FHIR IG analytics| Package | fhir.kenyaClaimsIG |
| Resource Type | ImplementationGuide |
| Id | ImplementationGuide-fhir.kenyaClaimsIG.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/IntelliSOFT-Consulting/Kenya-eClaims-FHIR-IG/index.html |
| URL | https://example.com/fhir/ImplementationGuide/fhir.kenyaClaimsIG |
| Version | 0.1.0 |
| Status | draft |
| Date | 2025-12-16T12:00:10+00:00 |
| Name | kenyaeClaimsIG |
| Title | Kenya eClaims FHIR IG |
| Realm | us |
| Authority | hl7 |
| Description | Kenya eClaims FHIR IG |
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Note: links and images are rebased to the (stated) source
Generated Narrative: ImplementationGuide fhir.kenyaClaimsIG
The official URL for this implementation guide is:
https://example.com/fhir/ImplementationGuide/fhir.kenyaClaimsIG
Kenya eClaims FHIR IG
FHIR
FHIRsmith{
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"name": "Anaesthesia Type",
"description": "Type of anaesthesia to be used (e.g. 'General', 'Local').",
"exampleBoolean": false
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{
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"description": "Classifies the attachment (e.g. Discharge Summary, Final Bill).",
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{
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],
"reference": {
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"name": "Claim Response - Preauthorization",
"description": "This profile defines constraints on the Claim resource for use within the Kenya eClaims Implementation Guide. It supports institutional claims with detailed clinical, financial, insurance, and adjudication metadata.",
"exampleBoolean": false
},
{
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],
"reference": {
"reference": "StructureDefinition/kenya-claim-submission"
},
"name": "Claim Submission",
"description": "This is the final request for payment sent after services are delivered.",
"exampleBoolean": false
},
{
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"valueString": "StructureDefinition:extension"
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],
"reference": {
"reference": "StructureDefinition/claim-state-extension"
},
"name": "Claim Workflow State",
"description": "Tracks the specific state of the claim (e.g., Sent Back, Approved, surveillance).",
"exampleBoolean": false
},
{
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"valueString": "StructureDefinition:extension"
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],
"reference": {
"reference": "StructureDefinition/clinical-indications"
},
"name": "Clinical Indications",
"description": "Clinical reasoning or specific indications for the procedure (e.g., 'End Stage Renal Disease').",
"exampleBoolean": false
},
{
"extension": [
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"valueString": "StructureDefinition:extension"
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],
"reference": {
"reference": "StructureDefinition/consultation-amount"
},
"name": "Consultation Amount",
"exampleBoolean": false
},
{
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{
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"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/cost-per-session"
},
"name": "Cost Per Session",
"description": "The cost per chemotherapy/radiotherapy session.",
"exampleBoolean": false
},
{
"extension": [
{
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"valueString": "StructureDefinition:resource"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-coverage"
},
"name": "Coverage Profile",
"description": "This profile defines constraints on the Coverage resource for use within the Kenya eClaims Implementation Guide. It represents insurance coverage for a patient under a specific insurance scheme, including SHA and specialised schemes such as POMF and POMF_TEACHERS.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
}
],
"reference": {
"reference": "Claim/CR-00001"
},
"name": "Example Claim Response",
"description": "An example Claim Response resource for Kenya eClaims Preauthorization, fully populated for testing.",
"exampleCanonical": "https://example.com/fhir/StructureDefinition/eclaims-claim"
},
{
"extension": [
{
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"valueString": "ClaimResponse"
}
],
"reference": {
"reference": "ClaimResponse/fd876fab-979d-4adb-8b32-46dff643b89f"
},
"name": "Example ClaimResponse - Canceled",
"description": "An example of a Preauthorization that was canceled by request.",
"exampleCanonical": "https://example.com/fhir/StructureDefinition/eClaims-claim-response"
},
{
"extension": [
{
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"valueString": "ClaimResponse"
}
],
"reference": {
"reference": "ClaimResponse/8e0e3d44-4b7a-47d6-8b82-39fa646f8088"
},
"name": "Example ClaimResponse - Sent Back",
"description": "An example of a ClaimResponse returned to the provider for surveillance review.",
"exampleCanonical": "https://example.com/fhir/StructureDefinition/eClaims-claim-response"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Coverage"
}
],
"reference": {
"reference": "Coverage/CR1569230130821-1-sha-coverage"
},
"name": "Example SHA Coverage",
"description": "An example insurance coverage for a patient under the SHA scheme.",
"exampleCanonical": "https://example.com/fhir/StructureDefinition/eclaims-coverage"
},
{
"extension": [
{
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"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/eye-examination-amount"
},
"name": "Eye Examination Amount",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/frame-amount"
},
"name": "Frame Amount",
"exampleBoolean": false
},
{
"extension": [
{
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"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/has-coinsurance"
},
"name": "Has Coinsurance",
"description": "Indicates if the patient has a coinsurance liability.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/hpi"
},
"name": "History of Present Illness",
"description": "Detailed history of the present illness.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
}
],
"reference": {
"reference": "StructureDefinition/kenya-imaging-preauth"
},
"name": "Imaging Preauthorization",
"description": "This profile is for authorizing high-cost Diagnostic Imaging.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/investigations"
},
"name": "Investigations",
"description": "List of investigations performed or requested (e.g. specific lab tests or imaging modalities).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/item-coverage-reference"
},
"name": "Item Coverage Reference",
"description": "Link to the specific coverage/scheme applicable to this line item.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
}
],
"reference": {
"reference": "StructureDefinition/kenya-claim-base"
},
"name": "Kenya eClaims Base Profile",
"description": "This is the foundation for all Financial Claims and Preauthorizations in Kenya. \nIt enforces standard identifiers, actor references (Patient, Provider) and common extensions \nused across the entire eClaims ecosystem.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
}
],
"reference": {
"reference": "StructureDefinition/eClaims-claim-response"
},
"name": "Kenya eClaims ClaimResponse Profile",
"description": "Profile for the response to a Claim or Preauthorization, including specific adjudication states and expiry logic.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/last-replacement-date"
},
"name": "Last Replacement Date",
"description": "Date when the item was last replaced (for eligibility checks).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/lens-amount"
},
"name": "Lens Amount",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/lens-prescription"
},
"name": "Lens Prescription",
"description": "Details of the lens prescription (Sphere, Cylinder, Axis).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/metastases"
},
"name": "Metastases",
"description": "Details on metastases (e.g. 'None', 'Bone', 'Liver').",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
}
],
"reference": {
"reference": "StructureDefinition/kenya-oncology-preauth"
},
"name": "Oncology Preauthorization",
"description": "This profile is for authorizing Cancer Treatment.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
}
],
"reference": {
"reference": "StructureDefinition/kenya-optical-preauth"
},
"name": "Optical Preauthorization",
"description": "This profile is for Optical Services.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/other-metastases"
},
"name": "Other Metastases",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/extension-patient-invoice"
},
"name": "Patient Invoice Details",
"description": "Details regarding the provider's invoice and patient liability.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/physical-examination"
},
"name": "Physical Examination",
"description": "Findings from the physical examination.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/claim-expiry-extension"
},
"name": "Preauthorization Expiry Date",
"description": "Indicates when the approved preauthorization expires.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/preauth-token"
},
"name": "Preauthorization Token",
"description": "The specific unique token generated for this preauthorization request.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/provider-auth-token"
},
"name": "Provider Auth Token",
"description": "The authorization token issued to the provider for this session.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/raw-preauth-source-data"
},
"name": "Raw Preauth Source Data",
"description": "Container for the full legacy JSON payload.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/reason-for-service"
},
"name": "Reason For Service",
"description": "The reason for the optical service (e.g., 'Glasses').",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
}
],
"reference": {
"reference": "StructureDefinition/kenya-renal-preauth"
},
"name": "Renal Preauthorization",
"description": "This profile is for requesting authorization for renal dialysis sessions.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/replacement"
},
"name": "Replacement Type",
"description": "Indicates if this item is 'New' or a 'Replacement'.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/session-expected-date"
},
"name": "Session Expected Date",
"description": "The expected date for the dialysis or therapy session.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
}
],
"reference": {
"reference": "StructureDefinition/kenya-surgical-preauth"
},
"name": "Surgical Preauthorization",
"description": "This profile covers invasive procedures requiring a theatre or sterile setting.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/treatment-setting"
},
"name": "Treatment Setting",
"description": "Setting where treatment is provided (e.g. 'DAY_WARD', 'INPATIENT').",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
}
],
"reference": {
"reference": "StructureDefinition/vital-signs"
},
"name": "Vital Signs",
"description": "Recorded vital signs (e.g. Temperature, BP).",
"exampleBoolean": false
}
],
"page": {
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "toc.html"
}
],
"nameUrl": "toc.html",
"title": "Table of Contents",
"generation": "html",
"page": [
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "index.html"
}
],
"nameUrl": "index.html",
"title": "Home",
"generation": "markdown"
}
]
},
"parameter": [
{
"code": "path-resource",
"value": "input/capabilities"
},
{
"code": "path-resource",
"value": "input/examples"
},
{
"code": "path-resource",
"value": "input/extensions"
},
{
"code": "path-resource",
"value": "input/models"
},
{
"code": "path-resource",
"value": "input/operations"
},
{
"code": "path-resource",
"value": "input/profiles"
},
{
"code": "path-resource",
"value": "input/resources"
},
{
"code": "path-resource",
"value": "input/vocabulary"
},
{
"code": "path-resource",
"value": "input/maps"
},
{
"code": "path-resource",
"value": "input/testing"
},
{
"code": "path-resource",
"value": "input/history"
},
{
"code": "path-resource",
"value": "fsh-generated/resources"
},
{
"code": "path-pages",
"value": "template/config"
},
{
"code": "path-pages",
"value": "input/images"
},
{
"code": "path-tx-cache",
"value": "input-cache/txcache"
}
]
}
}