Kenya eClaims Implementation Guide
0.1.0 - ci-build Kenya flag

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

Example Claim: Example Kenya Claim Base

identifier: https://nshr-uat.sha.go.ke/fhir/Identifier/claim-number/CLAIM-BASE-001

status: Active

type: Institutional

subType: Inpatient

use: Preauthorization

patient: John Mwangi Kamau (official) Male, DoB: 1985-06-15 ( National ID: 12345678 (use: official, ))

billablePeriod: 2025-11-01 --> 2025-11-07

created: 2025-11-08 09:00:00+0300

insurer: Organization Social Health Authority

provider: Organization Nairobi General Hospital

priority: Normal

Payees

-Type
*Provider

CareTeams

-SequenceProviderRoleQualification
*1Practitioner Dr. James Ochieng (official)Primary providerDoctor of Medicine

Diagnoses

-SequenceDiagnosis[x]
*1Fracture of shaft of femur

Insurances

-SequenceFocalCoverage
*1trueCoverage: extension = Mobile Money,Active,General Practice; identifier = https://nshr-uat.sha.go.ke/fhir/Identifier/coverage-number#COV-SHA-2024-001234; status = active; type = Medical; relationship = Self; period = 2024-01-01 --> 2024-12-31

item

sequence: 1

careTeamSequence: 1

category: Medical Care

productOrService: Inpatient Services

quantity: 7

UnitPrices

-ValueCurrency
*5000Kenyan shilling

Nets

-ValueCurrency
*35000Kenyan shilling