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 ClaimResponse: Example ClaimResponse - Sent Back

Claim Workflow State: Sent Back

status: Active

type: Institutional

use: Claim

patient: Jane Wanjiku Female, DoB: 1985-06-15

created: 2025-10-07 18:47:22+0000

insurer: Social Health Authority

request: Claim: status = active; type = Institutional; use = claim; created = 2025-10-01; priority = Normal

outcome: Processing Complete

item

itemSequence: 1

adjudication

category: benefit

reason: Auto Approved.

Amounts

-ValueCurrency
*11200Kenyan shilling

total

category: Benefit Amount

Amounts

-ValueCurrency
*11200Kenyan shilling

processNote

number: 1

type: Display

text: medical cases

processNote

number: 2

type: Display

text: For surveillance review