Profile Comparison between http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-payment-reconciliation vs http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-payment-reconciliation

Messages

Metadata

Name	Value		Comments
abstract	false
baseDefinition	http://hl7.org/fhir/StructureDefinition/PaymentReconciliation
copyright
date	2026-04-27	2026-07-20	Values Differ
description	Profile PaymentReconciliation cho biên bản quyết toán/thanh toán chi phí KCB BHYT giữa cơ sở KCB và cơ quan BHXH (biểu mẫu 06/BH). Mỗi PaymentReconciliation tổng hợp kết quả giám định cho một chu kỳ quyết toán (thông thường theo tháng/quý) và liệt kê các Claim được duyệt/từ chối/tranh chấp. Căn cứ: - TT 12/2026/TT-BTC — Bộ Tài chính, hướng dẫn giám định, thanh toán, quyết toán chi phí KCB BHYT điện tử; Điều 6 và Phụ lục biểu mẫu 06/BH. - NĐ 188/2025/NĐ-CP (ban hành 01/07/2025, hiệu lực 15/08/2025) — Hướng dẫn thi hành Luật BHYT. - NĐ 164/2025/NĐ-CP (29/06/2025) — Giao dịch điện tử trong lĩnh vực BHXH. - Luật 51/2024/QH15 — Luật BHYT sửa đổi.	Profile PaymentReconciliation cho thông báo chuyển tiền/remittance và phân bổ một khoản thanh toán BHYT tổng hợp về các yêu cầu hoặc giao dịch thành phần theo semantics FHIR R4. Resource này có thể tham chiếu kỳ nghiệp vụ và các Claim liên quan, nhưng không phải carrier chuẩn của Biên bản quyết toán Mẫu 06/BH. Dữ liệu 5 phần A–E và bộ chỉ tiêu quyết toán quý phải dùng LogicalModel `VNCoreQuarterlyHealthcareCostSettlement`; nếu cần văn bản ký, render LogicalModel rồi đóng gói bằng Composition/DocumentReference. Slice formNumber được giữ để tương thích dữ liệu cũ, không biến PaymentReconciliation thành biểu mẫu 06/BH. Căn cứ: [TT 12/2026/TT-BTC] (ban hành 10/02/2026, hiệu lực 10/02/2026) — Giám định, thanh toán và quyết toán chi phí KCB BHYT; [NĐ 188/2025/NĐ-CP] (ban hành 01/07/2025, hiệu lực 15/08/2025) — Hướng dẫn thi hành Luật BHYT; [NĐ 164/2025/NĐ-CP] (ban hành 29/06/2025, hiệu lực 01/07/2025) — Giao dịch điện tử trong lĩnh vực BHXH; [Luật 51/2024/QH15] (ban hành 27/11/2024, hiệu lực 01/07/2025) — Luật BHYT sửa đổi. English summary: This profile represents a BHYT remittance or bulk payment and allocates that payment to underlying requests or transactions in accordance with FHIR R4 PaymentReconciliation semantics. It is not the canonical carrier for quarterly Form 06/BH; use `VNCoreQuarterlyHealthcareCostSettlement` for the five-section quarterly settlement dataset and render/package that model separately when a signed document is required. The formNumber slice remains only for backward compatibility.	Values Differ
experimental
fhirVersion	4.0.1
jurisdiction
jurisdiction[0]	urn:iso:std:iso:3166#VN
kind	resource
name	VNCorePaymentReconciliation
publisher	Omi HealthTech / VN Core FHIR Community Initiative
purpose
status	draft
title	Quyết toán BHYT VN Core — VN Core Payment Reconciliation Profile	Đối soát và phân bổ khoản thanh toán BHYT — VN Core BHYT Payment Reconciliation	Values Differ
type	PaymentReconciliation
url	http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-payment-reconciliation
version	0.8.0	0.9.0	Values Differ

Structure

Name	L Flags	L Card.	L Type	L Description & Constraints	R Flags	R Card.	R Type	R Description & Constraints	Comments
PaymentReconciliation		0..*	PaymentReconciliation	PaymentReconciliation resource	C	0..*	PaymentReconciliation	PaymentReconciliation resource Constraints: vn-payment-reconciliation-detail-amount-sum, vn-payment-reconciliation-money-vnd
id	Σ	0..1	id	Logical id of this artifact	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding		0..1	code	Language of the resource content Binding: ?? (preferred): A human language. Additional Bindings Purpose ?? Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url		0..*	Extension	Extension Slice: Unordered, Open by value:url
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	Business Identifier for a payment reconciliation		0..*	Identifier	Business Identifier for a payment reconciliation
status	?!SΣ	1..1	code	Trạng thái resource (active | cancelled | draft | entered-in-error) Binding: ?? (required): A code specifying the state of the resource instance.	?!SΣ	1..1	code	Trạng thái resource (active | cancelled | draft | entered-in-error) Binding: ?? (required): A code specifying the state of the resource instance.
period	SΣ	1..1	Period	Chu kỳ quyết toán BHYT (tháng/quý)	SΣ	1..1	Period	Kỳ đối soát/phân bổ khoản thanh toán — Remittance or payment-allocation period
created	SΣ	1..1	dateTime	Ngày lập biên bản 06/BH	SΣ	1..1	dateTime	Ngày tạo thông báo đối soát/remittance — Reconciliation creation date
paymentIssuer	SΣ	0..1	Reference(http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization)	Cơ quan BHXH chi trả (BHXH cấp tỉnh/Trung ương)	SΣ	0..1	Reference(Organization)	Cơ quan BHXH chi trả (BHXH cấp tỉnh/Trung ương)	Type Mismatch: Reference([CanonicalType[http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization]]) vs Reference([CanonicalType[http://hl7.org/fhir/StructureDefinition/Organization|4.0.1]])
request	S	0..1	Reference(Task)	Hồ sơ/đề nghị thanh toán liên quan (optional)	S	0..1	Reference(Task)	Hồ sơ/đề nghị thanh toán liên quan (optional)
requestor		0..1	Reference(Practitioner | PractitionerRole | Organization)	Responsible practitioner		0..1	Reference(Practitioner | PractitionerRole | Organization)	Responsible practitioner
outcome	S	0..1	code	Kết quả tổng quát chuẩn FHIR (queued | complete | error | partial) Binding: ?? (required): The outcome of the processing.	S	0..1	code	Kết quả tổng quát chuẩn FHIR (queued | complete | error | partial) Binding: ?? (required): The outcome of the processing.
disposition		0..1	string	Disposition message		0..1	string	Disposition message
paymentDate	Σ	1..1	date	When payment issued	Σ	1..1	date	When payment issued
paymentAmount	SΣ	1..1	Money	Tổng tiền BHXH thanh toán theo biên bản 06/BH	SΣ	1..1	Money	Tổng khoản thanh toán/remittance BHXH — Total BHXH remittance amount
paymentIdentifier		0..1	Identifier	Business identifier for the payment		0..1	Identifier	Business identifier for the payment
detail	S	1..*	BackboneElement	Chi tiết quyết toán theo từng Claim (mỗi dòng 06/BH)	S	1..*	BackboneElement	Phân bổ khoản thanh toán theo giao dịch/Claim — Payment allocation by transaction or Claim
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
identifier		0..1	Identifier	Business identifier of the payment detail		0..1	Identifier	Business identifier of the payment detail
predecessor		0..1	Identifier	Business identifier of the prior payment detail		0..1	Identifier	Business identifier of the prior payment detail
type	S	1..1	CodeableConcept	Loại giao dịch (payment | adjustment | advance...) Binding: ?? (example): The reason for the amount: payment, adjustment, advance.	S	1..1	CodeableConcept	Loại giao dịch (payment | adjustment | advance...) Binding: ?? (example): The reason for the amount: payment, adjustment, advance.
request	S	0..1	Reference(http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim)	Tham chiếu Claim được quyết toán	S	0..1	Reference(Yêu cầu thanh toán KCB VN Core — VN Core Claim Profile)	Claim hoặc yêu cầu được phân bổ khoản thanh toán — Claim/request receiving the allocation	Type Mismatch: Reference([CanonicalType[http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim]]) vs Reference([CanonicalType[http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim]])
submitter		0..1	Reference(Practitioner | PractitionerRole | Organization)	Submitter of the request		0..1	Reference(Practitioner | PractitionerRole | Organization)	Submitter of the request
response		0..1	Reference(Resource)	Response committing to a payment		0..1	Reference(Resource)	Response committing to a payment
date		0..1	date	Date of commitment to pay		0..1	date	Date of commitment to pay
responsible		0..1	Reference(PractitionerRole)	Contact for the response		0..1	Reference(PractitionerRole)	Contact for the response
payee		0..1	Reference(Practitioner | PractitionerRole | Organization)	Recipient of the payment		0..1	Reference(Practitioner | PractitionerRole | Organization)	Recipient of the payment
amount	S	0..1	Money	Số tiền quyết toán cho Claim (VND)	S	1..1	Money	Số tiền được phân bổ cho giao dịch (VND) — Amount allocated to the transaction	Element minimum cardinalities differ: '0' vs '1'
id						0..1	string	Unique id for inter-element referencing	Added this element
Slices for extension						0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url	Added this element
value					Σ	1..1	decimal	Numerical value (with implicit precision)	Added this element
currency					Σ	0..1	code	ISO 4217 Currency Code Binding: ?? (required): A code indicating the currency, taken from ISO 4217.	Added this element
formCode		0..1	CodeableConcept	Printed form identifier Binding: ?? (example): The forms codes.		0..1	CodeableConcept	Printed form identifier Binding: ?? (example): The forms codes.
processNote		0..*	BackboneElement	Note concerning processing		0..*	BackboneElement	Note concerning processing
id		0..1	string	Unique id for inter-element referencing		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		0..1	code	display | print | printoper Binding: ?? (required): The presentation types of notes.		0..1	code	display | print | printoper Binding: ?? (required): The presentation types of notes.
text		0..1	string	Note explanatory text		0..1	string	Note explanatory text
Documentation for this format