NHDR Implementation Guide Release 1.0
0.1.0 - ci-build
NHDR Implementation Guide Release 1.0, published by NHDR. 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/PROJ-PHILHEALTH-EA-NHDR/PhilHealth-NHDR-IG-Review/ and changes regularly. See the Directory of published versions
| Series # | Claim.identifier | Identifier | 0..1 | 15 | — |
| Part I - Member Information | |||||
| PhilHealth Identification Number (PIN) of Member | RelatedPerson.identifier | Identifier(PhilHealthID) | 0..* | 12 | — |
| Name of Member (Last Name) | RelatedPerson.name.family | String | 0..* | 60 | — |
| Name of Member (First Name) | RelatedPerson.name.given[0] | String | 0..* | 60 | — |
| Name of Member (Name Extension) | RelatedPerson.name.suffix | String | 0..* | 5 | — |
| Name of Member (Middle Name) | RelatedPerson.name.given[1] | String | 0..* | 60 | — |
| Date of Birth | RelatedPerson.birthDate | date | 0..1 | 10 | — |
| Mailing Address (Unit/Room No./Floor) | RelatedPerson.address.line | String | 0..* | 150 | — |
| Mailing Address (Building Name) | RelatedPerson.address.line | String | 0..* | 150 | — |
| Mailing Address (Lot/Blk/House/Bldg. No.) | RelatedPerson.address.line | String | 0..* | 150 | — |
| Mailing Address (Street) | RelatedPerson.address.line | String | 0..* | 150 | — |
| Mailing Address (Subdivision/Village) | RelatedPerson.address.line | String | 0..* | 150 | — |
| Mailing Address (Barangay) | RelatedPerson.address.extension:barangay | Coding | 0..1 | 150 | Barangay |
| Mailing Address (City/Municipality) | RelatedPerson.address.extension:cityMunicipality | Coding | 0..1 | 150 | City |
| Mailing Address (Province) | RelatedPerson.address.extension:province | Coding | 0..1 | 150 | Province |
| Mailing Address (Country) | RelatedPerson.address.country | Coding | 0..* | 150 | |
| Mailing Address (Zip Code) | RelatedPerson.address.postalCode | Coding | 0..* | 4 | |
| Sex | RelatedPerson.extension:sex | CodeableConcept | 0..1 | 1 | Sex |
| Contact Information Landline # (Area Code + Tel. No.) | RelatedPerson.telecom.value | string | 0..1 | 20 | — |
| Contact Information (Mobile #) | RelatedPerson.telecom.value | string | 0..* | 20 | — |
| Contact Information (Email Address) | RelatedPerson.telecom.value | string | 0..* | 156 | — |
| Patient is the member? [Yes, Proceed to Part III] | Questionnaire.item.text | string | 0..1 | 1 | — |
| Part II - Patient Information | |||||
| PhilHealth Identification Number (PIN) of Patient | Patient.identifier | Identifier(PhilHealthID) | 0..1 | 12 | — |
| Name of Patient (Last Name) | Patient.name.family | String | 0..* | 60 | — |
| Name of Patient (First Name) | Patient.name.given[0] | String | 0..* | 60 | — |
| Name of Patient (Name Extension) | Patient.name.suffix | String | 0..* | 5 | — |
| Name of Patient (Middle Name) | Patient.name.given[1] | String | 0..* | 60 | — |
| Date of Birth | Patient.birthDate | date | 0..1 | 10 | — |
| Relationship to Member | Patient.contact.relationship | CodeableConcept | 0..* | — | Contact Relationship |
| Sex | Patient.extension:sex | CodeableConcept | 0..1 | 1 | Sex |
| Part III - Member Certification | |||||
| Signature Type | Provenance.signature.type | Coding | 1..* | — | Signature Type |
| Signature Image | Provenance.signature.data | base64Binary | 0..1 | — | — |
| Signature Name | Provenance.signature.who | Reference(PH_Patient or PH_Organization or PH_Practitioner or PH_PractitionerRole or PH_RelatedPerson or Device) | 1..1 | — | — |
| Date Signed (MM-DD-YYYY) | Provenance.signature.when | instant | 1..1 | — | — |
| Printed Thumbmark | Provenance.signature.data | base64Binary | 0..1 | — | — |
| Relationship of the representative to the member | Provenance.signature.onBehalfOf | Reference(PH_Patient or PH_Organization or PH_Practitioner or PH_PractitionerRole or PH_RelatedPerson or Device) | 0..1 | — | — |
| Reason for signing on behalf of the member | Provenance.signature.extension:signatureReason | string | 0..1 | — | — |
| Part IV - Employer's Certification (for employed members only) | |||||
| PhilHealth Employer Number (PEN) | Organization.identifier | Identifier(OtherID) | 0..1 | 12 | — |
| Contact No. | Organization.telecom.value | string | 0..1 | — | — |
| Business Name (Business Name of Employer) | Organization.name | string | 0..* | 100 | — |
| Signature Type | Provenance.signature.type | Coding | 1..* | — | Signature Type |
| Signature Image | Provenance.signature.data | base64Binary | 0..1 | — | — |
| Signature Over Printed Name of Employer/Authorized Representative | Provenance.signature.who | Reference(PH_Patient or PH_Organization or PH_Practitioner or PH_PractitionerRole or PH_RelatedPerson or Device) | 1..1 | — | — |
| Official Capacity/Designation | Provenance.signature.extension:signaturePosition | CodeableConcept | 0..* | — | |
| Certification of Employer (Date Signed) | Provenance.signature.when | instant | 1..1 | — | — |
| Part V - For PhilHealth Use Only | |||||
| Signature Type | Provenance.signature.type | CodeableConcept | 1..* | — | Signature Type |
| Date Received | Provenance.recorded | instant | 1..1 | — | — |
| Signature Image | Provenance.signature.data | base64Binary | 0..1 | — | — |
| Signature Name | Provenance.signature.who | Reference(PH_Patient or PH_Organization or PH_Practitioner or PH_PractitionerRole or PH_RelatedPerson or Device) | 1..1 | — | — |