This resource provides the details including amount of a payment and allocates the payment items being paid.

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.

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.

An Extension

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).

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.

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).

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.

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.

The status of the resource instance.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

A code specifying the state of the resource instance.

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'.

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.

Needed to allow receivers to monitor and reconcile payment issuer schedules.

The date when the resource was created.

Need to record a timestamp for use by both the recipient and the issuer.

The party who generated the payment.

This party is also responsible for the reconciliation.

Need to identify the party resonsible for the payment and this resource.

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.

Needed to allow the response to be linked to the request.

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.

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).

The outcome of the processing.

To advise the requestor of an overall processing outcome.

The date of payment as indicated on the financial instrument.

To advise the payee when payment can be expected.

Total payment amount as indicated on the financial instrument.

Needed to provide the actual payment amount.

Distribution of the payment amount for a previously acknowledged payable.

Needed to show how the payment amount is distributed across the payables.

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.

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.

Code to indicate the nature of the payment.

For example: payment, adjustment, funds advance, etc.

The reason for the amount: payment, adjustment, advance.

Needed to provide context for the amount.

A resource, such as a Claim, the evaluation of which could lead to payment.

Needed to provide a linkage to the original request.

The monetary amount allocated from the total payment to the payable.

Needed to explain the distribution of the payment to the payables.

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.

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.

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.

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.

This resource provides the details including amount of a payment and allocates the payment items being paid.

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.

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.

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.

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.

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). 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).

A human language.

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.

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.

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.

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.

An Extension

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).

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.

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).

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.

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.

A unique identifier assigned to this payment reconciliation.

Allows payment reconciliations to be distinguished and referenced.

The status of the resource instance.

This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.

A code specifying the state of the resource instance.

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'.

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.

Needed to allow receivers to monitor and reconcile payment issuer schedules.

The date when the resource was created.

Need to record a timestamp for use by both the recipient and the issuer.

The party who generated the payment.

This party is also responsible for the reconciliation.

Need to identify the party resonsible for the payment and this resource.

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.

Needed to allow the response to be linked to the request.

The practitioner who is responsible for the services rendered to the patient.

Need to identify the party responsible for the request.

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.

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).

The outcome of the processing.

To advise the requestor of an overall processing outcome.

A human readable description of the status of the request for the reconciliation.

Provided for user display.

The date of payment as indicated on the financial instrument.

To advise the payee when payment can be expected.

Total payment amount as indicated on the financial instrument.

Needed to provide the actual payment amount.

Issuer's unique identifier for the payment instrument.

For example: EFT number or check number.

Enable the receiver to reconcile when payment is received.

Distribution of the payment amount for a previously acknowledged payable.

Needed to show how the payment amount is distributed across the payables.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

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.

Unique identifier for the current payment item for the referenced payable.

Needed for reconciliation of payments.

Unique identifier for the prior payment item for the referenced payable.

Needed for reconciliation of payments.

Code to indicate the nature of the payment.

For example: payment, adjustment, funds advance, etc.

The reason for the amount: payment, adjustment, advance.

Needed to provide context for the amount.

A resource, such as a Claim, the evaluation of which could lead to payment.

Needed to provide a linkage to the original request.

The party which submitted the claim or financial transaction.

Needed for audit and validation.

A resource, such as a ClaimResponse, which contains a commitment to payment.

Needed to provide a linkage to the payment commitment.

The date from the response resource containing a commitment to pay.

Needed for audit and validation.

A reference to the individual who is responsible for inquiries regarding the response and its payment.

To provide contact information.

The party which is receiving the payment.

Needed for audit and validation.

The monetary amount allocated from the total payment to the payable.

Needed to explain the distribution of the payment to the payables.

A code for the form to be used for printing the content.

May be needed to identify specific jurisdictional forms.

The forms codes.

Needed to specify the specific form used for producing output for this response.

A note that describes or explains the processing in a human readable form.

Provides the specific textual explanations associated with the processing.

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

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.

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.

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.

The business purpose of the note text.

The presentation types of notes.

To convey the expectation for when the text is used.

The explanation or description associated with the processing.

Required to provide human readable explanation.