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Logical Model: Profile - Athena Custom BillingStatement
| Official URL: https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-billingStatement-profile | Version: 23.0.0 | |||
| Active as of 2023-03-01 | Computable Name: BillingStatement | |||
The BillingStatement describes a billing offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, EDI statement, contact information, etc..
This custom BillingStatement is part of the set of resource profiles
supported by the API Server used athenaPractice product starting with version 23.0 This is not a FHIR Conformant Resource. It further describes read and search capabilities of these products.
Note: Create and Update operations are NOT supported for this resource.
dataExtFormat :EDI Plug-in supported by athenaPractice.
Overview
BillingStatement used to support transaction, guarantor and billing information. In the healthcare field, used to track bill for a procedure, cost centers, etc
Scope and Usage
This profile is used to define the content that will be returned by the API Server in response to requests to access BillingStatement resources. All elements listed in the differential profile view are Supported, which means that the API Server is capable of supplying these fields from the product database when they have been populated via the product or its APIs.
Usage:
- This Logical Model Profile is not used by any profiles in this Implementation Guide
Formal Views of Profile Content
Description of Profiles, Differentials, Snapshots and how the different presentations work.
This structure is derived from Base
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
  athena-billingStatement-profile | 0..* | Base | Instances of this logical model are not marked to be the target of a Reference | |
  id | SΣ | 1..1 | id | Logical id of this artifact |
 meta | Σ | 0..1 | Meta | Metadata about the resource |
| pid | SΣ | 0..1 | integer | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
  patient | 1..1 | Reference(Patient) | Who/what is the patient of the billingStatement | |
 reference | 0..1 | string | Reference to the Patient | |
 display | 0..1 | string | Patient name | |
| patientProfileId | SΣ | 0..1 | unsignedInt | Patient specific id for practice management data including financial information |
| guarantor | 0..1 | Reference(guarantor) | Guarantor reference of patient. | |
| reference | 0..1 | string | Related person reference | |
| display | 0..1 | string | Guarantor Name | |
| guarantorId | 0..1 | integer | GuarantorId. | |
| dataExtFormat | 0..1 | string | Data Extension format | |
| data | 0..1 | string | EDI statement data | |
| Documentation for this format | ||||
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| athena-billingStatement-profile | 0..* | Base | Instances of this logical model are not marked to be the target of a Reference | |
| id | SΣ | 1..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| pid | SΣ | 0..1 | integer | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
| patient | C | 1..1 | Reference(Patient) | Who/what is the patient of the billingStatement ref-1: SHALL have a contained resource if a local reference is provided |
| reference | ΣC | 0..1 | string | Reference to the Patient |
| display | Σ | 0..1 | string | Patient name |
| patientProfileId | SΣ | 0..1 | unsignedInt | Patient specific id for practice management data including financial information |
| guarantor | C | 0..1 | Reference(guarantor) | Guarantor reference of patient. ref-1: SHALL have a contained resource if a local reference is provided |
| reference | ΣC | 0..1 | string | Related person reference |
| display | Σ | 0..1 | string | Guarantor Name |
| guarantorId | 0..1 | integer | GuarantorId. | |
| dataExtFormat | 0..1 | string | Data Extension format | |
| data | 0..1 | string | EDI statement data | |
| Documentation for this format | ||||
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| ref-1 | error | athena-billingStatement-profile.patient, athena-billingStatement-profile.guarantor | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| athena-billingStatement-profile | 0..* | Base | Instances of this logical model are not marked to be the target of a Reference | |
| id | SΣ | 1..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| pid | SΣ | 0..1 | integer | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
| patient | C | 1..1 | Reference(Patient) | Who/what is the patient of the billingStatement ref-1: SHALL have a contained resource if a local reference is provided |
| @id | 0..1 | string | Unique id for inter-element referencing | |
 extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| reference | ΣC | 0..1 | string | Reference to the Patient |
| type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). |
| identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
| display | Σ | 0..1 | string | Patient name |
| patientProfileId | SΣ | 0..1 | unsignedInt | Patient specific id for practice management data including financial information |
| guarantor | C | 0..1 | Reference(guarantor) | Guarantor reference of patient. ref-1: SHALL have a contained resource if a local reference is provided |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| reference | ΣC | 0..1 | string | Related person reference |
| type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). |
| identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
| display | Σ | 0..1 | string | Guarantor Name |
| guarantorId | 0..1 | integer | GuarantorId. | |
| dataExtFormat | 0..1 | string | Data Extension format | |
| data | 0..1 | string | EDI statement data | |
| Documentation for this format | ||||
Terminology Bindings
| Path | Conformance | ValueSet |
| athena-billingStatement-profile.patient.type | extensible | ResourceType |
| athena-billingStatement-profile.guarantor.type | extensible | ResourceType |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| ref-1 | error | athena-billingStatement-profile.patient, athena-billingStatement-profile.guarantor | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
This structure is derived from Base
Differential View
This structure is derived from Base
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| athena-billingStatement-profile | 0..* | Base | Instances of this logical model are not marked to be the target of a Reference | |
| id | SΣ | 1..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| pid | SΣ | 0..1 | integer | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
| patient | 1..1 | Reference(Patient) | Who/what is the patient of the billingStatement | |
| reference | 0..1 | string | Reference to the Patient | |
| display | 0..1 | string | Patient name | |
| patientProfileId | SΣ | 0..1 | unsignedInt | Patient specific id for practice management data including financial information |
| guarantor | 0..1 | Reference(guarantor) | Guarantor reference of patient. | |
| reference | 0..1 | string | Related person reference | |
| display | 0..1 | string | Guarantor Name | |
| guarantorId | 0..1 | integer | GuarantorId. | |
| dataExtFormat | 0..1 | string | Data Extension format | |
| data | 0..1 | string | EDI statement data | |
| Documentation for this format | ||||
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| athena-billingStatement-profile | 0..* | Base | Instances of this logical model are not marked to be the target of a Reference | |
| id | SΣ | 1..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| pid | SΣ | 0..1 | integer | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
| patient | C | 1..1 | Reference(Patient) | Who/what is the patient of the billingStatement ref-1: SHALL have a contained resource if a local reference is provided |
| reference | ΣC | 0..1 | string | Reference to the Patient |
| display | Σ | 0..1 | string | Patient name |
| patientProfileId | SΣ | 0..1 | unsignedInt | Patient specific id for practice management data including financial information |
| guarantor | C | 0..1 | Reference(guarantor) | Guarantor reference of patient. ref-1: SHALL have a contained resource if a local reference is provided |
| reference | ΣC | 0..1 | string | Related person reference |
| display | Σ | 0..1 | string | Guarantor Name |
| guarantorId | 0..1 | integer | GuarantorId. | |
| dataExtFormat | 0..1 | string | Data Extension format | |
| data | 0..1 | string | EDI statement data | |
| Documentation for this format | ||||
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| ref-1 | error | athena-billingStatement-profile.patient, athena-billingStatement-profile.guarantor | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
Snapshot View
| Name | Flags | Card. | Type | Description & Constraints |
|---|---|---|---|---|
| athena-billingStatement-profile | 0..* | Base | Instances of this logical model are not marked to be the target of a Reference | |
| id | SΣ | 1..1 | id | Logical id of this artifact |
| meta | Σ | 0..1 | Meta | Metadata about the resource |
| pid | SΣ | 0..1 | integer | PID is internal numeric value used in the Chart module and clinical data. This will be the same as the resource id in the Patient resource. |
| patient | C | 1..1 | Reference(Patient) | Who/what is the patient of the billingStatement ref-1: SHALL have a contained resource if a local reference is provided |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| reference | ΣC | 0..1 | string | Reference to the Patient |
| type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). |
| identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
| display | Σ | 0..1 | string | Patient name |
| patientProfileId | SΣ | 0..1 | unsignedInt | Patient specific id for practice management data including financial information |
| guarantor | C | 0..1 | Reference(guarantor) | Guarantor reference of patient. ref-1: SHALL have a contained resource if a local reference is provided |
| @id | 0..1 | string | Unique id for inter-element referencing | |
| extension | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |
| reference | ΣC | 0..1 | string | Related person reference |
| type | Σ | 0..1 | uri | Type the reference refers to (e.g. "Patient") Binding: ResourceType (extensible): Aa resource (or, for logical models, the URI of the logical model). |
| identifier | Σ | 0..1 | Identifier | Logical reference, when literal reference is not known |
| display | Σ | 0..1 | string | Guarantor Name |
| guarantorId | 0..1 | integer | GuarantorId. | |
| dataExtFormat | 0..1 | string | Data Extension format | |
| data | 0..1 | string | EDI statement data | |
| Documentation for this format | ||||
Terminology Bindings
| Path | Conformance | ValueSet |
| athena-billingStatement-profile.patient.type | extensible | ResourceType |
| athena-billingStatement-profile.guarantor.type | extensible | ResourceType |
Constraints
| Id | Grade | Path(s) | Details | Requirements |
| ref-1 | error | athena-billingStatement-profile.patient, athena-billingStatement-profile.guarantor | SHALL have a contained resource if a local reference is provided : reference.startsWith('#').not() or (reference.substring(1).trace('url') in %rootResource.contained.id.trace('ids')) |
This structure is derived from Base
Other representations of profile: CSV, Excel
Notes:
Supported Interactions
The Interactions supported by this resource are listed below.
Search Parameters
Search parameters are executed as specified in the HL7 FHIR RESTful API implementation definition. To search for BillingStatement resources, an application shall perform an HTTP GET, specifying the query parameters associated with the resource.
GET [base]/customresource/BillingStatement?{search-parameters}
Where:
| Name | Description |
|---|---|
| [base] | Specifies the base URL of the FHIR Server, e.g., https://ap22sandbox.athenahealth.com/demoAPIServer |
| _id (token) | The ID of the resource |
| patientProfileId | known id of the patient. |
| patient (reference) | Who the sensitivity is for |
| [_include] | Specifies the supported hl7 resources include which are defined as reference in examples. Note: The Patient and RelatedPerson resources are supported via the _include parameter. |
HTTP Response Codes
The following HTTP response codes are returned by this API call:
| 200 OK | The query was performed and any results found are contained within the body of the HTTP response. Note: The search API will return 200 OK when the query itself is successful, regardless of whether or not any matching results were found. |
| 401 Unauthorized | Authorization is required for this request, and either the Authorization header is missing or the supplied user credentials in the Authorization header are not valid or have expired. The body of the HTTP response will contain an OperationOutcome resource that indicates that Authorization is required. |
| 500 Server Error | The server may return other error codes to indicate other error conditions. The body of the HTTP response will contain an OperationOutcome resource that indicates the nature of the error. |