Kenya eClaims FHIR Implementation Guide
0.1.0 - ci-build KE

Kenya eClaims FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Example Claim for ClaimResponse (sent-back) - JSON Representation

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{
  "resourceType" : "Claim",
  "id" : "ae044c1d-9ecb-4294-be9b-0702e7892596",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim ae044c1d-9ecb-4294-be9b-0702e7892596</b></p><a name=\"ae044c1d-9ecb-4294-be9b-0702e7892596\"> </a><a name=\"hcae044c1d-9ecb-4294-be9b-0702e7892596\"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-example.html\">Jane Wanjiku  Female, DoB: 1985-06-15</a></p><p><b>created</b>: 2025-10-01</p><p><b>insurer</b>: <a href=\"Organization-sha-insurer.html\">Organization Social Health Authority</a></p><p><b>provider</b>: <a href=\"Organization-ORG-001.html\">Organization Nairobi General Hospital</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-COV-0001.html\">Coverage: status = active</a></td></tr></table></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "institutional"
      }
    ]
  },
  "use" : "claim",
  "patient" : {
    🔗 "reference" : "Patient/example"
  },
  "created" : "2025-10-01",
  "insurer" : {
    🔗 "reference" : "Organization/sha-insurer"
  },
  "provider" : {
    🔗 "reference" : "Organization/ORG-001"
  },
  "priority" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
        "code" : "normal",
        "display" : "Normal"
      }
    ]
  },
  "insurance" : [
    {
      "sequence" : 1,
      "focal" : true,
      "coverage" : {
        🔗 "reference" : "Coverage/COV-0001"
      }
    }
  ]
}