Charge Item Definition
Summary
The Charge Item Definition resource in the CARE system outlines the billing rules and pricing details associated with healthcare services and products. It serves as a blueprint for how charges are calculated, considering various factors such as patient demographics, service context, and applicable taxes.
This resource aligns with FHIR's ChargeItemDefinition resource, providing a standardized framework for representing billing information.FHIR Build
Key Purpose
- Define billing rules and pricing structures for healthcare services and products.
- Enable automated charge item creation based on clinical data entry.
- Support conditional pricing based on patient attributes and service context.
- Facilitate tax calculations and regional billing configurations.imagineteam.com+7HL7 Confluence+7RCM Matter+7Medical Billing Star
Core Relationships
| Related Resource | Purpose |
|---|---|
ActivityDefinition | Resource whose execution will generate this charge |
Medication | Medication product that incurs a cost |
Encounter, Patient | Used in condition evaluation for dynamic pricing |
Supported Fields
| Field Name | Description | Example |
|---|---|---|
title | Name for human readability | "CBC Test Standard Rate" |
slug | Unique internal reference | "cbc-charge" |
derivedFromUri | Canonical URL reference if derived from standard | "http://example.org/rates/cbc" |
status | Lifecycle status (draft, active, etc.) | "active" |
facility | The facility where this pricing applies | Facility/medicity |
description | Free-text description of the charge definition | "Pricing for CBC including lab work" |
purpose | Rationale for the charge | "Used to generate automated bills" |
code | Internal or external billing/product code | "CBC01" |
instance[] | List of linked resources (ActivityDefinition, Medication) | [ActivityDefinition/cbc] |
propertyGroup[] | Array of pricing conditions and breakdowns | See below |
baseprice[] | Base Charge for a lab test | See below |
discounts[] | Price reduction applied to the base amount before tax | See below |
taxes[] | Applicable government taxes | See below |
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### Functional Workflow
1. **Definition Creation**: A Charge Item Definition is created, detailing the billing rules and pricing structures for specific services or products.
2. **Automated Charge Generation**: When clinical data is entered (e.g., medication requests), the system automatically generates corresponding charge items based on the definitions.
3. **Conditional Pricing**: The system evaluates patient and encounter data against the applicability conditions to determine the appropriate pricing.
4. **Tax Calculation**: Applicable taxes are calculated based on configured tax codes and added to the total charge.
5. **Billing Integration**: The final charge, including all components, is integrated into the billing system for invoicing and payment processing.