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FIAB_HD010100UV02
Patient Billing Account Event

Description: Entry point for account management messages


(Link to Excel View)
Derived from RMIM: FIAB_RM010000UV02
 
Account
classCode [1..1] (M)
Act (CS) {CNE:V:ActClassAccount, root= "ACCT"}
moodCode [1..1] (M)
Act (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"}
id [1..*]
Act (DSET<II>)

Design Comments: bank account, transit number, etc.

code [0..1]
Act (CD) {CWE:V:ActAccountCode}
title [0..1]
Act (ST)
statusCode [1..1]
Act (CS) {CNE:D:ActStatus}
balanceAmt [0..1]
Account (MO)
currencyCode [0..1]
Account (CD) {CWE:D:Currency}
interestRateQuantity [0..1]
Account (RTO<MO,PQ>)
allowedBalanceQuantity [0..1]
Account (IVL<MO>)
subject [1..1] (Subject)

Design Comments: The named party for the account. For a patient billing account, this is the patient

holder [0..1] (Holder)
predecessor [0..1] (Predecessor)
coverage [0..*] (Coverage)
component [0..*] (Component)

Design Comments: Used to reference sub-accounts

pertainsTo [0..*] (PertinentInformation)
 
Subject

Design Comments: The named party for the account. For a patient billing account, this is the patient

typeCode [1..1] (M)
Participation (CS) {CNE:V:ParticipationTargetSubject, root= "SBJ"}
patientRole [1..1] (PatientRole)
 
PatientRole
classCode [1..1] (M)
Role (CS) {CNE:V:RoleClassPatient, root= "PAT"}
id [0..*]
Role (DSET<II>)

Design Comments: patient identifier

confidentialityCode [0..1]
Role (DSET<CD>) {CWE:D:Confidentiality}
veryImportantPersonCode [0..1]
Patient (CD) {CWE:D:PatientImportance}
patientPerson [0..1] (E_PersonUniversal)

Design Comments: Guarantor is scoped by the patient. Patient is also the subject of the account.

subjectOf [0..*] (Subject2)
 
Subject2
typeCode [1..1] (M)
Participation (CS) {CNE:V:ParticipationTargetSubject, root= "SBJ"}
encounter [1..1] (A_EncounterUniversal)
 
Holder
typeCode [1..1] (M)
Participation (CS) {CNE:V:ParticipationHolder, root= "HLD"}
guarantorRole [1..1] (GuarantorRole)

Design Comments: Guarantor takes financial responsibility over the account

 
GuarantorRole

Design Comments: Guarantor takes financial responsibility over the account

classCode [1..1] (M)
Role (CS) {CNE:V:RoleClassGuarantor, root= "GUAR"}
id [0..*]
Role (DSET<II>)

Design Comments: Guarantor identifier

negationInd [0..1]
Role (BL)
addr [0..1]
Role (AD)

Design Comments: Can be used to indicate where to mail the statement

telecom [0..1]
Role (TEL)

Design Comments: Can be used to indicate where to call regarding the statement

statusCode [0..1]
Role (CS) {CNE:D:RoleStatus}
effectiveTime [0..1]
Role (IVL<TS>)
guarantorChoice [0..1] (GuarantorChoice)
promisorPerson [0..1] (E_PersonUniversal)

Design Comments: Guarantor is scoped by the patient. Patient is also the subject of the account.

 
GuarantorChoice
guarantorLanguage [0..*] (GuarantorLanguage)
choice of GuarantorPerson
          or GuarantorOrganization
 
GuarantorLanguage
languageCode [1..1] (M)
LanguageCommunication (CS) {CNE:D:HumanLanguage}
modeCode [1..1] (M)
LanguageCommunication (CS) {CNE:D:LanguageAbilityMode, default= "RWR"}

Design Comments: Received Written

preferenceInd [1..1]
LanguageCommunication (BL)
 
GuarantorPerson
classCode [1..1] (M)
Entity (CS) {CNE:V:EntityClassPerson, root= "PSN"}
determinerCode [1..1] (M)
Entity (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"}
id [0..*]
Entity (DSET<II>)

Design Comments: Can be used to supply non-guarantor role ids such as SSN

name [1..*]
Entity (COLL<PN>)
addr [0..1]
Person (AD)
Inherits associations from GuarantorChoice
 
GuarantorOrganization
classCode [1..1] (M)
Entity (CS) {CNE:V:EntityClassOrganization, root= "ORG"}
determinerCode [1..1] (M)
Entity (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"}
id [0..*]
Entity (DSET<II>)

Design Comments: Can be used to supply non-guarantor role ides such as TIN-tax id number

code [0..1]
Entity (CD) {CNE:D:EntityCode}
name [0..1]
Entity (ON)
Inherits associations from GuarantorChoice
 
Predecessor
typeCode [1..1] (M)
ActRelationship (CS) {CNE:V:ActRelationshipSucceeds, root= "SUCC"}
oldAccount [1..1] (OldAccount)
 
OldAccount
classCode [1..1] (M)
Act (CS) {CNE:V:ActClassAccount, root= "ACCT"}
moodCode [1..1] (M)
Act (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"}
id [0..*]
Act (DSET<II>)

Design Comments: bank account, transit number, etc.

statusCode [0..*]
Act (CS) {CNE:D:ActStatus}
allowedBalanceQuantity [0..1]
Account (IVL<MO>)
 
Coverage
typeCode [1..1] (M)
ActRelationship (CS) {CNE:V:ActRelationshipCoveredBy, root= "COVBY"}
sequenceNumber [0..1]
ActRelationship (INT)

Design Comments: COB Priority

insurancePolicy [1..1] (InsurancePolicy)
 
InsurancePolicy
classCode [1..1] (M)
Act (CS) {CNE:V:ActClassCoverage, root= "COV"}
moodCode [1..1] (M)
Act (CS) {CNE:V:ActMoodEventOccurrence, root= "EVN"}
id [0..*]
Act (DSET<II>)

Design Comments: Insurance policy identifier

code [0..1]
Act (CD) {CWE:V:ActInsurancePolicyCode}

Design Comments: Type of insurance policy

statusCode [0..1]
Act (CS) {CNE:D:ActStatus}
effectiveTime [0..1]
Act (IVL<TS>)
beneficiary [0..1] (Beneficiary)
author [1..1] (PolicyUnderwriter)
 
Beneficiary
typeCode [1..1] (M)
Participation (CS) {CNE:V:ParticipationBeneficiary, root= "BEN"}
patientRole [1..1] (PatientRole)
 
PolicyUnderwriter
typeCode [1..1] (M)
Participation (CS) {CNE:V:ParticipationAuthorOriginator, root= "AUT"}
carrierRole [1..1] (CarrierRole)
 
CarrierRole
classCode [1..1] (M)
Role (CS) {CNE:V:RoleClassUnderwriter, root= "UNDWRT"}
id [1..1] (M)
Role (II)
underwritingCarrierOrganization [0..1] (CarrierOrganization)
 
CarrierOrganization
classCode [1..1] (M)
Entity (CS) {CNE:V:EntityClassOrganization, root= "ORG"}
determinerCode [1..1] (M)
Entity (CS) {CNE:V:EntityDeterminerSpecific, root= "INSTANCE"}
name [1..1] (M)
Entity (EN)
 
Component

Design Comments: Used to reference sub-accounts

typeCode [1..1] (M)
ActRelationship (CS) {CNE:V:ActRelationshipHasComponent, root= "COMP"}
account [1..1] (Account)
 
PertinentInformation
typeCode [1..1] (M)
ActRelationship (CS) {CNE:V:ActRelationshipPertains, root= "PERT"}
encounter [1..1] (A_EncounterUniversal)