True when the Invoice represents a shadow bill (capitated FHO/FHN submission) rather than a regular FFS claim. Derived from Oscar billing status H (Capitated).
Elements / Details
Every element this profile touches, with its full definition. Element names in the tables link here.
True when the Invoice represents a shadow bill — a capitated submission under Ontario's
FHO/FHN models where payment is via capitation and the bill is submitted for tracking and
utilization-reporting purposes only. Derived from Oscar Pro's billing_on_cheader1.status = 'H'
(Capitated).
When true, Invoice.totalGross reflects the shadow bill value (typically a fraction of the FFS
rate under FHO/FHN capitation; exact percentages are set by Ontario MoH policy and not encoded
in Oscar source — consult the OHIP Schedule of Benefits + the relevant MoH contract). Consumers
should not expect a payment remittance for shadow bills.
May 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.
Comments
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.
Source of the definition for the extension code - a logical name or a URL.
Comments
The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.