DHIN 2025Connectathon FHIR IG
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DHIN 2025Connectathon FHIR IG, published by DHIN. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Nigeria-FHIR-Community/2025Connectathon/ and changes regularly. See the Directory of published versions

: Claim Submission - Request (Transaction) - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "ClaimSubmission-Request",
  "meta" : {
    "profile" : [
      🔗 "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-submission-bundle"
    ]
  },
  "type" : "transaction",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "NgPatient-Claim-001",
        "meta" : {
          "lastUpdated" : "2025-10-25T14:30:00+01:00",
          "profile" : [
            🔗 "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-patient"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_NgPatient-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient NgPatient-Claim-001</b></p><a name=\"NgPatient-Claim-001\"> </a><a name=\"hcNgPatient-Claim-001\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2025-10-25 14:30:00+0100</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-patient.html\">NG Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Amaka Nwosu  Female, DoB: 1992-07-15 ( mobile: 08045678901)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td colspan=\"3\">true</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">22 River Road Port Harcourt RI </td></tr></table></div>"
        },
        "identifier" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs",
                  "code" : "MOBILE",
                  "display" : "mobile"
                }
              ]
            },
            "system" : "https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs",
            "value" : "08045678901"
          }
        ],
        "active" : true,
        "name" : [
          {
            "family" : "Nwosu",
            "given" : [
              "Amaka"
            ]
          }
        ],
        "gender" : "female",
        "birthDate" : "1992-07-15",
        "address" : [
          {
            "line" : [
              "22 River Road"
            ],
            "city" : "Port Harcourt",
            "district" : "ri-oyigbo",
            "state" : "RI"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Patient"
      }
    },
    {
      "fullUrl" : "urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "NgOrganization-Provider-Claim-001",
        "meta" : {
          "profile" : [
            🔗 "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-provider-organization"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_NgOrganization-Provider-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization NgOrganization-Provider-Claim-001</b></p><a name=\"NgOrganization-Provider-Claim-001\"> </a><a name=\"hcNgOrganization-Provider-Claim-001\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-provider-organization.html\">NG Provider Organization</a></p></div><p><b>NG Owner of Facility</b>: <span title=\"Codes:{https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs public}\">Public Health Institution Location</span></p><p><b>identifier</b>: <code>https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry</code>/HCF-RS-5678</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: Rivers State Teaching Hospital</p><p><b>telecom</b>: ph: 084-234-5678</p><p><b>address</b>: 100 Hospital Boulevard Port Harcourt RI </p></div>"
        },
        "extension" : [
          {
            "url" : "https://sandbox.dhin-hie.org/ig/StructureDefinition/organization-owner",
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs",
                  "code" : "public"
                }
              ]
            }
          }
        ],
        "identifier" : [
          {
            "system" : "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry",
            "value" : "HCF-RS-5678"
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "prov",
                "display" : "Healthcare Provider"
              }
            ]
          }
        ],
        "name" : "Rivers State Teaching Hospital",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "084-234-5678"
          }
        ],
        "address" : [
          {
            "line" : [
              "100 Hospital Boulevard"
            ],
            "city" : "Port Harcourt",
            "district" : "ri-oyigbo",
            "state" : "RI"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Organization"
      }
    },
    {
      "fullUrl" : "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "NgOrganization-Insurer-Claim-001",
        "meta" : {
          "profile" : [
            🔗 "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-insurer-organization"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_NgOrganization-Insurer-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization NgOrganization-Insurer-Claim-001</b></p><a name=\"NgOrganization-Insurer-Claim-001\"> </a><a name=\"hcNgOrganization-Insurer-Claim-001\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-insurer-organization.html\">NG Insurer Organization</a></p></div><p><b>identifier</b>: <code>https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry</code>/HMO-MC-9988</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type ins}\">Insurance Company</span></p><p><b>name</b>: MediCare Plus HMO</p><p><b>telecom</b>: ph: 0700-MEDICARE</p><p><b>address</b>: 15 Insurance Plaza Port Harcourt RI </p></div>"
        },
        "identifier" : [
          {
            "system" : "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry",
            "value" : "HMO-MC-9988"
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
                "code" : "ins",
                "display" : "Insurance Company"
              }
            ]
          }
        ],
        "name" : "MediCare Plus HMO",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "0700-MEDICARE"
          }
        ],
        "address" : [
          {
            "line" : [
              "15 Insurance Plaza"
            ],
            "city" : "Port Harcourt",
            "district" : "ri-oyigbo",
            "state" : "RI"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Organization"
      }
    },
    {
      "fullUrl" : "urn:uuid:eee55566-e5f6-4789-a123-456789abcdef",
      "resource" : {
        "resourceType" : "Coverage",
        "id" : "NgCoverage-Claim-001",
        "meta" : {
          "profile" : [
            🔗 "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_NgCoverage-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage NgCoverage-Claim-001</b></p><a name=\"NgCoverage-Claim-001\"> </a><a name=\"hcNgCoverage-Claim-001\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-coverage.html\">NG Claim Coverage</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode EHCPOL}\">extended healthcare</span></p><p><b>beneficiary</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-aaabbbc2-e5f6-4789-a123-456789abcdef\">Amaka Nwosu  Female, DoB: 1992-07-15 ( mobile: 08045678901)</a></p><p><b>period</b>: 2025-01-01 --&gt; 2025-12-31</p><p><b>payor</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-ddd44455-e5f6-4789-a123-456789abcdef\">Organization MediCare Plus HMO</a></p></div>"
        },
        "status" : "active",
        "type" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code" : "EHCPOL",
              "display" : "extended healthcare"
            }
          ]
        },
        "beneficiary" : {
          "reference" : "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef"
        },
        "period" : {
          "start" : "2025-01-01",
          "end" : "2025-12-31"
        },
        "payor" : [
          {
            "reference" : "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef"
          }
        ]
      },
      "request" : {
        "method" : "POST",
        "url" : "Coverage"
      }
    },
    {
      "fullUrl" : "urn:uuid:fff66677-e5f6-4789-a123-456789abcdef",
      "resource" : {
        "resourceType" : "Claim",
        "id" : "NgClaim-Claim-001",
        "meta" : {
          "profile" : [
            🔗 "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_NgClaim-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim NgClaim-Claim-001</b></p><a name=\"NgClaim-Claim-001\"> </a><a name=\"hcNgClaim-Claim-001\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-claim.html\">NG Claim</a></p></div><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>: Claim</p><p><b>patient</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-aaabbbc2-e5f6-4789-a123-456789abcdef\">Amaka Nwosu  Female, DoB: 1992-07-15 ( mobile: 08045678901)</a></p><p><b>created</b>: 2025-10-25 14:35:00+0100</p><p><b>provider</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-ccc33344-e5f6-4789-a123-456789abcdef\">Organization Rivers State Teaching 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=\"Bundle-ClaimSubmission-Request.html#urn-uuid-eee55566-e5f6-4789-a123-456789abcdef\">Coverage: status = active; type = extended healthcare; period = 2025-01-01 --&gt; 2025-12-31</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1205}\">Appendectomy</span></p><p><b>serviced</b>: 2025-10-22</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>150000</td><td>Nigerian naira</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>150000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1201}\">Exam, recall</span></p><p><b>serviced</b>: 2025-10-22 --&gt; 2025-10-25</p><p><b>quantity</b>: 3</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>20000</td><td>Nigerian naira</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>60000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1101}\">Laboratory Tests</span></p><p><b>serviced</b>: 2025-10-22</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>15000</td><td>Nigerian naira</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>15000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 4</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1102}\">Medications</span></p><p><b>serviced</b>: 2025-10-22</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>25000</td><td>Nigerian naira</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>25000</td><td>Nigerian naira</td></tr></table></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>250000</td><td>Nigerian naira</td></tr></table></div>"
        },
        "status" : "active",
        "type" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
              "code" : "institutional",
              "display" : "Institutional"
            }
          ]
        },
        "use" : "claim",
        "patient" : {
          "reference" : "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef"
        },
        "created" : "2025-10-25T14:35:00+01:00",
        "provider" : {
          "reference" : "urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef"
        },
        "priority" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
              "code" : "normal"
            }
          ]
        },
        "insurance" : [
          {
            "sequence" : 1,
            "focal" : true,
            "coverage" : {
              "reference" : "urn:uuid:eee55566-e5f6-4789-a123-456789abcdef"
            }
          }
        ],
        "item" : [
          {
            "sequence" : 1,
            "productOrService" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/ex-USCLS",
                  "code" : "1205"
                }
              ],
              "text" : "Appendectomy"
            },
            "servicedDate" : "2025-10-22",
            "quantity" : {
              "value" : 1
            },
            "unitPrice" : {
              "value" : 150000,
              "currency" : "NGN"
            },
            "net" : {
              "value" : 150000,
              "currency" : "NGN"
            }
          },
          {
            "sequence" : 2,
            "productOrService" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/ex-USCLS",
                  "code" : "1201"
                }
              ],
              "text" : "Exam, recall"
            },
            "servicedPeriod" : {
              "start" : "2025-10-22",
              "end" : "2025-10-25"
            },
            "quantity" : {
              "value" : 3
            },
            "unitPrice" : {
              "value" : 20000,
              "currency" : "NGN"
            },
            "net" : {
              "value" : 60000,
              "currency" : "NGN"
            }
          },
          {
            "sequence" : 3,
            "productOrService" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/ex-USCLS",
                  "code" : "1101"
                }
              ],
              "text" : "Laboratory Tests"
            },
            "servicedDate" : "2025-10-22",
            "quantity" : {
              "value" : 1
            },
            "unitPrice" : {
              "value" : 15000,
              "currency" : "NGN"
            },
            "net" : {
              "value" : 15000,
              "currency" : "NGN"
            }
          },
          {
            "sequence" : 4,
            "productOrService" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/ex-USCLS",
                  "code" : "1102"
                }
              ],
              "text" : "Medications"
            },
            "servicedDate" : "2025-10-22",
            "quantity" : {
              "value" : 1
            },
            "unitPrice" : {
              "value" : 25000,
              "currency" : "NGN"
            },
            "net" : {
              "value" : 25000,
              "currency" : "NGN"
            }
          }
        ],
        "total" : {
          "value" : 250000,
          "currency" : "NGN"
        }
      },
      "request" : {
        "method" : "POST",
        "url" : "Claim"
      }
    }
  ]
}