vn-core-payment-reconciliation
type: StructureDefinition
node role: treeRoot
id:
  v: vn-core-payment-reconciliation
language:
  v: vi
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: StructureDefinition vn-core-payment-reconciliation Name Flags Card. Type Description & Constraints<img src="[binary]" alt="doco" style="background-color: inherit"/> PaymentReconciliation 0..* PaymentReconciliation PaymentReconciliation resource #xD; Slices for extension 0..* Extension Extension Slice: Unordered, Open by value:url #xD; extension:formNumber S 0..1 string Số hiệu biên bản 06/BH (TT 12/2026/TT-BTC) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-reconciliation-form #xD; extension:auditStatus S 0..1 CodeableConcept Trạng thái giám định BHYT (received | under-review | approved | rejected | disputed) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-audit-status Binding: Trạng thái giám định BHYT — VN Claim Audit Status ValueSet (extensible) #xD; status S 1..1 code Trạng thái resource (active | cancelled | draft | entered-in-error) #xD; period S 1..1 Period Chu kỳ quyết toán BHYT (tháng/quý) #xD; created S 1..1 dateTime Ngày lập biên bản 06/BH #xD; paymentIssuer S 0..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Cơ quan BHXH chi trả (BHXH cấp tỉnh/Trung ương) #xD; request S 0..1 Reference(Task) Hồ sơ/đề nghị thanh toán liên quan (optional) #xD; outcome S 0..1 code Kết quả tổng quát chuẩn FHIR (queued | complete | error | partial) #xD; paymentAmount S 1..1 Money Tổng tiền BHXH thanh toán theo biên bản 06/BH #xD; detail S 1..* BackboneElement Chi tiết quyết toán theo từng Claim (mỗi dòng 06/BH) #xD; type S 1..1 CodeableConcept Loại giao dịch (payment | adjustment | advance...) #xD; request S 0..1 Reference(Yêu cầu thanh toán KCB VN Core — VN Core Claim Profile) Tham chiếu Claim được quyết toán #xD; amount S 0..1 Money Số tiền quyết toán cho Claim (VND) #xD; <img src="[binary]" alt="doco" style="background-color: inherit"/> Documentation for this format
extension:
  url:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-legal-basis
    l: vn-ext-legal-basis
  value: Coding
    system:
      v: http://fhir.hl7.org.vn/core/CodeSystem/vn-legal-document-ref-cs
      l: vn-legal-document-ref-cs
    code:
      v: TT-12-2026-BTC
extension:
  url:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-legal-basis
    l: vn-ext-legal-basis
  value: Coding
    system:
      v: http://fhir.hl7.org.vn/core/CodeSystem/vn-legal-document-ref-cs
      l: vn-legal-document-ref-cs
    code:
      v: ND-188-2025
extension:
  url:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-legal-basis
    l: vn-ext-legal-basis
  value: Coding
    system:
      v: http://fhir.hl7.org.vn/core/CodeSystem/vn-legal-document-ref-cs
      l: vn-legal-document-ref-cs
    code:
      v: ND-164-2025
extension:
  url:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-legal-basis
    l: vn-ext-legal-basis
  value: Coding
    system:
      v: http://fhir.hl7.org.vn/core/CodeSystem/vn-legal-document-ref-cs
      l: vn-legal-document-ref-cs
    code:
      v: ND-233-2025
extension:
  url:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-legal-basis
    l: vn-ext-legal-basis
  value: Coding
    system:
      v: http://fhir.hl7.org.vn/core/CodeSystem/vn-legal-document-ref-cs
      l: vn-legal-document-ref-cs
    code:
      v: L-51-2024
url:
  v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-payment-reconciliation
  l: vn-core-payment-reconciliation
version:
  v: 0.5.1
name:
  v: VNCorePaymentReconciliation
title:
  v: Quyết toán BHYT VN Core — VN Core Payment Reconciliation Profile
status:
  v: draft
date:
  v: 2026-04-27
publisher:
  v: Omi HealthTech / VN Core FHIR Community Initiative
contact:
  name:
    v: Omi HealthTech / VN Core FHIR Community Initiative
  telecom:
    system:
      v: url
    value:
      v: https://hl7.org.vn
  telecom:
    system:
      v: email
contact:
  name:
    v: Omi HealthTech (OmiGroup)
  telecom:
    system:
      v: url
    value:
      v: https://omihealthtech.vn
  telecom:
    system:
      v: url
    value:
      v: https://omigroup.vn
  telecom:
    system:
      v: email
description:
  v: Profile PaymentReconciliation cho biên bản quyết toán/thanh toán chi phí KCB BHYT giữa cơ sở KCB và cơ quan BHXH (biểu mẫu 06/BH). Mỗi PaymentReconciliation tổng hợp kết quả giám định cho một chu kỳ quyết toán (thông thường theo tháng/quý) và liệt kê các Claim được duyệt/từ chối/tranh chấp. Căn cứ: - TT 12/2026/TT-BTC — Bộ Tài chính, hướng dẫn giám định, thanh toán, quyết toán chi phí KCB BHYT điện tử; Điều 6 và Phụ lục biểu mẫu 06/BH. - NĐ 188/2025/NĐ-CP (ban hành 01/07/2025, hiệu lực 15/08/2025) — Hướng dẫn thi hành Luật BHYT. - NĐ 164/2025/NĐ-CP (29/06/2025) — Giao dịch điện tử trong lĩnh vực BHXH. - Luật 51/2024/QH15 — Luật BHYT sửa đổi.
jurisdiction:
  coding:
    system:
      v: urn:iso:std:iso:3166
      l: 3166
    code:
      v: VN
    display:
      v: Viet Nam
fhir version:
  v: 4.0.1
mapping:
  identity:
    v: workflow
  uri:
    v: http://hl7.org/fhir/workflow
    l: workflow
  name:
    v: Workflow Pattern
mapping:
  identity:
    v: w5
  uri:
    v: http://hl7.org/fhir/fivews
    l: fivews
  name:
    v: FiveWs Pattern Mapping
mapping:
  identity:
    v: cdanetv4
  uri:
    v: http://www.cda-adc.ca/en/services/cdanet/
    l: cdanet
  name:
    v: Canadian Dental Association eclaims standard
mapping:
  identity:
    v: rim
  uri:
    v: http://hl7.org/v3
    l: v3
  name:
    v: RIM Mapping
kind:
  v: resource
abstract:
  v: false
type:
  v: PaymentReconciliation
  l: PaymentReconciliation
base definition:
  v: http://hl7.org/fhir/StructureDefinition/PaymentReconciliation
  l: PaymentReconciliation
derivation:
  v: constraint
snapshot:
  extension:
    url:
      v: http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version
      l: snapshot-base-version
    value: String
      v: 4.0.1
  element:
    id:
      v: PaymentReconciliation
    path:
      v: PaymentReconciliation
    short:
      v: PaymentReconciliation resource
    definition:
      v: This resource provides the details including amount of a payment and allocates the payment items being paid.
    min:
      v: 0
    max:
      v: *
    base:
      path:
        v: PaymentReconciliation
      min:
        v: 0
      max:
        v: *
    constraint:
      key:
        v: dom-2
      severity:
        v: error
      human:
        v: If the resource is contained in another resource, it SHALL NOT contain nested Resources
      expression:
        v: contained.contained.empty()
      xpath:
        v: not(parent::f:contained and f:contained)
      source:
        v: http://hl7.org/fhir/StructureDefinition/DomainResource
        l: DomainResource
    constraint:
      key:
        v: dom-3

v: error

v: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource

v: contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()

v: not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))

key:
  v: dom-4
severity:
  v: error
human:
  v: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
expression:
  v: contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
xpath:
  v: not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))
source:
  v: http://hl7.org/fhir/StructureDefinition/DomainResource
  l: DomainResource

key:
  v: dom-5
severity:
  v: error
human:
  v: If a resource is contained in another resource, it SHALL NOT have a security label
expression:
  v: contained.meta.security.empty()
xpath:
  v: not(exists(f:contained/*/f:meta/f:security))
source:
  v: http://hl7.org/fhir/StructureDefinition/DomainResource
  l: DomainResource

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice
    l: elementdefinition-bestpractice
  value: Boolean
    v: true
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation
    l: elementdefinition-bestpractice-explanation
  value: Markdown
    v: When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time.
key:
  v: dom-6
severity:
  v: warning
human:
  v: A resource should have narrative for robust management
expression:
  v: text.`div`.exists()
xpath:
  v: exists(f:text/h:div)
source:
  v: http://hl7.org/fhir/StructureDefinition/DomainResource
  l: DomainResource

v: false

v: false

identity:
  v: rim
map:
  v: Entity. Role, or Act

identity:
  v: workflow
map:
  v: Event

id:
  v: PaymentReconciliation.id
path:
  v: PaymentReconciliation.id
short:
  v: Logical id of this artifact
definition:
  v: The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
comment:
  v: The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: id
      l: id
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: true

id:
  v: PaymentReconciliation.meta
path:
  v: PaymentReconciliation.meta
short:
  v: Metadata about the resource
definition:
  v: The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.meta
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Meta
    l: Meta
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: PaymentReconciliation.implicitRules
path:
  v: PaymentReconciliation.implicitRules
short:
  v: A set of rules under which this content was created
definition:
  v: A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.
comment:
  v: Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.implicitRules
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: uri
    l: uri
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: true
is modifier reason:
  v: This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
is summary:
  v: true

id:
  v: PaymentReconciliation.language
path:
  v: PaymentReconciliation.language
short:
  v: Language of the resource content
definition:
  v: The base language in which the resource is written.
comment:
  v: Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Resource.language
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet
      l: elementdefinition-maxValueSet
    value: Canonical
      v: http://hl7.org/fhir/ValueSet/all-languages
      l: all-languages
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Language
  strength:
    v: preferred
  description:
    v: A human language.
  value set:
    v: http://hl7.org/fhir/ValueSet/languages|4.0.1
    l: http://hl7.org/fhir/ValueSet/languages

id:
  v: PaymentReconciliation.text
path:
  v: PaymentReconciliation.text
short:
  v: Text summary of the resource, for human interpretation
definition:
  v: A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
comment:
  v: Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.
alias:
  v: narrative
alias:
  v: html
alias:
  v: xhtml
alias:
  v: display
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Narrative
    l: Narrative
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: Act.text?

id:
  v: PaymentReconciliation.contained
path:
  v: PaymentReconciliation.contained
short:
  v: Contained, inline Resources
definition:
  v: These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
comment:
  v: This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.
alias:
  v: inline resources
alias:
  v: anonymous resources
alias:
  v: contained resources
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.contained
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Resource
    l: Resource
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: PaymentReconciliation.extension
path:
  v: PaymentReconciliation.extension
slicing:
  discriminator:
    type:
      v: value
    path:
      v: url
  ordered:
    v: false
  rules:
    v: open
short:
  v: Extension
definition:
  v: An Extension
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.extension:formNumber
path:
  v: PaymentReconciliation.extension
slice name:
  v: formNumber
short:
  v: Số hiệu biên bản 06/BH (TT 12/2026/TT-BTC)
definition:
  v: Số hiệu biên bản quyết toán/thanh toán chi phí KCB BHYT (biểu mẫu 06/BH) giữa cơ sở KCB và cơ quan BHXH. Căn cứ: - TT 12/2026/TT-BTC — Bộ Tài chính, Điều 6 và Phụ lục biểu mẫu 06/BH (Biên bản quyết toán chi phí KCB BHYT).
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-reconciliation-form
    l: vn-ext-payment-reconciliation-form
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.extension:auditStatus
path:
  v: PaymentReconciliation.extension
slice name:
  v: auditStatus
short:
  v: Trạng thái giám định BHYT (received | under-review | approved | rejected | disputed)
definition:
  v: Mở rộng vòng đời giám định BHYT Việt Nam theo TT 12/2026/TT-BTC. Bổ sung cho `PaymentReconciliation.outcome` chuẩn FHIR vốn chỉ có queued/complete/error/partial.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: DomainResource.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
  profile:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-audit-status
    l: vn-ext-claim-audit-status
condition:
  v: ele-1
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.modifierExtension
path:
  v: PaymentReconciliation.modifierExtension
short:
  v: Extensions that cannot be ignored
definition:
  v: May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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 is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: 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.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: DomainResource.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: PaymentReconciliation.identifier
path:
  v: PaymentReconciliation.identifier
short:
  v: Business Identifier for a payment reconciliation
definition:
  v: A unique identifier assigned to this payment reconciliation.
requirements:
  v: Allows payment reconciliations to be distinguished and referenced.
min:
  v: 0
max:
  v: *
base:
  path:
    v: PaymentReconciliation.identifier
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Event.identifier
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.identifier

id:
  v: PaymentReconciliation.status
path:
  v: PaymentReconciliation.status
short:
  v: Trạng thái resource (active | cancelled | draft | entered-in-error)
definition:
  v: The status of the resource instance.
comment:
  v: This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
requirements:
  v: Need to track the status of the resource as 'draft' resources may undergo further edits while 'active' resources are immutable and may only have their status changed to 'cancelled'.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.status
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: true
is modifier reason:
  v: This element is labelled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid
is summary:
  v: true
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: PaymentReconciliationStatus
  strength:
    v: required
  description:
    v: A code specifying the state of the resource instance.
  value set:
    v: http://hl7.org/fhir/ValueSet/fm-status|4.0.1
    l: http://hl7.org/fhir/ValueSet/fm-status
mapping:
  identity:
    v: workflow
  map:
    v: Event.status
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.status

id:
  v: PaymentReconciliation.period
path:
  v: PaymentReconciliation.period
short:
  v: Chu kỳ quyết toán BHYT (tháng/quý)
definition:
  v: Khoảng thời gian áp dụng cho biên bản quyết toán 06/BH — thông thường là một tháng hoặc một quý theo TT 12/2026/TT-BTC.
requirements:
  v: Needed to allow receivers to monitor and reconcile payment issuer schedules.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.period
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Period
    l: Period
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.done[x]

id:
  v: PaymentReconciliation.created
path:
  v: PaymentReconciliation.created
short:
  v: Ngày lập biên bản 06/BH
definition:
  v: The date when the resource was created.
requirements:
  v: Need to record a timestamp for use by both the recipient and the issuer.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.created
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: dateTime
    l: dateTime
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.occurrence[x]
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.recorded

id:
  v: PaymentReconciliation.paymentIssuer
path:
  v: PaymentReconciliation.paymentIssuer
short:
  v: Cơ quan BHXH chi trả (BHXH cấp tỉnh/Trung ương)
definition:
  v: The party who generated the payment.
comment:
  v: This party is also responsible for the reconciliation.
requirements:
  v: Need to identify the party resonsible for the payment and this resource.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.paymentIssuer
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization
    l: vn-core-organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true
mapping:
  identity:
    v: workflow
  map:
    v: Event.performer.actor
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.source

id:
  v: PaymentReconciliation.request
path:
  v: PaymentReconciliation.request
short:
  v: Hồ sơ/đề nghị thanh toán liên quan (optional)
definition:
  v: Tham chiếu Task đại diện cho hồ sơ đề nghị thanh toán mà PaymentReconciliation này quyết toán. Optional — có thể null nếu workflow không track Task.
requirements:
  v: Needed to allow the response to be linked to the request.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.request
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Task|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Task
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: w5
  map:
    v: FiveWs.why[x]
mapping:
  identity:
    v: cdanetv4
  map:
    v: A02|G01

id:
  v: PaymentReconciliation.requestor
path:
  v: PaymentReconciliation.requestor
short:
  v: Responsible practitioner
definition:
  v: The practitioner who is responsible for the services rendered to the patient.
requirements:
  v: Need to identify the party responsible for the request.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.requestor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: cdanetv4
  map:
    v: B01

id:
  v: PaymentReconciliation.outcome
path:
  v: PaymentReconciliation.outcome
short:
  v: Kết quả tổng quát chuẩn FHIR (queued | complete | error | partial)
definition:
  v: Giữ binding required chuẩn FHIR. Để biểu diễn vòng đời giám định BHYT Việt Nam theo TT 12/2026/TT-BTC, dùng PaymentReconciliation.extension[auditStatus] với VNClaimAuditStatusVS.
comment:
  v: The resource may be used to indicate that: the request has been held (queued) for processing; that it has been processed and errors found (error); that no errors were found and that some of the adjudication has been undertaken (partial) or that all of the adjudication has been undertaken (complete).
requirements:
  v: To advise the requestor of an overall processing outcome.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.outcome
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: RemittanceOutcome
  strength:
    v: required
  description:
    v: The outcome of the processing.
  value set:
    v: http://hl7.org/fhir/ValueSet/remittance-outcome|4.0.1
    l: http://hl7.org/fhir/ValueSet/remittance-outcome

id:
  v: PaymentReconciliation.disposition
path:
  v: PaymentReconciliation.disposition
short:
  v: Disposition message
definition:
  v: A human readable description of the status of the request for the reconciliation.
requirements:
  v: Provided for user display.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.disposition
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: workflow
  map:
    v: Event.note

id:
  v: PaymentReconciliation.paymentDate
path:
  v: PaymentReconciliation.paymentDate
short:
  v: When payment issued
definition:
  v: The date of payment as indicated on the financial instrument.
requirements:
  v: To advise the payee when payment can be expected.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.paymentDate
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: date
    l: date
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: true

id:
  v: PaymentReconciliation.paymentAmount
path:
  v: PaymentReconciliation.paymentAmount
short:
  v: Tổng tiền BHXH thanh toán theo biên bản 06/BH
definition:
  v: Total payment amount as indicated on the financial instrument.
requirements:
  v: Needed to provide the actual payment amount.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.paymentAmount
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: true

id:
  v: PaymentReconciliation.paymentIdentifier
path:
  v: PaymentReconciliation.paymentIdentifier
short:
  v: Business identifier for the payment
definition:
  v: Issuer's unique identifier for the payment instrument.
comment:
  v: For example: EFT number or check number.
requirements:
  v: Enable the receiver to reconcile when payment is received.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.paymentIdentifier
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail
path:
  v: PaymentReconciliation.detail
short:
  v: Chi tiết quyết toán theo từng Claim (mỗi dòng 06/BH)
definition:
  v: Distribution of the payment amount for a previously acknowledged payable.
requirements:
  v: Needed to show how the payment amount is distributed across the payables.
min:
  v: 1
max:
  v: *
base:
  path:
    v: PaymentReconciliation.detail
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.id
path:
  v: PaymentReconciliation.detail.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: PaymentReconciliation.detail.extension
path:
  v: PaymentReconciliation.detail.extension
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: PaymentReconciliation.detail.modifierExtension
path:
  v: PaymentReconciliation.detail.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: 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.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: PaymentReconciliation.detail.identifier
path:
  v: PaymentReconciliation.detail.identifier
short:
  v: Business identifier of the payment detail
definition:
  v: Unique identifier for the current payment item for the referenced payable.
requirements:
  v: Needed for reconciliation of payments.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.identifier
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.predecessor
path:
  v: PaymentReconciliation.detail.predecessor
short:
  v: Business identifier of the prior payment detail
definition:
  v: Unique identifier for the prior payment item for the referenced payable.
requirements:
  v: Needed for reconciliation of payments.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.predecessor
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Identifier
    l: Identifier
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.type
path:
  v: PaymentReconciliation.detail.type
short:
  v: Loại giao dịch (payment | adjustment | advance...)
definition:
  v: Code to indicate the nature of the payment.
comment:
  v: For example: payment, adjustment, funds advance, etc.
requirements:
  v: Needed to provide context for the amount.
min:
  v: 1
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.type
  min:
    v: 1
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: PaymentType
  strength:
    v: example
  description:
    v: The reason for the amount: payment, adjustment, advance.
  value set:
    v: http://hl7.org/fhir/ValueSet/payment-type|4.0.1
    l: http://hl7.org/fhir/ValueSet/payment-type

id:
  v: PaymentReconciliation.detail.request
path:
  v: PaymentReconciliation.detail.request
short:
  v: Tham chiếu Claim được quyết toán
definition:
  v: A resource, such as a Claim, the evaluation of which could lead to payment.
requirements:
  v: Needed to provide a linkage to the original request.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.request
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim
    l: vn-core-claim
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.submitter
path:
  v: PaymentReconciliation.detail.submitter
short:
  v: Submitter of the request
definition:
  v: The party which submitted the claim or financial transaction.
requirements:
  v: Needed for audit and validation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.submitter
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.response
path:
  v: PaymentReconciliation.detail.response
short:
  v: Response committing to a payment
definition:
  v: A resource, such as a ClaimResponse, which contains a commitment to payment.
requirements:
  v: Needed to provide a linkage to the payment commitment.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.response
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Resource|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Resource
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.date
path:
  v: PaymentReconciliation.detail.date
short:
  v: Date of commitment to pay
definition:
  v: The date from the response resource containing a commitment to pay.
requirements:
  v: Needed for audit and validation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.date
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: date
    l: date
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.responsible
path:
  v: PaymentReconciliation.detail.responsible
short:
  v: Contact for the response
definition:
  v: A reference to the individual who is responsible for inquiries regarding the response and its payment.
requirements:
  v: To provide contact information.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.responsible
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/PractitionerRole
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.payee
path:
  v: PaymentReconciliation.detail.payee
short:
  v: Recipient of the payment
definition:
  v: The party which is receiving the payment.
requirements:
  v: Needed for audit and validation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.payee
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Reference
    l: Reference
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Practitioner|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Practitioner
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/PractitionerRole|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/PractitionerRole
  target profile:
    v: http://hl7.org/fhir/StructureDefinition/Organization|4.0.1
    l: http://hl7.org/fhir/StructureDefinition/Organization
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.detail.amount
path:
  v: PaymentReconciliation.detail.amount
short:
  v: Số tiền quyết toán cho Claim (VND)
definition:
  v: The monetary amount allocated from the total payment to the payable.
requirements:
  v: Needed to explain the distribution of the payment to the payables.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.detail.amount
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: Money
    l: Money
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
must support:
  v: true
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.formCode
path:
  v: PaymentReconciliation.formCode
short:
  v: Printed form identifier
definition:
  v: A code for the form to be used for printing the content.
comment:
  v: May be needed to identify specific jurisdictional forms.
requirements:
  v: Needed to specify the specific form used for producing output for this response.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.formCode
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: CodeableConcept
    l: CodeableConcept
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: Forms
  strength:
    v: example
  description:
    v: The forms codes.
  value set:
    v: http://hl7.org/fhir/ValueSet/forms|4.0.1
    l: http://hl7.org/fhir/ValueSet/forms

id:
  v: PaymentReconciliation.processNote
path:
  v: PaymentReconciliation.processNote
short:
  v: Note concerning processing
definition:
  v: A note that describes or explains the processing in a human readable form.
requirements:
  v: Provides the specific textual explanations associated with the processing.
min:
  v: 0
max:
  v: *
base:
  path:
    v: PaymentReconciliation.processNote
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: BackboneElement
    l: BackboneElement
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false

id:
  v: PaymentReconciliation.processNote.id
path:
  v: PaymentReconciliation.processNote.id
representation:
  v: xmlAttr
short:
  v: Unique id for inter-element referencing
definition:
  v: Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: Element.id
  min:
    v: 0
  max:
    v: 1
type:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type
      l: structuredefinition-fhir-type
    value: Url
      v: string
      l: string
  code:
    v: http://hl7.org/fhirpath/System.String
    l: System.String
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: PaymentReconciliation.processNote.extension
path:
  v: PaymentReconciliation.processNote.extension
short:
  v: Additional content defined by implementations
definition:
  v: 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.
comment:
  v: 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.
alias:
  v: extensions
alias:
  v: user content
min:
  v: 0
max:
  v: *
base:
  path:
    v: Element.extension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: rim
  map:
    v: n/a

id:
  v: PaymentReconciliation.processNote.modifierExtension
path:
  v: PaymentReconciliation.processNote.modifierExtension
short:
  v: Extensions that cannot be ignored even if unrecognized
definition:
  v: May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. 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. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
comment:
  v: 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.
requirements:
  v: Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension).
alias:
  v: extensions
alias:
  v: user content
alias:
  v: modifiers
min:
  v: 0
max:
  v: *
base:
  path:
    v: BackboneElement.modifierExtension
  min:
    v: 0
  max:
    v: *
type:
  code:
    v: Extension
    l: Extension
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
constraint:
  key:
    v: ext-1
  severity:
    v: error
  human:
    v: Must have either extensions or value[x], not both
  expression:
    v: extension.exists() != value.exists()
  xpath:
    v: exists(f:extension)!=exists(f:*[starts-with(local-name(.), "value")])
  source:
    v: http://hl7.org/fhir/StructureDefinition/Extension
    l: Extension
is modifier:
  v: true
is modifier reason:
  v: Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
is summary:
  v: true
mapping:
  identity:
    v: rim
  map:
    v: N/A

id:
  v: PaymentReconciliation.processNote.type
path:
  v: PaymentReconciliation.processNote.type
short:
  v: display | print | printoper
definition:
  v: The business purpose of the note text.
requirements:
  v: To convey the expectation for when the text is used.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.processNote.type
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: code
    l: code
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
binding:
  extension:
    url:
      v: http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName
      l: elementdefinition-bindingName
    value: String
      v: NoteType
  strength:
    v: required
  description:
    v: The presentation types of notes.
  value set:
    v: http://hl7.org/fhir/ValueSet/note-type|4.0.1
    l: http://hl7.org/fhir/ValueSet/note-type

id:
  v: PaymentReconciliation.processNote.text
path:
  v: PaymentReconciliation.processNote.text
short:
  v: Note explanatory text
definition:
  v: The explanation or description associated with the processing.
requirements:
  v: Required to provide human readable explanation.
min:
  v: 0
max:
  v: 1
base:
  path:
    v: PaymentReconciliation.processNote.text
  min:
    v: 0
  max:
    v: 1
type:
  code:
    v: string
    l: string
constraint:
  key:
    v: ele-1
  severity:
    v: error
  human:
    v: All FHIR elements must have a @value or children
  expression:
    v: hasValue() or (children().count() > id.count())
  xpath:
    v: @value|f:*|h:div
  source:
    v: http://hl7.org/fhir/StructureDefinition/Element
    l: Element
is modifier:
  v: false
is summary:
  v: false
mapping:
  identity:
    v: cdanetv4
  map:
    v: G32

element:
  id:
    v: PaymentReconciliation
  path:
    v: PaymentReconciliation
element:
  id:
    v: PaymentReconciliation.extension
  path:
    v: PaymentReconciliation.extension
  slicing:
    discriminator:
      type:
        v: value
      path:
        v: url
    ordered:
      v: false
    rules:
      v: open
element:
  id:
    v: PaymentReconciliation.extension:formNumber
  path:
    v: PaymentReconciliation.extension
  slice name:
    v: formNumber
  short:
    v: Số hiệu biên bản 06/BH (TT 12/2026/TT-BTC)
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: Extension
      l: Extension
    profile:
      v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-reconciliation-form
      l: vn-ext-payment-reconciliation-form
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.extension:auditStatus
  path:
    v: PaymentReconciliation.extension
  slice name:
    v: auditStatus
  short:
    v: Trạng thái giám định BHYT (received | under-review | approved | rejected | disputed)
  definition:
    v: Mở rộng vòng đời giám định BHYT Việt Nam theo TT 12/2026/TT-BTC. Bổ sung cho `PaymentReconciliation.outcome` chuẩn FHIR vốn chỉ có queued/complete/error/partial.
  min:
    v: 0
  max:
    v: 1
  type:
    code:
      v: Extension
      l: Extension
    profile:
      v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-audit-status
      l: vn-ext-claim-audit-status
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.status
  path:
    v: PaymentReconciliation.status
  short:
    v: Trạng thái resource (active | cancelled | draft | entered-in-error)
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.period
  path:
    v: PaymentReconciliation.period
  short:
    v: Chu kỳ quyết toán BHYT (tháng/quý)
  definition:
    v: Khoảng thời gian áp dụng cho biên bản quyết toán 06/BH — thông thường là một tháng hoặc một quý theo TT 12/2026/TT-BTC.
  min:
    v: 1
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.created
  path:
    v: PaymentReconciliation.created
  short:
    v: Ngày lập biên bản 06/BH
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.paymentIssuer
  path:
    v: PaymentReconciliation.paymentIssuer
  short:
    v: Cơ quan BHXH chi trả (BHXH cấp tỉnh/Trung ương)
  type:
    code:
      v: Reference
      l: Reference
    target profile:
      v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization
      l: vn-core-organization
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.request
  path:
    v: PaymentReconciliation.request
  short:
    v: Hồ sơ/đề nghị thanh toán liên quan (optional)
  definition:
    v: Tham chiếu Task đại diện cho hồ sơ đề nghị thanh toán mà PaymentReconciliation này quyết toán. Optional — có thể null nếu workflow không track Task.
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.outcome
  path:
    v: PaymentReconciliation.outcome
  short:
    v: Kết quả tổng quát chuẩn FHIR (queued | complete | error | partial)
  definition:
    v: Giữ binding required chuẩn FHIR. Để biểu diễn vòng đời giám định BHYT Việt Nam theo TT 12/2026/TT-BTC, dùng PaymentReconciliation.extension[auditStatus] với VNClaimAuditStatusVS.
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.paymentAmount
  path:
    v: PaymentReconciliation.paymentAmount
  short:
    v: Tổng tiền BHXH thanh toán theo biên bản 06/BH
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.detail
  path:
    v: PaymentReconciliation.detail
  short:
    v: Chi tiết quyết toán theo từng Claim (mỗi dòng 06/BH)
  min:
    v: 1
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.detail.type
  path:
    v: PaymentReconciliation.detail.type
  short:
    v: Loại giao dịch (payment | adjustment | advance...)
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.detail.request
  path:
    v: PaymentReconciliation.detail.request
  short:
    v: Tham chiếu Claim được quyết toán
  type:
    code:
      v: Reference
      l: Reference
    target profile:
      v: http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim
      l: vn-core-claim
  must support:
    v: true
element:
  id:
    v: PaymentReconciliation.detail.amount
  path:
    v: PaymentReconciliation.detail.amount
  short:
    v: Số tiền quyết toán cho Claim (VND)
  must support:
    v: true