R4 APIs (Millennium)

Organization Information

Are you an Oracle Partner Network Member?
Yes

Partner / Company Name:
Steer Health

Is your company enrolled in the Industry Healthcare Path?
Yes

Does your company have the Oracle Health Millennium Platform (OHMP) Environment Access Technical Accelerator?
We currently have access to the Oracle Health FHIR R4 sandbox environment.

Are you developing on behalf of an Oracle Health client?
No.
We are currently integrating and testing against the Oracle Health FHIR R4 sandbox for our platform.

Application Client ID / App ID:
(Add your Client ID / App ID here if required)

Background Information

Steer Health is integrating Oracle Health Millennium FHIR R4 APIs into our patient-centric healthcare platform.

Our platform supports the following capabilities:

• Patient search and management
• Appointment scheduling
• Payment collection
• Integration with EHR systems through FHIR APIs

We are currently testing and validating our integration using the Oracle FHIR R4 sandbox environment.

Our goal is to support the following workflow:

1. A patient books an appointment through our platform.
2. The appointment is created in Oracle Millennium through the FHIR Appointment API.
3. The patient makes a payment through our platform.
4. The payment information is sent to Oracle Millennium through FHIR APIs.

During testing, we observed that payments in Millennium appear to be linked to encounter-level accounts rather than patient-level accounts, and we would like clarification on the correct workflow.

Workflow / API Calls Being Tested

Our current integration workflow includes the following API operations:

1. Patient APIs

   • Search or retrieve patient

2. Scheduling APIs

   • Retrieve schedules
   • Retrieve slots

3. Appointment APIs

   • Create appointment
   • Retrieve appointment information

4. Encounter APIs

   • Retrieve encounter created or associated with the appointment

5. Account APIs

   • Retrieve account associated with an encounter
     Example:

   GET /Account?-encounter=<encounterId>&type=guarantor-balance

6. Financial Transaction APIs

   • Post payment using the FinancialTransaction resource (Basic resource)

Observations During Testing

While testing in the sandbox, we observed the following behavior:

• Appointment creation through the FHIR API works successfully.
• In some cases an Encounter resource becomes available after appointment creation.
• However, an Account resource is not always immediately available.
• The guarantor-balance account appears to be created only after encounter information is completed through the scheduling or registration workflow.

This creates a challenge for our workflow because payments collected in our platform may occur immediately after appointment booking, before the encounter registration process is completed.

Questions / Clarifications Requested

We would appreciate clarification on the following points:

1. Patient-Level Financial Account

Is there a way to retrieve a patient-level financial account using the FHIR APIs when we only have the Patient resource ID?

For example, we attempted:

GET /Account?-guarantor=<id>&type=financial-account

However, using the Patient ID as the guarantor ID did not return any results.

Could you clarify:

• What identifier should be used for the guarantor parameter?
• Is a patient-level financial account available in the sandbox domain?

2. Payment Posting Workflow

Is the encounter-level guarantor-balance account the only supported workflow for posting payments in Millennium?

Example workflow we currently see:

Patient
↓
Appointment
↓
Encounter
↓
Account (guarantor-balance)
↓
FinancialTransaction

Is this the expected workflow for Millennium integrations?

3. Account Creation Timing

Is it possible for the financial account to be created earlier in the workflow, such as during:

• Appointment booking
• Pre-registration
• Encounter creation via API

This would allow payment to be posted immediately after appointment booking.

4. Patient-Level Payment Support

If a patient-level financial account does not exist in the current domain configuration, is it possible to configure Millennium so that:

• a patient-level account is created, and
• payments can be posted at the patient level rather than encounter level?

This would better support patient-centric payment workflows.

Expected Result

We would like confirmation of the recommended Oracle Millennium workflow for appointment booking and payment posting using FHIR APIs, including:

• Whether patient-level financial accounts are supported
• The correct identifier to retrieve financial accounts
• When accounts are created in the scheduling/registration process
• The recommended integration approach for collecting and posting payments

Actual Result

In the sandbox environment:

• Appointment creation works successfully.
• Encounter resources can be retrieved.
• Encounter-level account lookup works only after additional registration details are completed.
• Patient-level account retrieval using the guarantor parameter does not return results.

Request Identifiers

X-Request-Id / Cerner-Correlation-Id / opc-request-id:
(Add request IDs from example API calls here)