Kenya eClaims FHIR IG
0.1.0 - ci-build Kenya flag

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

: Claim - Example - XML Representation

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<Claim xmlns="http://hl7.org/fhir">
  <id value="f6dc7f9e-1558-4b92-adbd-447771c7b2f9"/>
  <meta>
    <profile
             value="https://example.com/fhir/StructureDefinition/eclaims-claim"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Claim f6dc7f9e-1558-4b92-adbd-447771c7b2f9</b></p><a name="f6dc7f9e-1558-4b92-adbd-447771c7b2f9"> </a><a name="hcf6dc7f9e-1558-4b92-adbd-447771c7b2f9"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-eclaims-claim.html">Claim Profile</a></p></div><p><b>identifier</b>: <code>https://uat-mis.apeiro-digital.com/fhir/claim</code>/f6dc7f9e-1558-4b92-adbd-447771c7b2f9</p><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>subType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/ex-claimsubtype op}">op</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href="https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6">https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6</a></p><p><b>billablePeriod</b>: 2025-01-04 --&gt; 2025-01-05</p><p><b>created</b>: 2025-01-03</p><p><b>provider</b>: <a href="Organization/FID-22-101101-0">Organization/FID-22-101101-0</a></p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></p><h3>Diagnoses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{https://uat-mis.apeiro-digital.com/fhir/terminology/CodeSystem/icd-11 XT77}">XT77</span></td></tr></table><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="https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage">https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage</a></td></tr></table><blockquote><p><b>item</b></p><p><b>com/fhir/sha-coverage/StructureDefinition/Coverage</b>: <a href="https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage">https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage</a></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title="Codes:{https://uat-mis.apeiro-digital.com/fhir/CodeSystem/category-codes procedure}">Procedure</span></p><p><b>productOrService</b>: <span title="Codes:{https://uat-mis.apeiro-digital.com/fhir/CodeSystem/intervention-codes SHA-12-001}">SHA-12-001</span></p><p><b>serviced</b>: 2025-01-04</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>50</td><td>Kenyan shilling</td></tr></table><p><b>factor</b>: 1</p><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>50</td><td>Kenyan shilling</td></tr></table></blockquote><h3>Totals</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>50</td><td>Kenyan shilling</td></tr></table></div>
  </text>
  <identifier>
    <system value="https://uat-mis.apeiro-digital.com/fhir/claim"/>
    <value value="f6dc7f9e-1558-4b92-adbd-447771c7b2f9"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="institutional"/>
    </coding>
  </type>
  <subType>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/ex-claimsubtype"/>
      <code value="op"/>
    </coding>
  </subType>
  <use value="preauthorization"/>
  <patient>
    <reference
               value="https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6"/>
    <type value="Patient"/>
    <identifier>
      <use value="official"/>
      <system
              value="https://uat-mis.apeiro-digital.com/fhir/identifier/shanumber"/>
      <value value="BZ38380568-6"/>
    </identifier>
  </patient>
  <billablePeriod>
    <start value="2025-01-04"/>
    <end value="2025-01-05"/>
  </billablePeriod>
  <created value="2025-01-03"/>
  <provider>
    <reference value="Organization/FID-22-101101-0"/>
    <type value="Organization"/>
    <identifier>
      <use value="official"/>
      <type>
        <coding>
          <system value="http://ts-kenyahie.health/facility-identifier-type"/>
          <code value="fr-code"/>
        </coding>
      </type>
      <system value="https://fr.kenya-hie.health/api/v4/Organization"/>
      <value value="FID-22-101101-0"/>
    </identifier>
  </provider>
  <priority>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/processpriority"/>
      <code value="normal"/>
    </coding>
  </priority>
  <diagnosis>
    <sequence value="1"/>
    <diagnosisCodeableConcept>
      <coding>
        <system
                value="https://uat-mis.apeiro-digital.com/fhir/terminology/CodeSystem/icd-11"/>
        <code value="XT77"/>
        <display value="XT77"/>
      </coding>
    </diagnosisCodeableConcept>
  </diagnosis>
  <insurance>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference
                 value="https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage"/>
    </coverage>
  </insurance>
  <item>
    <extension
               url="https://uat-mis.apeiro-digital.com/fhir/sha-coverage/StructureDefinition/Coverage">
      <valueReference>
        <reference
                   value="https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage"/>
      </valueReference>
    </extension>
    <sequence value="1"/>
    <category>
      <coding>
        <system
                value="https://uat-mis.apeiro-digital.com/fhir/CodeSystem/category-codes"/>
        <code value="procedure"/>
        <display value="Procedure"/>
      </coding>
    </category>
    <productOrService>
      <coding>
        <system
                value="https://uat-mis.apeiro-digital.com/fhir/CodeSystem/intervention-codes"/>
        <code value="SHA-12-001"/>
        <display value="SHA-12-001"/>
      </coding>
    </productOrService>
    <servicedDate value="2025-01-04"/>
    <quantity>
      <value value="1"/>
    </quantity>
    <unitPrice>
      <value value="50"/>
      <currency value="KES"/>
    </unitPrice>
    <factor value="1"/>
    <net>
      <value value="50"/>
      <currency value="KES"/>
    </net>
  </item>
  <total>
    <value value="50"/>
    <currency value="KES"/>
  </total>
</Claim>