Representing Encounter-related charges

Question

Where is the appropriate place in the FHIR model for encounter-related charges (professional or facility)?

Should these be stored:

1. as an extension within the Encounter resource?
2. in the Claim resource
3. somewhere else altogether?

Answer 1

In a future release of FHIR, we'll be introducing a "BillableItem" or similarly named resource that will capture the details of a specific charge or set of charges associated with an activity. It will be able to link to an encounter, patient and/or account. Unfortunately, there's been a limit to how many new resources the Financial Management work group has been able to develop given the bandwidth of their membership. In the interim, you'll need to make use of the Other (DSTU1) or Basic (DSTU2) resource if you want to stay within the schema and be technically compliant or create your own custom resource (if you're willing to be non-compliant). We'd certainly invite you to contribute back whatever you develop.

Alternatively, you may be able to get by in the interim with an extension. You can stick the extension where-ever you wish because it should be an interim solution until the appropriate work is developed.