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Segment

Invoice processing results

Communicates the adjudication results for a healthcare invoice, including the adjudication status, adjudicated amount, and expected payment date. It is returned by a payer application to a provider application in EHC (Edit/Adjudication Results) messages after processing a submitted healthcare services invoice. IPR is part of the HL7 v2 claims and reimbursement chapter and is used in electronic claims adjudication workflows.

8fields
6required
v2.9HL7 version
ipr.py
from zato.hl7v2.v2_9 import IPR
from zato.hl7v2.v2_9 import EI, CP, CWE

ipr = IPR()
identifier = EI(entity_identifier='IPR202401150001')
ipr.ipr_identifier = identifier
ipr.adjudicated_paid_amount = CP(price='75.00')
ipr.ipr_status = CWE(
    identifier='1',
    text='Paid'
)

Build IPR segments in Python

How to construct and work with real-world IPR segments.

1

Wellness visit payment

Payment result for fitness assessment

from zato.hl7v2.v2_9 import IPR
from zato.hl7v2.v2_9 import EI, CP, CWE, DTM

ipr = IPR()
ipr.ipr_identifier = EI(entity_identifier='IPR202401150001')
ipr.ipr_status = CWE(
    identifier='1',
    text='Paid'
)
ipr.adjudication_date_time = DTM('20240120')
ipr.adjudicated_paid_amount = CP(price='75.00')
ipr.adjustment_amount = CP(price='0.00')
2

Partial payment result

Partial reimbursement for nutrition services

from zato.hl7v2.v2_9 import IPR
from zato.hl7v2.v2_9 import EI, CP, CWE, DTM

ipr = IPR()
ipr.ipr_identifier = EI(entity_identifier='IPR202401160002')
ipr.ipr_status = CWE(
    identifier='2',
    text='Partial'
)
ipr.adjudication_date_time = DTM('20240125')
ipr.adjudicated_paid_amount = CP(price='70.00')
ipr.adjustment_amount = CP(price='25.00')
3

Denied claim result

Denial for preventive service

from zato.hl7v2.v2_9 import IPR
from zato.hl7v2.v2_9 import EI, CP, CWE, DTM

ipr = IPR()
ipr.ipr_identifier = EI(entity_identifier='IPR202401170003')
ipr.ipr_status = CWE(
    identifier='3',
    text='Denied'
)
ipr.adjudication_date_time = DTM('20240130')
ipr.adjudicated_paid_amount = CP(price='0.00')
ipr.adjustment_amount = CP(price='150.00')

Learn by building

Step-by-step guides for working with HL7 v2 in Zato.

Frequently asked questions

IPR contains invoice processing results including adjudication results, payment amounts, and adjustment codes for wellness program billing.

Common status values include 1 (Paid), 2 (Partial), and 3 (Denied). These indicate the outcome of claim adjudication for wellness services.

Use adjustment_amount and adjustment_reason fields:

ipr.adjustment_amount = CP(price='25.00')
ipr.adjustment_reason = CWE(
    identifier='CO',
    text='Contractual Obligation'
)

IVC contains the invoice details while IPR contains the processing results. IPR segments follow IVC to report adjudication outcomes for wellness claims.

Zato connects to any system that speaks HL7v2 over MLLP or FHIR over REST. This includes Epic, Cerner, Meditech, Allscripts, and other EHR platforms.

Yes, Zato has built-in MLLP support for sending and receiving HL7v2 messages. MLLP channels handle the framing protocol automatically.

Zato supports HL7 v2.9, which is backward compatible with earlier versions including v2.3, v2.5, and v2.7. Standard segments and datatypes are available as typed Python classes.

Yes. Zato handles both HL7v2 and FHIR natively, so you can parse v2 messages and build FHIR resources with IG-specific extensions in the same service. Typed Python classes are available for both protocols, including extensions from US Core, UK Core, Da Vinci, and other Implementation Guides.

IPR field reference

Complete list of fields in the IPR segment, HL7 v2.9.

#Python nameDatatypeUsageRepeatableTable
1ipr_identifierEIRequiredNo-
2provider_cross_reference_identifierEIRequiredNo-
3payer_cross_reference_identifierEIRequiredNo-
4ipr_statusCWERequiredNoHL70571
5ipr_date_timeDTMRequiredNo-
6adjudicated_paid_amountCPOptionalNo-
7expected_payment_date_timeDTMOptionalNo-
8ipr_checksumSTRequiredNo-

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Open source In Python