The Charge Item Definition holds all relevant billing information pertaining to a billing code or a product. Many billing systems have rules associated with the code which may define whether a billing code is applicable in a specific context or whether certain billing details (surcharges, discounts) apply. Charge Item Definitions may also be used to hold pricing information pertaining to only one specific instance of a product (e.g. Device, Medication or Substance) which may be a requirement for custom made devices or medications or other products where prices vary by instance. Rules for applicability may include
– A billing code is only applicable in an outpatient setting
– A surcharge that applies only to services provided outside regular business hours
– A discount that applies only to patients up to the age of 14
– A billing code that may only be charged once per Encounter
– A billing code that can only be charged in combination with another code from the same billing system
A billing engine will apply the Charge Item Definitions to all Charge Items within a specific Account in order to select all billable items an acquire the pricing details to create an Invoice. However, Charge Items may be validated against a Charge Item Definition at any point in time, using the $apply-Operation.
Fast Healthcare Interoperability Resources (FHIR) is a draft standard describing data formats and elements (known as “resources”) and an application programming interface (API) for exchanging electronic health records. The standard was created by the Health Level Seven International (HL7) health-care standards organization.
Its goal is to facilitate interoperation between legacy healthcare systems, to make it easy to provide healthcare information to healthcare providers and individuals on a wide variety of devices from computers to tablets to cell phones, and to allow third-party application developers to provide medical applications which can be easily integrated into existing systems.
FHIR provides an alternative to document-centric approaches by directly exposing discrete data elements as services. For example, basic elements of healthcare like patients, admissions, diagnostic reports and medications can each be retrieved and manipulated via their own resource URLs (Uniform Resource Locators). FHIR was supported at an American Medical Informatics Association meeting by many EHR (Electronic Health Record) vendors which value its open and extensible nature.