DHIN 2025Connectathon FHIR IG
0.1.0 - draft

DHIN 2025Connectathon FHIR IG, published by DHIN. This guide is not an authorized publication; it is the continuous build for version 0.1.0 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

: Example — HMO → Insurer Claims Transaction - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="bundle-hmo-insurance"/>
  <meta>
    <profile
             value="https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-transaction-bundle"/>
  </meta>
  <identifier>
    <system
            value="https://sandbox.dhin-hie.org/ig/CodeSystem/ng-bundle-identifier-cs"/>
    <value value="BND-0011"/>
  </identifier>
  <type value="transaction"/>
  <timestamp value="2025-10-16T08:00:00+01:00"/>
  <entry>
    <fullUrl value="urn:uuid:0b1a1a2d-6a53-4e4a-a5f4-b8d7f6d9e011"/>
    <resource>
      <Coverage>
        <id value="NgCoverage-001"/>
        <meta>
          <profile
                   value="https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-coverage"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Coverage_NgCoverage-001"> </a><p class="res-header-id"><b>Generated Narrative: Coverage NgCoverage-001</b></p><a name="NgCoverage-001"> </a><a name="hcNgCoverage-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-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/coverage-copay-type emergency}">NHIA Plan A</span></p><p><b>subscriber</b>: <a href="Patient-NgPatient-002.html">Musa Abdullahi  Male, DoB: 1987-07-06 ( nin)</a></p><p><b>beneficiary</b>: <a href="Patient-NgPatient-002.html">Musa Abdullahi  Male, DoB: 1987-07-06 ( nin)</a></p><p><b>period</b>: 2025-01-01 --&gt; 2025-12-31</p><p><b>payor</b>: <a href="Organization-NgOrganization-001.html">Organization Asokoro District Hospital</a></p></div>
        </text>
        <status value="active"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/coverage-copay-type"/>
            <code value="emergency"/>
          </coding>
          <text value="NHIA Plan A"/>
        </type>
        <subscriber>🔗 
          <reference value="Patient/NgPatient-002"/>
        </subscriber>
        <beneficiary>🔗 
          <reference value="Patient/NgPatient-002"/>
        </beneficiary>
        <period>
          <start value="2025-01-01"/>
          <end value="2025-12-31"/>
        </period>
        <payor>🔗 
          <reference value="Organization/NgOrganization-001"/>
        </payor>
      </Coverage>
    </resource>
    <request>
      <method value="POST"/>
      <url value="https://sandbox.dhin-hie.org/ig/resources/NgCoverage"/>
    </request>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:1c2b3c4d-7e65-4f70-9ab2-5f3a1c9d2f12"/>
    <resource>
      <Claim>
        <id value="NgClaim-001"/>
        <meta>
          <profile
                   value="https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Claim_NgClaim-001"> </a><p class="res-header-id"><b>Generated Narrative: Claim NgClaim-001</b></p><a name="NgClaim-001"> </a><a name="hcNgClaim-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>identifier</b>: <code>https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry</code>/CLM-2025-0001</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type pharmacy}">Pharmacy</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href="Patient-NgPatient-002.html">Musa Abdullahi  Male, DoB: 1987-07-06 ( nin)</a></p><p><b>created</b>: 2025-11-04 12:30:00+0000</p><p><b>provider</b>: <a href="Organization-NgOrganization-001.html">Organization Asokoro District Hospital</a></p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></p><h3>Payees</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Party</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/payeetype provider}">Provider</span></td><td><a href="Practitioner-NgPractitioner-002.html">Practitioner Nkiru Okeke </a></td></tr></table><h3>Diagnoses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{http://snomed.info/sct 59621000}">Essential hypertension</span></td></tr></table><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Identifier</b></td><td><b>Coverage</b></td><td><b>BusinessArrangement</b></td><td><b>PreAuthRef</b></td></tr><tr><td style="display: none">*</td><td>654</td><td>true</td><td><code>https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry</code>/NHIA-0011223344</td><td><a href="Bundle-bundle-hmo-insurance.html#urn-uuid-0b1a1a2d-6a53-4e4a-a5f4-b8d7f6d9e011">Coverage: status = active; type = Emergency; period = 2025-01-01 --&gt; 2025-12-31</a></td><td>NHIA-PlanA-2025</td><td>PA-2025-ABC123</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>diagnosisSequence</b>: 1</p><p><b>productOrService</b>: <span title="Codes:{http://www.whocc.no/atc J01CA04}">Amoxicillin</span></p><p><b>quantity</b>: 30</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>500</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><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>15000</td><td>Nigerian naira</td></tr></table></div>
        </text>
        <identifier>
          <system
                  value="https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry"/>
          <value value="CLM-2025-0001"/>
        </identifier>
        <status value="active"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
            <code value="pharmacy"/>
          </coding>
        </type>
        <use value="claim"/>
        <patient>🔗 
          <reference value="Patient/NgPatient-002"/>
        </patient>
        <created value="2025-11-04T12:30:00Z"/>
        <provider>🔗 
          <reference value="Organization/NgOrganization-001"/>
        </provider>
        <priority>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/processpriority"/>
            <code value="normal"/>
          </coding>
        </priority>
        <payee>
          <type>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/payeetype"/>
              <code value="provider"/>
            </coding>
          </type>
          <party>🔗 
            <reference value="Practitioner/NgPractitioner-002"/>
          </party>
        </payee>
        <diagnosis>
          <sequence value="1"/>
          <diagnosisCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="59621000"/>
              <display value="Essential hypertension"/>
            </coding>
          </diagnosisCodeableConcept>
        </diagnosis>
        <insurance>
          <sequence value="654"/>
          <focal value="true"/>
          <identifier>
            <system
                    value="https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry"/>
            <value value="NHIA-0011223344"/>
          </identifier>
          <coverage>
            <reference value="urn:uuid:0b1a1a2d-6a53-4e4a-a5f4-b8d7f6d9e011"/>
          </coverage>
          <businessArrangement value="NHIA-PlanA-2025"/>
          <preAuthRef value="PA-2025-ABC123"/>
        </insurance>
        <item>
          <sequence value="1"/>
          <diagnosisSequence value="1"/>
          <productOrService>
            <coding>
              <system value="http://www.whocc.no/atc"/>
              <code value="J01CA04"/>
              <display value="Amoxicillin"/>
            </coding>
          </productOrService>
          <quantity>
            <value value="30"/>
          </quantity>
          <unitPrice>
            <value value="500"/>
            <currency value="NGN"/>
          </unitPrice>
          <net>
            <value value="15000"/>
            <currency value="NGN"/>
          </net>
        </item>
        <total>
          <value value="15000"/>
          <currency value="NGN"/>
        </total>
      </Claim>
    </resource>
    <request>
      <method value="POST"/>
      <url value="https://sandbox.dhin-hie.org/ig/resources/NgClaim"/>
    </request>
  </entry>
</Bundle>