Kenya eClaims Implementation Guide
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: Example Claim for ClaimResponse (canceled) - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/Claim/a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8> a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8</b></p><a name=\"a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8\"> </a><a name=\"hca7dcd571-d8a2-483a-8a45-e3c8bcbff8b8\"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-example.html\">Jane Wanjiku  Female, DoB: 1985-06-15</a></p><p><b>created</b>: 2025-10-01</p><p><b>insurer</b>: <a href=\"Organization-sha-insurer.html\">Organization Social Health Authority</a></p><p><b>provider</b>: <a href=\"Organization-ORG-001.html\">Organization Nairobi General Hospital</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-COV-0001.html\">Coverage: status = active</a></td></tr></table></div>"
  ] ;
  fhir:Claim.status [ fhir:value "active"] ;
  fhir:Claim.type [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ;
       fhir:Coding.code [ fhir:value "institutional" ]
     ]
  ] ;
  fhir:Claim.use [ fhir:value "preauthorization"] ;
  fhir:Claim.patient [
     fhir:link <http://hl7.org/fhir/Patient/example> ;
     fhir:Reference.reference [ fhir:value "Patient/example" ]
  ] ;
  fhir:Claim.created [ fhir:value "2025-10-01"^^xsd:date] ;
  fhir:Claim.insurer [
     fhir:link <http://hl7.org/fhir/Organization/sha-insurer> ;
     fhir:Reference.reference [ fhir:value "Organization/sha-insurer" ]
  ] ;
  fhir:Claim.provider [
     fhir:link <http://hl7.org/fhir/Organization/ORG-001> ;
     fhir:Reference.reference [ fhir:value "Organization/ORG-001" ]
  ] ;
  fhir:Claim.priority [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ] ;
       fhir:Coding.code [ fhir:value "normal" ] ;
       fhir:Coding.display [ fhir:value "Normal" ]
     ]
  ] ;
  fhir:Claim.insurance [
     fhir:index 0 ;
     fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ] ;
     fhir:Claim.insurance.coverage [
       fhir:link <http://hl7.org/fhir/Coverage/COV-0001> ;
       fhir:Reference.reference [ fhir:value "Coverage/COV-0001" ]
     ]
  ] .

<http://hl7.org/fhir/Patient/example> a fhir:Patient .

<http://hl7.org/fhir/Organization/sha-insurer> a fhir:Organization .

<http://hl7.org/fhir/Organization/ORG-001> a fhir:Organization .

<http://hl7.org/fhir/Coverage/COV-0001> a fhir:Coverage .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Claim/a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/Claim/a7dcd571-d8a2-483a-8a45-e3c8bcbff8b8.ttl> .