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Invoice Profile

Canonical../StructureDefinition/nexus-emr-core-invoice
Statusdraft · 1.26.0
BaseInvoice (constraint)
CQL primary code pathtypewhat this means
SourceFSH · 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 / Key elements

The working view: must-support, required, modifier and sliced elements from the effective (snapshot) definition.

Element Flags Card. Type Description & Constraints
Invoice 0..* Nexus EMR Invoice Core
Invariants: dom-2, dom-3, dom-4, dom-5, dom-6, nexus-note-extension-not-where-native
id S 0..1 http://hl7.org/fhirpath/System.String Logical id of this artifact i
meta 0..1 Meta Metadata about the resource
Invariants: ele-1
source S 0..1 uri Identifies EMR instance & pipeline version the resource came from i
Invariants: ele-1
implicitRules ?! 0..1 uri A set of rules under which this content was created i
Invariants: ele-1
extension:oscarBillingStatus S 0..1 Extension(Oscar Billing Status Extension) Additional content defined by implementations i
Invariants: ele-1, ext-1
extension:shadowBill S 0..1 Extension(Shadow Bill Extension) Additional content defined by implementations i
Invariants: ele-1, ext-1
extension:serviceLocation S 0..1 Extension(Invoice Service Location Extension) Additional content defined by implementations i
Invariants: ele-1, ext-1
identifier S 0..* Identifier Invoice identifier(s) (recommended; any system) i
Invariants: ele-1
use ?! 0..1 code usual | official | temp | secondary | old (If known) i
Binding: identifier-use (required)
Invariants: ele-1
system 1..1 uri The namespace for the identifier value i
Invariants: ele-1
value 1..1 string The value that is unique i
Invariants: ele-1
status S ?! 1..1 code draft | issued | balanced | cancelled | entered-in-error
Binding: invoice-status (required)
Invariants: ele-1
type S 0..1 CodeableConcept Type of invoice — carries pay_program coding for Canadian billing
Invariants: ele-1
coding S 1..* Coding Code defined by a terminology system i
Slicing: value:system (open)
Invariants: ele-1
coding:payProgram S 0..1 Coding The payment program the invoice is billed under i
Invariants: ele-1
system 1..1 uri Identity of the terminology system i
Fixed: ../CodeSystem/oscar-pay-program-cs
Invariants: ele-1
code S 1..1 code Symbol in syntax defined by the system
Binding: Oscar Pay Program Value Set (extensible)
e.g. HCP · RMB · PAT
Invariants: ele-1
subject S 1..1 Reference(Patient Profile) The patient who received the services
Invariants: ele-1
date S 0..1 dateTime Billing date i
Invariants: ele-1
participant S 0..* BackboneElement Billing provider and related roles (billing, appointment, assistant, referring)
Invariants: ele-1
role S 0..1 CodeableConcept billing | appointment | assistant | referring | etc.
Invariants: ele-1
actor 1..1 Reference(Practitioner Profile | PractitionerRole Profile | Organization Profile) Individual who was involved
Invariants: ele-1
issuer S 0..1 Reference(Organization Profile) Organization issuing the invoice i
Invariants: ele-1
lineItem S 1..* BackboneElement One line per billing service code
Invariants: ele-1
sequence S 1..1 positiveInt Sequence number of line item
Invariants: ele-1
chargeItem[x] S 1..1 CodeableConcept OHIP fee code (e.g. A007)
Invariants: ele-1
coding S 1..* Coding Code defined by a terminology system i
Slicing: value:system (open)
Invariants: ele-1
coding:ohip S 0..1 Coding OHIP Schedule of Benefits fee code i
Invariants: ele-1
system 1..1 uri Identity of the terminology system i
Fixed: ../CodeSystem/on-ohip-schedule-of-benefits
Invariants: ele-1
code S 1..1 code Symbol in syntax defined by the system
Invariants: ele-1
priceComponent S 1..* BackboneElement Components of total line item price
Invariants: ele-1
type S 1..1 code base | surcharge | deduction | discount | tax | informational
Binding: invoice-priceComponentType (required)
Invariants: ele-1
factor S 0..1 decimal Service count / quantity i
Invariants: ele-1
amount S 0..1 Money Fee amount i
Invariants: ele-1
totalGross S 0..1 Money Total gross amount i
Invariants: ele-1
note S 0..* Annotation Free-text comment
Invariants: ele-1