Invoice Provider
Invoice Provider
Introduction
The Invoice Provider data model is a crucial component within healthcare information systems, designed to manage and record detailed information about healthcare providers responsible for generating and sending invoices to patients or insurance companies for services rendered. This model primarily focuses on capturing provider-related data, especially as detailed in the FT1 (Financial Transaction) and PV1 (Patient Visit) segments of HL7 messages. It plays a vital role in facilitating accurate and transparent billing processes within healthcare organizations.
Use Case
Developers can harness the capabilities of the Invoice Provider data model to support various technical use cases, allowing for the efficient management of provider-related invoicing and financial transactions:
- Billing System Integration: Developers can use this model to integrate provider information into billing systems, ensuring that invoices are generated accurately and attributed to the correct healthcare provider.
- Provider Performance Analysis: Developers can query this model to analyze provider performance in terms of the volume and value of services provided. This information aids in assessing provider efficiency and profitability.
- Billing Audits: Developers can use this model to support billing audits by tracking invoice IDs, batch IDs, and provider details, ensuring that invoices are correctly issued and compliant with regulations.
- Revenue Attribution: Developers can attribute revenue to specific providers based on the data captured in this model. This information is crucial for understanding revenue distribution among providers.
- Provider Compensation: Healthcare organizations often compensate providers based on services rendered. Developers can use this model to calculate and manage provider compensation, taking into account service volumes and types.
- Claims Management: Developers can integrate this model with claims processing systems to streamline the verification of provider information on insurance claims, reducing errors and claim denials.
- Financial Reporting: Developers can generate financial reports that include provider-specific data, helping organizations gain insights into the financial performance of individual providers.
- Compliance Monitoring: The model aids developers in monitoring provider compliance with billing regulations and standards. It enables tracking of provider-specific billing practices.
- Provider Billing History: Developers can create applications that provide providers with access to their billing history, including invoice details, payment status, and adjustments.
- Data Analytics: Researchers and analysts can use this model to perform data analytics, such as assessing provider billing patterns and identifying billing discrepancies.
Data Fields
| Attribute Name | Description | HL7 Mapping | Data Type | Label | Use Case |
|---|---|---|---|---|---|
| alternate_visit_id | Alternative visit id | PV1-50/PID-18 | string | Alternate Visit Id | This field provides an alternate identifier for a patient's visit. It is used for tracking and cross-referencing patient visits and records, especially in scenarios requiring multiple identifiers or references. This field is recorded during patient registration and aids in accurate record linkage. |
| provider_type | Role of the provider | FT1-20 | string | Provider Type | This field categorises the type of healthcare provider or entity associated with a particular financial transaction. It specifies the provider's role or category. |
| xc_visit_id | XC visit id | Based on alternate_visit_id followed by visit_number followed by system generated ID | string | XC visit id | The "xc_visit_id" is a unique identifier used to group together all the interactions, procedures, tests, and check-ups associated with a single patient visit in a healthcare setting. This identifier helps in organising and managing various activities and data related to that specific patient encounter. |
| patient_id | This is patient_id attribute | PID-3-1 | string | Patient ID | The patient ID is a unique identifier assigned to a patient within the healthcare system. It is used to accurately identify and link a patient's medical records, treatments, and history. |
| lineage | This is lineage attribute | Fixed - HL7 | string | Lineage | "lineage" refers to the information about the origin or source of a message. It helps trace the path of the message, indicating where it originated, how it was transmitted, and any intermediate systems or components it passed through before reaching its destination. |
| invoice_id | This is invoice_id attribute | FT1+MSH-10 | string | Invoice ID | This field can be used to create a unique identifier for an invoice or financial transaction. Healthcare organisations may use such an identifier to manage and track invoices related to patient billing. |
| provider_uid | This is provider_uid attribute | System Generated | string | Provider UID | This is the unique identifier assigned to a healthcare provider. It distinguishes one provider from another within the XC system. |
| bundle_id | ID of bundle | MSH-10 | string | Bundle ID | “bundle ID" typically refers to a unique identifier assigned to a group or bundle of related messages or data elements. This identifier is used to associate multiple messages or pieces of information that are related to a specific patient, event, or transaction. |
| batch_id | Batch id | System Generated | string | Batch ID | "batch ID" is a unique identifier assigned to a group of messages that are logically grouped together for processing or transmission. Batching messages is a common practice in healthcare systems to efficiently manage and transmit multiple messages as a single unit |
| encounter_id | Encounter ID | PV1+MSH-10 | string | Encounter ID | This unique identifier is used to associate various HL7 messages with a specific patient encounter or visit. It ensures that data and events are accurately linked to the correct patient's healthcare journey. |
| provider_id | Id of the provider | FT1-20+MSH-10, FT1-21+ MSH-10, FT1-24+MSH-10 | string | Provider Id | This fields contain identifiers that specify the healthcare provider or entity associated with a particular financial transaction. These identifiers can include National Provider Identifiers (NPIs) or other provider-specific codes. |
| visit_number | Id of the visit | PV1-19-1 | string | Visit Number | The visit number serves as a unique identifier for a specific patient visit or encounter within a healthcare facility. It distinguishes one visit from another. |