
| type | S | 0..1 | CodeableConcept | Type of invoice — carries pay_program coding for Canadian billing |
| coding | S | 1..* | Coding | i Slicing: value:system (open) |
| coding:payProgram | S | 0..1 | Coding | The payment program the invoice is billed under i |
| system | 1..1 | uri | i Fixed: ../CodeSystem/oscar-pay-program-cs |
|
| code | S | 1..1 | code | Binding: Oscar Pay Program Value Set (extensible)e.g. HCP · RMB · PAT … |
| subject | S | 1..1 | Reference(Patient Profile) | The patient who received the services |
| date | S | 0..1 | dateTime | Billing date i |
| participant | S | 0..* | BackboneElement | Billing provider and related roles (billing, appointment, assistant, referring) |
| role | S | 0..1 | CodeableConcept | billing | appointment | assistant | referring | etc. |
| actor | 1..1 | Reference(Practitioner Profile | PractitionerRole Profile | Organization Profile) | ||
| issuer | S | 0..1 | Reference(Organization Profile) | Organization issuing the invoice i |
| lineItem | S | 1..* | BackboneElement | One line per billing service code |
| sequence | S | 1..1 | positiveInt | |
| chargeItem[x] | S | 1..1 | CodeableConcept | OHIP fee code (e.g. A007) |
| coding | S | 1..* | Coding | i Slicing: value:system (open) |
| coding:ohip | S | 0..1 | Coding | OHIP Schedule of Benefits fee code i |
| system | 1..1 | uri | i Fixed: ../CodeSystem/on-ohip-schedule-of-benefits |
|
| code | S | 1..1 | code | |
| priceComponent | S | 1..* | BackboneElement | |
| type | S | 1..1 | code | |
| factor | S | 0..1 | decimal | Service count / quantity i |
| amount | S | 0..1 | Money | Fee amount i |
| totalGross | S | 0..1 | Money | Total gross amount i |
| note | S | 0..* | Annotation | Free-text comment |