Billing

The FHIR spec supports many resources related to billing and payments. These resources can be created programmatically to support billing and payments. Commonly as part of a billing implementation, FHIR resources are created by applications and synchronized to clearinghouses or billing providers using subscriptions and bots.

For example, after a lab test is completed, a DiagnosticReport is created and it and related resources like are automatically sent to a billing system after the report is finalized.

Coding

For resources to be billed appropriately, they often need to be tagged with CPT Codes, LOINC or SNOMED ontologies. To accomplish this, resources are often tagged with a Codeable Concept. Coding will be determined by the service provided.

Through automation and integration, more complex scenarios like determining authorization or checking whether insurance is active can be automated via bots.