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Packagefhir.kenyaClaimsIG
Resource TypeClaimResponse
IdClaimResponse-fd876fab-979d-4adb-8b32-46dff643b89f.json
FHIR VersionR4

Resources that use this resource

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Resources that this resource uses

No resources found


Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ClaimResponse fd876fab-979d-4adb-8b32-46dff643b89f

Preauthorization Expiry Date: 2025-11-01

Claim Workflow State: Canceled

status: Active

type: Institutional

use: Preauthorization

patient: Patient/example

created: 2025-10-03 07:36:24+0000

insurer: Organization/sha-insurer

request: Claim/a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8

outcome: Processing Complete

item

itemSequence: 1

adjudication

category: benefit

reason: Auto Approved.

Amounts

-ValueCurrency
*11200Kenyan shilling

value: 0

total

category: benefit

Amounts

-ValueCurrency
*11200Kenyan shilling

ProcessNotes

-NumberTypeText
*1Displaycancelled as requested

Source1

{
  "resourceType": "ClaimResponse",
  "id": "fd876fab-979d-4adb-8b32-46dff643b89f",
  "meta": {
    "profile": [
      "https://example.com/fhir/StructureDefinition/eClaims-claim-response"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "https://fhir.sha.go.ke/fhir/StructureDefinition/claim-expiry-extension",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.sha.go.ke/fhir/CodeSystem/claim-expiry",
            "code": "expiry-date",
            "display": "2025-11-01"
          }
        ]
      }
    },
    {
      "url": "https://fhir.sha.go.ke/fhir/StructureDefinition/claim-state-extension",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.sha.go.ke/fhir/CodeSystem/claim-state",
            "code": "canceled",
            "display": "Canceled"
          }
        ]
      }
    }
  ],
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/claim-type",
        "code": "institutional"
      }
    ]
  },
  "use": "preauthorization",
  "patient": {
    "reference": "Patient/example"
  },
  "created": "2025-10-03T07:36:24+00:00",
  "insurer": {
    "reference": "Organization/sha-insurer"
  },
  "request": {
    "reference": "Claim/a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8"
  },
  "outcome": "complete",
  "item": [
    {
      "itemSequence": 1,
      "adjudication": [
        {
          "category": {
            "text": "benefit"
          },
          "reason": {
            "text": "Auto Approved."
          },
          "amount": {
            "value": 11200,
            "currency": "KES"
          },
          "value": 0
        }
      ]
    }
  ],
  "total": [
    {
      "category": {
        "text": "benefit"
      },
      "amount": {
        "value": 11200,
        "currency": "KES"
      }
    }
  ],
  "processNote": [
    {
      "number": 1,
      "type": "display",
      "text": "cancelled as requested"
    }
  ]
}