FHIR IG analytics| Package | ke.fhir.eclaims |
| Resource Type | ImplementationGuide |
| Id | ImplementationGuide-ke.fhir.eclaims.json |
| FHIR Version | R4 |
| Source | https://build.fhir.org/ig/IntelliSOFT-Consulting/Kenya-eClaims-FHIR-IG/index.html |
| URL | https://fhir.dha.go.ke/ig/eclaims/ImplementationGuide/ke.fhir.eclaims |
| Version | 0.1.0 |
| Status | draft |
| Date | 2026-08-07T13:06:49+00:00 |
| Name | KenyaEClaims |
| Title | Kenya eClaims Implementation Guide |
| Description | The Kenya eClaims FHIR Implementation Guide defines standardized FHIR R4 profiles, extensions, value sets, and terminologies for electronic claims submission, preauthorization, and adjudication between healthcare providers and health insurance schemes in Kenya, including the Social Health Authority (SHA). |
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Note: links and images are rebased to the (stated) source
Generated Narrative: ImplementationGuide ke.fhir.eclaims
The official URL for this implementation guide is:
https://fhir.dha.go.ke/ig/eclaims/ImplementationGuide/ke.fhir.eclaims
The Kenya eClaims FHIR Implementation Guide defines standardized FHIR R4 profiles, extensions, value sets, and terminologies for electronic claims submission, preauthorization, and adjudication between healthcare providers and health insurance schemes in Kenya, including the Social Health Authority (SHA).
FHIR
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"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-attachment-type-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-attachment-type-vs"
},
"name": "Attachment Type ValueSet",
"description": "ValueSet for types of attachments submitted with a claim in Kenya eClaims.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-KenyaBodySiteCS.html"
}
],
"reference": {
"reference": "CodeSystem/KenyaBodySiteCS"
},
"name": "BodySite Code System",
"description": "A code system that defines categories for Institutional Body Sites",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-carcinoma-staging.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-carcinoma-staging"
},
"name": "Carcinoma Staging",
"description": "Stage of the carcinoma (e.g. 'STAGE_3').",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-chief-complaint.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-chief-complaint"
},
"name": "Chief Complaint",
"description": "The patient's primary complaint.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-civil-status-cs.html"
}
],
"reference": {
"reference": "CodeSystem/civil-status-cs"
},
"name": "Civil Status Code System",
"description": "Codes for civil/marital status (MOH-Kenya OCL: CIVIL-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-civil-status-vs.html"
}
],
"reference": {
"reference": "ValueSet/civil-status-vs"
},
"name": "Civil Status ValueSet",
"description": "ValueSet for civil/marital status codes (MOH-Kenya OCL: CIVIL-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-claim-care-team-role-cs.html"
}
],
"reference": {
"reference": "CodeSystem/claim-care-team-role-cs"
},
"name": "Claim Care Team Role Code System",
"description": "Codes for the role of a care team member in a claim (MOH-Kenya OCL: CLAIM-CARE-TEAM-ROLE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaim-care-team-role-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaim-care-team-role-vs"
},
"name": "Claim Care Team Role ValueSet",
"description": "ValueSet for the role of a care team member in a claim (MOH-Kenya OCL: CLAIM-CARE-TEAM-ROLE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-claim-diagnosis-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-claim-diagnosis-vs"
},
"name": "Claim Diagnosis ValueSet",
"description": "ValueSet for diagnosis codes used in Kenya eClaims. Includes both Kenya-defined ICD-11 category codes and the local ICD-11 MMS code system for individual clinical diagnoses.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-claim-expiry-cs.html"
}
],
"reference": {
"reference": "CodeSystem/claim-expiry-cs"
},
"name": "Claim Expiry Code System",
"description": "Codes for claim or preauthorization expiry types in Kenya eClaims.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-claim.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-claim"
},
"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
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-claim-state-cs.html"
}
],
"reference": {
"reference": "CodeSystem/claim-state-cs"
},
"name": "Claim State Code System",
"description": "Codes for the specific workflow state of a claim in Kenya eClaims.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-claim-status-cs.html"
}
],
"reference": {
"reference": "CodeSystem/claim-status-cs"
},
"name": "Claim Status Code System",
"description": "Codes for the status of a claim. Codes align with FHIR fm-status to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaim-status-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaim-status-vs"
},
"name": "Claim Status ValueSet",
"description": "ValueSet for claim status codes (MOH-Kenya OCL: CLAIM-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-claimsubmission.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-claimsubmission"
},
"name": "Claim Submission",
"description": "This is the final request for payment sent after services are delivered.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-claim-subtype-cs.html"
}
],
"reference": {
"reference": "CodeSystem/claim-subtype-cs"
},
"name": "Claim Subtype Code System",
"description": "Kenya-specific codes for the subtype of claim (MOH-Kenya OCL: CLAIM-SUBTYPE).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaim-subtype-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaim-subtype-vs"
},
"name": "Claim Subtype ValueSet",
"description": "ValueSet for claim subtype codes (MOH-Kenya OCL: CLAIM-SUBTYPE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-claim-type-cs.html"
}
],
"reference": {
"reference": "CodeSystem/claim-type-cs"
},
"name": "Claim Type Code System",
"description": "Codes for the type of claim. Codes align with FHIR claim-type to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaim-type-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaim-type-vs"
},
"name": "Claim Type ValueSet",
"description": "ValueSet for claim type codes (MOH-Kenya OCL: CLAIM-TYPE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-claim-use-cs.html"
}
],
"reference": {
"reference": "CodeSystem/claim-use-cs"
},
"name": "Claim Use Code System",
"description": "Codes for the intended use of a claim. Codes align with FHIR claim-use to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaim-use-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaim-use-vs"
},
"name": "Claim Use ValueSet",
"description": "ValueSet for intended use of a claim (MOH-Kenya OCL: CLAIM-USE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaim-state-extension.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaim-state-extension"
},
"name": "Claim Workflow State",
"description": "Tracks the specific state of the claim (e.g., Sent Back, Approved, surveillance).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-claimresponse-adjudication-error-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-claimresponse-adjudication-error-vs"
},
"name": "ClaimResponse Adjudication Error ValueSet",
"description": "Non-experimental wrapper for adjudication error codes returned in a ClaimResponse.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-claimresponse-forms-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-claimresponse-forms-vs"
},
"name": "ClaimResponse Forms ValueSet",
"description": "Non-experimental wrapper for printed or electronic form identifiers used with ClaimResponse.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-claimresponse-fundsreserve-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-claimresponse-fundsreserve-vs"
},
"name": "ClaimResponse Funds Reserve ValueSet",
"description": "Non-experimental wrapper for funds reserve codes indicating to whom excess funds belong.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-claimresponse-payeetype-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-claimresponse-payeetype-vs"
},
"name": "ClaimResponse Payee Type ValueSet",
"description": "Non-experimental wrapper for payee type codes used in ClaimResponse adjudication.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-clinical-indications.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-clinical-indications"
},
"name": "Clinical Indications",
"description": "Clinical reasoning or specific indications for the procedure (e.g., 'End Stage Renal Disease').",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-KenyaSocialHealthAuthorityInterventionCS.html"
}
],
"reference": {
"reference": "CodeSystem/KenyaSocialHealthAuthorityInterventionCS"
},
"name": "Condition Category Code System",
"description": "A code system that defines categories for Social Health Authority Interventions",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-condition-category-cs.html"
}
],
"reference": {
"reference": "CodeSystem/condition-category-cs"
},
"name": "Condition Category Code System",
"description": "Codes for the category of a condition (MOH-Kenya OCL: CONDITION-CATEGORY)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-condition-category-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-condition-category-vs"
},
"name": "Condition Category ValueSet",
"description": "ValueSet for condition category codes (MOH-Kenya OCL: CONDITION-CATEGORY)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-condition-clinical-status-cs.html"
}
],
"reference": {
"reference": "CodeSystem/condition-clinical-status-cs"
},
"name": "Condition Clinical Status Code System",
"description": "Codes for the clinical status of a condition. Codes align with FHIR condition-clinical to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-condition-clinical-status-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-condition-clinical-status-vs"
},
"name": "Condition Clinical Status ValueSet",
"description": "ValueSet for condition clinical status codes (MOH-Kenya OCL: CONDITION-CLINICAL-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-condition-codes-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-condition-codes-vs"
},
"name": "Condition Codes ValueSet",
"description": "Codes for clinical conditions and diagnoses using the local ICD-11 MMS code system (MOH-KENYA ICD-11 OCL collection).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-condition-severity-cs.html"
}
],
"reference": {
"reference": "CodeSystem/condition-severity-cs"
},
"name": "Condition Severity Code System",
"description": "Codes for the clinical severity of a condition, replacing SNOMED CT-based HL7 ValueSet",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-condition-severity-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-condition-severity-vs"
},
"name": "Condition Severity ValueSet",
"description": "ValueSet for the clinical severity of a condition (local replacement for SNOMED CT-based http://hl7.org/fhir/ValueSet/condition-severity)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-condition-verification-status-cs.html"
}
],
"reference": {
"reference": "CodeSystem/condition-verification-status-cs"
},
"name": "Condition Verification Status Code System",
"description": "Codes for the verification status of a condition. Codes align with FHIR condition-ver-status to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-condition-verification-status-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-condition-verification-status-vs"
},
"name": "Condition Verification Status ValueSet",
"description": "ValueSet for condition verification status codes (MOH-Kenya OCL: CONDITION-VERIFICATION-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-consultation-amount.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-consultation-amount"
},
"name": "Consultation Amount",
"description": "The amount charged for the optical consultation service.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-contact-point-system-cs.html"
}
],
"reference": {
"reference": "CodeSystem/contact-point-system-cs"
},
"name": "Contact Point System Code System",
"description": "Codes for contact point systems. Codes align with FHIR contact-point-system to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-contact-point-system-vs.html"
}
],
"reference": {
"reference": "ValueSet/contact-point-system-vs"
},
"name": "Contact Point System ValueSet",
"description": "ValueSet for contact point system codes (MOH-Kenya OCL: CONTACT-POINT-SYSTEM)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-contact-point-use-cs.html"
}
],
"reference": {
"reference": "CodeSystem/contact-point-use-cs"
},
"name": "Contact Point Use Code System",
"description": "Codes for contact point use. Codes align with FHIR contact-point-use to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-contact-point-use-vs.html"
}
],
"reference": {
"reference": "ValueSet/contact-point-use-vs"
},
"name": "Contact Point Use ValueSet",
"description": "ValueSet for contact point use codes (MOH-Kenya OCL: CONTACT-POINT-USE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-cost-per-session.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-cost-per-session"
},
"name": "Cost Per Session",
"description": "The cost per chemotherapy/radiotherapy session.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-coverage-class-cs.html"
}
],
"reference": {
"reference": "CodeSystem/coverage-class-cs"
},
"name": "Coverage Class Code System",
"description": "Codes for insurance coverage class categories (MOH-Kenya OCL: COVERAGE-CLASS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-coverage-class-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-coverage-class-vs"
},
"name": "Coverage Class ValueSet",
"description": "ValueSet for insurance coverage class codes (MOH-Kenya OCL: COVERAGE-CLASS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-exclusion-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-exclusion-vs"
},
"name": "Coverage Exclusion Reason ValueSet",
"description": "ValueSet for reasons a service is excluded from coverage in Kenya health insurance (MOH-Kenya OCL: COVERAGE-EXCLUSION-REASON)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-coverage-member-status-cs.html"
}
],
"reference": {
"reference": "CodeSystem/coverage-member-status-cs"
},
"name": "Coverage Member Status Code System",
"description": "Codes for the status of a coverage member (MOH-Kenya OCL: COVERAGE-MEMBER-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-coverage-member-status-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-coverage-member-status-vs"
},
"name": "Coverage Member Status ValueSet",
"description": "ValueSet for the status of a coverage member (MOH-Kenya OCL: COVERAGE-MEMBER-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-coverage-plan-type-cs.html"
}
],
"reference": {
"reference": "CodeSystem/coverage-plan-type-cs"
},
"name": "Coverage Plan Type Code System",
"description": "Codes for types of coverage plan (MOH-Kenya OCL: COVERAGE-PLAN-TYPE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-coverage-plan-type-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-coverage-plan-type-vs"
},
"name": "Coverage Plan Type ValueSet",
"description": "ValueSet for coverage plan type codes (MOH-Kenya OCL: COVERAGE-PLAN-TYPE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-coverage.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-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": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-coverage-type-cs.html"
}
],
"reference": {
"reference": "CodeSystem/coverage-type-cs"
},
"name": "Coverage Type Code System",
"description": "Codes for the type of insurance coverage (MOH-Kenya OCL: COVERAGE-TYPE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-coverage-type-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-coverage-type-vs"
},
"name": "Coverage Type ValueSet",
"description": "ValueSet for insurance coverage type codes (MOH-Kenya OCL: COVERAGE-TYPE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-member-status-extension.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-member-status-extension"
},
"name": "Current member status Extension",
"description": "Current member status",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-eclaims-diagnostic-report-codes-cs.html"
}
],
"reference": {
"reference": "CodeSystem/eclaims-diagnostic-report-codes-cs"
},
"name": "Diagnostic Report Codes Code System",
"description": "Codes for diagnostic report types used in Kenya eClaims (laboratory, radiology, pathology, and other diagnostic panels).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-diagnostic-report-codes-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-diagnostic-report-codes-vs"
},
"name": "Diagnostic Report Codes ValueSet",
"description": "ValueSet for diagnostic report types used in Kenya eClaims (laboratory, radiology, pathology panels).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-dosage-additional-instruction-cs.html"
}
],
"reference": {
"reference": "CodeSystem/dosage-additional-instruction-cs"
},
"name": "Dosage Additional Instruction Code System",
"description": "Codes for additional dispensing/dosage instructions, replacing SNOMED CT-based HL7 ValueSet",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-dosage-additional-instruction-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-dosage-additional-instruction-vs"
},
"name": "Dosage Additional Instruction ValueSet",
"description": "ValueSet for additional dosage/dispensing instructions (local replacement for SNOMED CT-based http://hl7.org/fhir/ValueSet/additional-instruction-codes)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-condition.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-condition"
},
"name": "eClaims Condition/Diagnosis Profile",
"description": "This profile defines constraints on the Condition resource for use within the Kenya eClaims Implementation Guide. It represents a clinical diagnosis or problem associated with a patient's healthcare encounter.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-diagnosticreport.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-diagnosticreport"
},
"name": "eClaims Diagnostic Report Profile",
"description": "This profile defines constraints on the DiagnosticReport resource for use within the Kenya eClaims Implementation Guide. It represents findings from diagnostic tests (lab, radiology, pathology) associated with a claim.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-encounter.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-encounter"
},
"name": "eClaims Encounter Profile",
"description": "This profile defines constraints on the Encounter resource for use within the Kenya eClaims Implementation Guide. It captures the healthcare interaction during which services are rendered and claims are generated.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-episodeofcare.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-episodeofcare"
},
"name": "eClaims Episode of Care Profile",
"description": "This profile defines constraints on the EpisodeOfCare resource for use within the Kenya eClaims Implementation Guide. It groups a set of related encounters and activities for a patient within a specific care program.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-medicationdispense.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-medicationdispense"
},
"name": "eClaims Medication Dispense Profile",
"description": "This profile defines constraints on the MedicationDispense resource for use within the Kenya eClaims Implementation Guide. It represents the dispensing of a medication to a patient.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-medicationrequest.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-medicationrequest"
},
"name": "eClaims Medication Request Profile",
"description": "This profile defines constraints on the MedicationRequest resource for use within the Kenya eClaims Implementation Guide. It represents a prescription or order for a medication for a patient.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-medicationstatement.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-medicationstatement"
},
"name": "eClaims Medication Statement Profile",
"description": "This profile defines constraints on the MedicationStatement resource for use within the Kenya eClaims Implementation Guide. It records information about a medication being taken by a patient.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-organization.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-organization"
},
"name": "eClaims Organization Profile",
"description": "This profile defines constraints on the Organization resource for use within the Kenya eClaims Implementation Guide. It represents healthcare providers, insurers, and other organizations involved in claim processing.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-patient.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-patient"
},
"name": "eClaims Patient Profile",
"description": "This profile defines constraints on the Patient resource for use within the Kenya eClaims Implementation Guide. It represents a patient receiving healthcare services under the national insurance scheme.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-paymentnotice.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-paymentnotice"
},
"name": "eClaims Payment Notice Profile",
"description": "This profile defines constraints on the PaymentNotice resource for use within the Kenya eClaims Implementation Guide. It provides notice of a payment-related event, such as the issuance or receipt of funds for a healthcare claim, supporting financial reconciliation and tracking.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-practitioner.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-practitioner"
},
"name": "eClaims Practitioner Profile",
"description": "This profile defines constraints on the Practitioner resource for use within the Kenya eClaims Implementation Guide. It represents a healthcare professional involved in claim processing or service delivery.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-provenance.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-provenance"
},
"name": "eClaims Provenance Profile",
"description": "This profile defines constraints on the Provenance resource for use within the Kenya eClaims Implementation Guide. It tracks the origin, authorship, and handling of claims, preauthorizations, and related clinical resources submitted to the Social Health Authority.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-encounter-status-cs.html"
}
],
"reference": {
"reference": "CodeSystem/encounter-status-cs"
},
"name": "Encounter Status Code System",
"description": "Codes for the status of an encounter. Codes align with FHIR encounter-status to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-claims-encounter-status-vs.html"
}
],
"reference": {
"reference": "ValueSet/claims-encounter-status-vs"
},
"name": "Encounter Status ValueSet",
"description": "ValueSet for encounter status codes (MOH-Kenya OCL: ENCOUNTER-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-eepisode-of-care-status-cs.html"
}
],
"reference": {
"reference": "CodeSystem/eepisode-of-care-status-cs"
},
"name": "Episode of Care Status Code System",
"description": "Codes for the status of an episode of care. Codes align with FHIR episode-of-care-status to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-episode-of-care-status-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-episode-of-care-status-vs"
},
"name": "Episode of Care Status ValueSet",
"description": "ValueSet for episode of care status codes (MOH-Kenya OCL: EPISODE-OF-CARE-STATUS)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-episode-of-care-type-cs.html"
}
],
"reference": {
"reference": "CodeSystem/episode-of-care-type-cs"
},
"name": "Episode of Care Type Code System",
"description": "Codes for the type of episode of care (MOH-Kenya OCL: EPISODE-OF-CARE-TYPE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-episode-of-care-type-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-episode-of-care-type-vs"
},
"name": "Episode of Care Type ValueSet",
"description": "ValueSet for episode of care type codes (MOH-Kenya OCL: EPISODE-OF-CARE-TYPE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8.html"
}
],
"reference": {
"reference": "Claim/a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8"
},
"name": "Example Claim for ClaimResponse (canceled)",
"description": "Stub claim used as a reference target in the ClaimResponseCanceledExample.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-ae044c1d-9ecb-4294-be9b-0702e7892596.html"
}
],
"reference": {
"reference": "Claim/ae044c1d-9ecb-4294-be9b-0702e7892596"
},
"name": "Example Claim for ClaimResponse (sent-back)",
"description": "Stub claim used as a reference target in the ClaimResponseSentBackExample.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-CR-00001.html"
}
],
"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://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-claim"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-ECLM-SUB-001.html"
}
],
"reference": {
"reference": "Claim/ECLM-SUB-001"
},
"name": "Example Claim Submission",
"description": "An example Claim conforming to KenyaClaimSubmission for final payment after inpatient services.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-claimsubmission"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ClaimResponse"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ClaimResponse-fd876fab-979d-4adb-8b32-46dff643b89f.html"
}
],
"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://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-claimresponse"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ClaimResponse"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ClaimResponse-8e0e3d44-4b7a-47d6-8b82-39fa646f8088.html"
}
],
"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://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-claimresponse"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Coverage"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Coverage-COV-0001.html"
}
],
"reference": {
"reference": "Coverage/COV-0001"
},
"name": "Example Coverage",
"description": "Stub coverage used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Condition"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Condition-ECLM-COND-001.html"
}
],
"reference": {
"reference": "Condition/ECLM-COND-001"
},
"name": "Example eClaims Condition",
"description": "An example Condition resource conforming to EClaimsCondition.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-condition"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Coverage"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Coverage-ECLM-COV-001.html"
}
],
"reference": {
"reference": "Coverage/ECLM-COV-001"
},
"name": "Example eClaims Coverage",
"description": "An example Coverage resource conforming to EclaimsCoverage.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-coverage"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "DiagnosticReport"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "DiagnosticReport-ECLM-DR-001.html"
}
],
"reference": {
"reference": "DiagnosticReport/ECLM-DR-001"
},
"name": "Example eClaims Diagnostic Report",
"description": "An example DiagnosticReport conforming to EClaimsDiagnosticReport.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-diagnosticreport"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Encounter"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Encounter-ECLM-ENC-001.html"
}
],
"reference": {
"reference": "Encounter/ECLM-ENC-001"
},
"name": "Example eClaims Encounter",
"description": "An example Encounter resource conforming to EClaimsEncounter.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-encounter"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "EpisodeOfCare"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "EpisodeOfCare-ECLM-EOC-001.html"
}
],
"reference": {
"reference": "EpisodeOfCare/ECLM-EOC-001"
},
"name": "Example eClaims Episode of Care",
"description": "An example EpisodeOfCare resource conforming to EClaimsEpisodeOfCare.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-episodeofcare"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Organization"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Organization-ECLM-INS-001.html"
}
],
"reference": {
"reference": "Organization/ECLM-INS-001"
},
"name": "Example eClaims Insurer Organization",
"description": "An example Social Health Authority insurer Organization conforming to EClaimsOrganization.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-organization"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "MedicationDispense"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "MedicationDispense-ECLM-DISP-001.html"
}
],
"reference": {
"reference": "MedicationDispense/ECLM-DISP-001"
},
"name": "Example eClaims Medication Dispense",
"description": "An example MedicationDispense conforming to EClaimsMedicationDispense.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-medicationdispense"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "MedicationRequest"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "MedicationRequest-ECLM-MR-001.html"
}
],
"reference": {
"reference": "MedicationRequest/ECLM-MR-001"
},
"name": "Example eClaims Medication Request",
"description": "An example MedicationRequest conforming to EClaimsMedicationRequest.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-medicationrequest"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "MedicationStatement"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "MedicationStatement-ECLM-MEDS-001.html"
}
],
"reference": {
"reference": "MedicationStatement/ECLM-MEDS-001"
},
"name": "Example eClaims Medication Statement",
"description": "An example MedicationStatement conforming to EClaimsMedicationStatement.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-medicationstatement"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Patient"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Patient-ECLM-PT-001.html"
}
],
"reference": {
"reference": "Patient/ECLM-PT-001"
},
"name": "Example eClaims Patient",
"description": "An example Patient resource conforming to the EClaimsPatient profile.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-patient"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "PaymentNotice"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "PaymentNotice-ECLM-PN-001.html"
}
],
"reference": {
"reference": "PaymentNotice/ECLM-PN-001"
},
"name": "Example eClaims Payment Notice",
"description": "An example PaymentNotice conforming to EClaimsPaymentNotice.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-paymentnotice"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Practitioner"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Practitioner-ECLM-PRA-001.html"
}
],
"reference": {
"reference": "Practitioner/ECLM-PRA-001"
},
"name": "Example eClaims Practitioner",
"description": "An example Practitioner resource conforming to EClaimsPractitioner.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-practitioner"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Organization"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Organization-ECLM-ORG-001.html"
}
],
"reference": {
"reference": "Organization/ECLM-ORG-001"
},
"name": "Example eClaims Provider Organization",
"description": "An example healthcare provider Organization conforming to EClaimsOrganization.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-organization"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-ECLM-IMG-001.html"
}
],
"reference": {
"reference": "Claim/ECLM-IMG-001"
},
"name": "Example Imaging Preauthorization",
"description": "An example Claim conforming to KenyaImagingPreauth for MRI of the right femur.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-imagingpreauth"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Organization"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Organization-INS-001.html"
}
],
"reference": {
"reference": "Organization/INS-001"
},
"name": "Example Insurer Organization",
"description": "Stub insurer organization used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-ECLM-CB-001.html"
}
],
"reference": {
"reference": "Claim/ECLM-CB-001"
},
"name": "Example Kenya Claim Base",
"description": "An example Claim conforming to the KenyaClaimBase profile.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-claimbase"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Location"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Location-LOC-001.html"
}
],
"reference": {
"reference": "Location/LOC-001"
},
"name": "Example Location",
"description": "Stub location used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "MedicationRequest"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "MedicationRequest-MED-0001.html"
}
],
"reference": {
"reference": "MedicationRequest/MED-0001"
},
"name": "Example Medication Request",
"description": "Stub medication request used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-ECLM-ONC-001.html"
}
],
"reference": {
"reference": "Claim/ECLM-ONC-001"
},
"name": "Example Oncology Preauthorization",
"description": "An example Claim conforming to KenyaOncologyPreauth for a chemotherapy session.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-oncologypreauth"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-ECLM-OPT-001.html"
}
],
"reference": {
"reference": "Claim/ECLM-OPT-001"
},
"name": "Example Optical Preauthorization",
"description": "An example Claim conforming to KenyaOpticalPreauth for prescription eyeglasses.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-opticalpreauth"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Patient"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Patient-PT-0001.html"
}
],
"reference": {
"reference": "Patient/PT-0001"
},
"name": "Example Patient",
"description": "Stub patient instance used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Patient"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Patient-example.html"
}
],
"reference": {
"reference": "Patient/example"
},
"name": "Example Patient (generic)",
"description": "Stub patient instance used as a reference target in claim response examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Practitioner"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Practitioner-PRA-001.html"
}
],
"reference": {
"reference": "Practitioner/PRA-001"
},
"name": "Example Practitioner",
"description": "Stub practitioner used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Provenance"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Provenance-provenance-claim-submission-001.html"
}
],
"reference": {
"reference": "Provenance/provenance-claim-submission-001"
},
"name": "Example Provenance - Claim Submission",
"description": "An example of a Provenance record tracking the submission of an institutional claim to the Social Health Authority by a healthcare provider.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-provenance"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Organization"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Organization-ORG-001.html"
}
],
"reference": {
"reference": "Organization/ORG-001"
},
"name": "Example Provider Organization",
"description": "Stub provider organization used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-CLAIM-0000X.html"
}
],
"reference": {
"reference": "Claim/CLAIM-0000X"
},
"name": "Example Related Claim",
"description": "Stub related claim used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-ECLM-REN-001.html"
}
],
"reference": {
"reference": "Claim/ECLM-REN-001"
},
"name": "Example Renal Preauthorization",
"description": "An example Claim conforming to KenyaRenalPreauth for a haemodialysis session.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-renalpreauth"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ServiceRequest"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ServiceRequest-SRV-0001.html"
}
],
"reference": {
"reference": "ServiceRequest/SRV-0001"
},
"name": "Example Service Request",
"description": "Stub service request used as a reference target in claim examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Claim"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Claim-ECLM-SUR-001.html"
}
],
"reference": {
"reference": "Claim/ECLM-SUR-001"
},
"name": "Example Surgical Preauthorization",
"description": "An example Claim conforming to KenyaSurgicalPreauth for an appendicectomy.",
"exampleCanonical": "https://fhir.dha.go.ke/ig/eclaims/StructureDefinition/ke-eclaims-surgicalpreauth"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-ExclusionCS.html"
}
],
"reference": {
"reference": "CodeSystem/ExclusionCS"
},
"name": "Exclusion Code System",
"description": "A code system that defines Exclusion",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-exclusion-extension.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-exclusion-extension"
},
"name": "Exclusion Extension",
"description": "A list of services or conditions that are explicitly not covered by this plan.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-eye-examination-amount.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-eye-examination-amount"
},
"name": "Eye Examination Amount",
"description": "The amount charged for the eye examination service.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-frame-amount.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-frame-amount"
},
"name": "Frame Amount",
"description": "The amount charged for spectacle frames.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-gender-cs.html"
}
],
"reference": {
"reference": "CodeSystem/gender-cs"
},
"name": "Gender Code System",
"description": "Extended gender identity codes for Kenya (MOH-Kenya OCL: GENDER). Extends beyond FHIR administrative-gender with additional local codes.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-gender-vs.html"
}
],
"reference": {
"reference": "ValueSet/gender-vs"
},
"name": "Gender ValueSet",
"description": "ValueSet for extended gender codes in Kenya (MOH-Kenya OCL: GENDER)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-eclaims-generic-products-cs.html"
}
],
"reference": {
"reference": "CodeSystem/eclaims-generic-products-cs"
},
"name": "Generic Products CodeSystem",
"description": "Generic medicinal product codes from MOH PPB OCL.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-generic-products-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-generic-products-vs"
},
"name": "Generic Products ValueSet",
"description": "ValueSet for generic pharmaceutical products (MOH-Kenya: GenericProducts)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-has-coinsurance.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-hpi.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-icd11-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-icd11-vs"
},
"name": "ICD ValueSet",
"description": "ValueSet for ICD codes used in Kenya eClaims.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-icd11-codes-cs.html"
}
],
"reference": {
"reference": "CodeSystem/icd11-codes-cs"
},
"name": "ICD-11 Code System",
"description": "ICD-11 codes for mortality and morbidity statistics. Source: MOH-KENYA OCL ICD-11-FOR-MORTALITY-AND-MORBIDITY-STATISTICS.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-identifier-types-cs.html"
}
],
"reference": {
"reference": "CodeSystem/identifier-types-cs"
},
"name": "Identifier Types Code System",
"description": "Codes for types of identifiers used in Kenya (MOH-Kenya OCL: IDENTIFIER-TYPES)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-identifier-types-vs.html"
}
],
"reference": {
"reference": "ValueSet/identifier-types-vs"
},
"name": "Identifier Types ValueSet",
"description": "ValueSet for identifier type codes used in Kenya (MOH-Kenya OCL: IDENTIFIER-TYPES)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-identifier-use-cs.html"
}
],
"reference": {
"reference": "CodeSystem/identifier-use-cs"
},
"name": "Identifier Use Code System",
"description": "Codes for the use of an identifier. Codes align with FHIR identifier-use to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-identifier-use-vs.html"
}
],
"reference": {
"reference": "ValueSet/identifier-use-vs"
},
"name": "Identifier Use ValueSet",
"description": "ValueSet for identifier use codes (MOH-Kenya OCL: IDENTIFIER-USE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-imagingpreauth.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-imagingpreauth"
},
"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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-investigations.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-item-coverage-reference.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-claimbase.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-claimbase"
},
"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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-claimresponse.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-claimresponse"
},
"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": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-body-site-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-body-site-vs"
},
"name": "Kenya Institutional Body Site ValueSet",
"description": "ValueSet for body site codes used in Kenya institutional claims (MOH-Kenya OCL: INSTITUTIONAL-BODY-SITE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-social-health-authority-interventions-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-social-health-authority-interventions-vs"
},
"name": "Kenya Social Health Authority Interventions ValueSet",
"description": "ValueSet for interventions approved by the Kenya Social Health Authority (MOH-Kenya OCL: KenyaSocialHealthAuthorityInterventions)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-sub-site-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-sub-site-vs"
},
"name": "Kenya Subsite ValueSet",
"description": "ValueSet for sub-site codes used in Kenya claims (MOH-Kenya OCL: SUBSITE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-last-replacement-date.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-lens-amount.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-lens-amount"
},
"name": "Lens Amount",
"description": "The amount charged for spectacle lenses.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-lens-prescription.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-medication-status-reason-cs.html"
}
],
"reference": {
"reference": "CodeSystem/medication-status-reason-cs"
},
"name": "Medication Status Reason Code System",
"description": "Codes for the reason a medication was stopped or paused, replacing SNOMED CT-based HL7 ValueSet",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-medication-status-reason-vs.html"
}
],
"reference": {
"reference": "ValueSet/medication-status-reason-vs"
},
"name": "Medication Status Reason ValueSet",
"description": "ValueSet for reasons a medication was stopped or paused (local replacement for SNOMED CT-based http://hl7.org/fhir/ValueSet/reason-medication-status-codes)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-metastases.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-name-use-cs.html"
}
],
"reference": {
"reference": "CodeSystem/name-use-cs"
},
"name": "Name Use Code System",
"description": "Codes for the use of a name. Codes align with FHIR name-use to allow required binding as a subset.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-name-use-vs.html"
}
],
"reference": {
"reference": "ValueSet/name-use-vs"
},
"name": "Name Use ValueSet",
"description": "ValueSet for name use codes (MOH-Kenya OCL: NAME-USE)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-oncologypreauth.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-oncologypreauth"
},
"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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-opticalpreauth.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-opticalpreauth"
},
"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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-other-metastases.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-other-metastases"
},
"name": "Other Metastases",
"description": "Details on additional metastases not captured in the main metastases field.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-patient-invoice.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-payment-method-extension.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-payment-method-extension"
},
"name": "Paymen tMethod Extension",
"description": "The preferred method of payment for the beneficiary's share (e.g., credit card, direct debit).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-payment-method-cs.html"
}
],
"reference": {
"reference": "CodeSystem/payment-method-cs"
},
"name": "Payment Method Code System",
"description": "Codes for payment methods (MOH-Kenya OCL: PAYMENT-METHOD)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-payment-method-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-payment-method-vs"
},
"name": "Payment Method ValueSet",
"description": "ValueSet for payment method codes (MOH-Kenya OCL: PAYMENT-METHOD)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-physical-examination.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-plan-type-extension.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-plan-type-extension"
},
"name": "Plan Type Extension",
"description": "The specific type of plan",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-PreAuthExclusionsCS.html"
}
],
"reference": {
"reference": "CodeSystem/PreAuthExclusionsCS"
},
"name": "PreAuthExclusions Code System",
"description": "A code system that defines PreAuth Exclusions",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-pre-auth-exclusions-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-pre-auth-exclusions-vs"
},
"name": "Preauthorization Exclusion Reason ValueSet",
"description": "ValueSet for reasons a service may be excluded from preauthorization in Kenya (MOH-Kenya OCL: PREAUTH-EXCLUSION-REASON)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaim-expiry-extension.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaim-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-pre-auth-exclusion-extension.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-pre-auth-exclusion-extension"
},
"name": "Preauthorization Expiry Date",
"description": "Services excluded from preauthorization.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-waiver-type-extension.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-waiver-type-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-preauth-token.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-provider-auth-token.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-eclaims-provider-qualification-cs.html"
}
],
"reference": {
"reference": "CodeSystem/eclaims-provider-qualification-cs"
},
"name": "Provider Qualification Code System",
"description": "Qualification and credential codes for healthcare providers in Kenya eClaims. Codes align with HL7 v2 Table 0360 to ensure interoperability.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-provider-qualification-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-provider-qualification-vs"
},
"name": "Provider Qualification ValueSet",
"description": "Qualification and credential codes for healthcare providers in Kenya eClaims, drawn from the local ProviderQualificationCS.",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:extension"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-raw-preauth-source-data.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-reason-for-service.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-related-claim-relationship-cs.html"
}
],
"reference": {
"reference": "CodeSystem/related-claim-relationship-cs"
},
"name": "Related Claim Relationship Code System",
"description": "Codes for the relationship between related claims (MOH-Kenya OCL: RELATED-CLAIM-RELATIONSHIP)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-related-claim-relationship-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-related-claim-relationship-vs"
},
"name": "Related Claim Relationship ValueSet",
"description": "ValueSet for related claim relationship codes (MOH-Kenya OCL: RELATED-CLAIM-RELATIONSHIP)",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-renalpreauth.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-renalpreauth"
},
"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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-replacement.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-session-expected-date.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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": "Organization"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Organization-sha-insurer.html"
}
],
"reference": {
"reference": "Organization/sha-insurer"
},
"name": "Social Health Authority",
"description": "Stub SHA insurer organization used as a reference target in claim response examples.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "Observation"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "Observation-ECLM-OBS-001.html"
}
],
"reference": {
"reference": "Observation/ECLM-OBS-001"
},
"name": "Stub Observation for DiagnosticReport",
"description": "A minimal stub Observation referenced by the DiagnosticReport example.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "PaymentReconciliation"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "PaymentReconciliation-ECLM-PR-001.html"
}
],
"reference": {
"reference": "PaymentReconciliation/ECLM-PR-001"
},
"name": "Stub PaymentReconciliation for PaymentNotice",
"description": "A minimal stub PaymentReconciliation referenced by the PaymentNotice example.",
"exampleBoolean": true
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-ClaimDiagnosisCodeableConceptCS.html"
}
],
"reference": {
"reference": "CodeSystem/ClaimDiagnosisCodeableConceptCS"
},
"name": "Subsite Code System",
"description": "A code system that defines Subsite",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-KenyaSubSiteCS.html"
}
],
"reference": {
"reference": "CodeSystem/KenyaSubSiteCS"
},
"name": "Subsite Code System",
"description": "A code system that defines Subsite",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "StructureDefinition:resource"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-ke-eclaims-surgicalpreauth.html"
}
],
"reference": {
"reference": "StructureDefinition/ke-eclaims-surgicalpreauth"
},
"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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-treatment-setting.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-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"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "StructureDefinition-eclaims-vital-signs.html"
}
],
"reference": {
"reference": "StructureDefinition/eclaims-vital-signs"
},
"name": "Vital Signs",
"description": "Recorded vital signs (e.g. Temperature, BP).",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "CodeSystem"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "CodeSystem-WaiverTypeCS.html"
}
],
"reference": {
"reference": "CodeSystem/WaiverTypeCS"
},
"name": "Waiver Type Code System",
"description": "A code system that defines Waiver Type",
"exampleBoolean": false
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/resource-information",
"valueString": "ValueSet"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/implementationguide-page",
"valueUri": "ValueSet-eclaims-waiver-type-vs.html"
}
],
"reference": {
"reference": "ValueSet/eclaims-waiver-type-vs"
},
"name": "Waiver Type ValueSet",
"description": "ValueSet for types of waivers applicable in Kenya health insurance claims (MOH-Kenya OCL: WAIVER-TYPE)",
"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"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "background.html"
}
],
"nameUrl": "background.html",
"title": "Background",
"generation": "markdown"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "usecases.html"
}
],
"nameUrl": "usecases.html",
"title": "Use Cases",
"generation": "markdown"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "actors.html"
}
],
"nameUrl": "actors.html",
"title": "Actors & Transactions",
"generation": "markdown"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "security.html"
}
],
"nameUrl": "security.html",
"title": "Security & Privacy",
"generation": "markdown"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "conformance.html"
}
],
"nameUrl": "conformance.html",
"title": "Conformance Requirements",
"generation": "markdown"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "terminology.html"
}
],
"nameUrl": "terminology.html",
"title": "Terminology Guidance",
"generation": "markdown"
},
{
"extension": [
{
"url": "http://hl7.org/fhir/tools/StructureDefinition/ig-page-name",
"valueUrl": "downloads.html"
}
],
"nameUrl": "downloads.html",
"title": "Downloads & Validation",
"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"
}
]
}
}