Account | Medplum

A financial tool for tracking value accrued for a particular purpose. In the healthcare field, used to track charges for a patient, cost centers, etc.

Elements

Name	Required	Type	Description
identifier		Identifier[]	Account number Details Unique identifier used to reference the account. Might or might not be intended for human use (e.g. credit card number).
status	✓	code	active \| inactive \| entered-in-error \| on-hold \| unknown Details Indicates whether the account is presently used/usable or not. This element is labeled as a modifier because the status contains the codes inactive and entered-in-error that mark the Account as not currently valid.
type		CodeableConcept	E.g. patient, expense, depreciation Details Categorizes the account for reporting and searching purposes.
name		string	Human-readable label Details Name used for the account when displaying it to humans in reports, etc.
subject		Reference< Patient\| Device\| Practitioner\| PractitionerRole\| Location\| HealthcareService\| Organization >[]	The entity that caused the expenses Details Identifies the entity which incurs the expenses. While the immediate recipients of services or goods might be entities related to the subject, the expenses were ultimately incurred by the subject of the Account. Accounts can be applied to non-patients for tracking other non-patient related activities, such as group services (patients not tracked, and costs charged to another body), or might not be allocated.
servicePeriod		Period	Transaction window Details The date range of services associated with this account. It is possible for transactions to be posted outside the service period, as long as the service was provided within the defined service period.
coverage		AccountCoverage[]	The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account Details The party(s) that are responsible for covering the payment of this account, and what order should they be applied to the account. Typically. this may be some form of insurance, internal charges, or self-pay. Local or jurisdictional business rules may determine which coverage covers which types of billable items charged to the account, and in which order. Where the order is important, a local/jurisdictional extension may be defined to specify the order for the type of charge.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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). 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.
coverage	✓	Reference< Coverage >	The party(s), such as insurances, that may contribute to the payment of this account Details The party(s) that contribute to payment (or part of) of the charges applied to this account (including self-pay). A coverage may only be responsible for specific types of charges, and the sequence of the coverages in the account could be important when processing billing.
priority		positiveInt	The priority of the coverage in the context of this account Details The priority of the coverage in the context of this account. It is common in some jurisdictions for there to be multiple coverages allocated to an account, and a sequence is required to order the settling of the account (often with insurance claiming).
owner		Reference< Organization >	Entity managing the Account Details Indicates the service area, hospital, department, etc. with responsibility for managing the Account.
description		string	Explanation of purpose/use Details Provides additional information about what the account tracks and how it is used.
guarantor		AccountGuarantor[]	The parties ultimately responsible for balancing the Account Details The parties responsible for balancing the account if other payment options fall short.
id		string	Unique id for inter-element referencing Details Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
extension		Extension[]	Additional content defined by implementations Details 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. 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.
modifierExtension		Extension[]	Extensions that cannot be ignored even if unrecognized Details 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). 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.
party	✓	Reference< Patient\| RelatedPerson\| Organization >	Responsible entity Details The entity who is responsible.
onHold		boolean	Credit or other hold applied Details A guarantor may be placed on credit hold or otherwise have their role temporarily suspended.
period		Period	Guarantee account during Details The timeframe during which the guarantor accepts responsibility for the account.
partOf		Reference< Account >	Reference to a parent Account Details Reference to a parent Account.

Search Parameters

Name	Type	Description	Expression
identifier	token	Account number	Account.identifier
name	string	Human-readable label	Account.name
owner	reference	Entity managing the Account	Account.owner
patient	reference	The entity that caused the expenses	Account.subject.where((resolve() is Patient))
period	date	Transaction window	Account.servicePeriod
status	token	active \| inactive \| entered-in-error \| on-hold \| unknown	Account.status
subject	reference	The entity that caused the expenses	Account.subject
type	token	E.g. patient, expense, depreciation	Account.type

Inherited Elements

Name	Type	Description
id	string	Logical id of this artifact Details The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
meta	Meta	Metadata about the resource Details 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.
implicitRules	uri	A set of rules under which this content was created Details A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
language	code	Language of the resource content Details The base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag).
text	Narrative	Text summary of the resource, for human interpretation Details 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.
contained	Resource[]	Contained, inline Resources Details 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.
extension	Extension[]	Additional content defined by implementations Details May be used to represent additional information that is not part of the basic definition of the resource.
modifierExtension	Extension[]	Extensions that cannot be ignored Details 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.

The Account resource acts as a central record against which charges, payments, and adjustments are applied. It contains information about which parties are responsible for payment of the account.

While the Account does conceptually have a balance, expressing that balance directly as a resource property is challenging due to the complexity of pricing contracts. An operation to retrieve the current balance of an account is in consideration as future work.

The Account itself does not include information about the charges, payments or adjustments, but rather those resources, such as ChargeItem point to the account to which they apply. Payment and adjustment resources have not yet been developed.

The Account resource can be considered a "bucket" to which ChargeItem resources are linked. These charges are processed by a billing system, which determines the responsible parties for the balance of the account. The billing system then submits claims or sends statements to the appropriate parties. Once payment is received, an adjustment is applied to the Account. The internal calculation of balances and allocation of responsibility is expected to be internal to the billing systems. Only the inputs and outputs of the billing process is communicated in the relevant financial FHIR resources.