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
given[0]
is used to capture a person's first name.given[1]
is used to capture a person's middle name.Encounter.reasonCode SHALL be supported if Patient Disposition
is Transferred/Referred.
Condition.code
or Procedure.code
respectively. If the data fits in Procedure.code
, you SHOULD use a separate resource as Procedure.code
has a maximum cardinality of 1.Series # | Claim.identifier | Identifier | 0..1 | 15 | — |
Part I - Health Care Institution (HCI) Information | |||||
PhilHealth Accreditation No. (PAN) - Institutional Health Care Provider | Organization.identifier | Identifier(OtherIDs) | 0..1 | — | #AN "Accreditation Number" |
Name of Health Care Institution | Organization.name | string | 0..1 | — | — |
Address (Building Number and Street Name) | Organization.address.line | string | 0..* | — | — |
Address (City/Municipality) | Organization.address.extension:cityMunicipality | 0..* | — | City | |
Address (Province) | Organization.address.extension:province | 0..* | — | Province | |
Part II - Patient Confinement Information | |||||
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 | — |
Was Patient referred by another HCI? [Yes/No] | QuestionnaireResponse.item.answer.value[x] | boolean | 0..1 | 1 | — |
Name of referring Health Care Institution | Encounter.hospitalization.origin | string | 0..1 | 12 | — |
Address of referring HCI (Building Number and Street Name) | Organization.address.line | string | 0..* | — | — |
Address of referring HCI (City/Municipality) | Organization.address.extension:cityMunicipality | 0..* | — | City | |
Address of referring HCI (Province) | Organization.address.extension:province | 0..* | — | Province | |
Address of referring HCI (ZIP Code) | Organization.address.postalCode | integer | 0..* | — | — |
Confinement Period (Date & Time Admitted) | Encounter.period | Period | — | — | — |
Confinement Period (Date & Time Discharged) | Encounter.period | Period | — | — | — |
Patient Disposition | Condition.clinicalStatus | CodeableConcept | 0..1 | 1 | ClinicalStatus |
Patient Disposition: Expired | Patient.deceased[x] | dateTime | 0..1 | — | — |
Patient Disposition: Transferred/Referred (Name of Referral Health Care Institution) | Encounter.hospitalization.destination | string | 0..* | — | — |
Patient Disposition: Transferred/Referred HCI Address (Building Number and Street Name) | Organization.address.line | string | 0..* | — | — |
Patient Disposition: Transferred/Referred HCI Address (City/Municipality) | Organization.address.extension:province | 0..* | — | City | |
Patient Disposition: Transferred/Referred HCI Address (Province) | Organization.address.extension:province | 0..* | — | Province | |
Patient Disposition: Transferred/Referred HCI Address (Postal Code) | Organization.address.postalCode | integer | 0..* | — | — |
Patient Disposition: Reason/s for referral/transfer | Encounter.reasonCode | CodeableConcept | 0..1 | — | ReasonCode |
Type of Accomodation [Private/Non-Private] | Encounter.location.physicalType | CodeableConcept | 0..1 | 4 | Location Physical Type |
Admission Diagnosis/es | Encounter.diagnosis.condition | string | 0..1 | 500 | — |
Discharge Diagnosis/es: Diagnosis | |||||
Discharge Diagnosis/es: ICD-10 Code/s | — | — | |||
Discharge Diagnosis/es: Related Procedure/s (if there's any) | Procedure.code.text | string | 0..1 | 150 | — |
Discharge Diagnosis/es: RVS Code | Procedure.code | CodeableConcept | 0..1 | 6 | RVS Codes |
Discharge Diagnosis/es: Date of Procedure | Procedure.performed[x] | dateTime | 0..1 | 10 | — |
Discharge Diagnosis/es: Laterality (Left, Right, Both) | Procedure.bodySite | CodeableConcept | 0..* | Procedure Body Site | |
Package Code | Coverage.identifier | CodeableConcept | — | — | |
Package (Procedure) | Procedure.extension:illnessClass | CodeableConcept | — | — | — |
Package (Session) | Encounter.extension:illnessClass | CodeableConcept | — | — | — |
Date of Package | Coverage.period | Period | — | — | — |
TB DOTS Phase | Coverage.class.type | CodeableConcept | — | — | — |
Animal Bite Vaccination | MedicalAdministrataion.medication[x] | Reference(PH_Medication) | — | — | — |
Animal Bite Vaccination Date | MedicationAdministration.effective[x] | dateTime | — | — | — |
Newborn Care Screening | Coverage.class.type | CodeableConcept | — | — | |
Newborn Care Sub-screening | Coverage.class.type | CodeableConcept | — | — | |
Laboratory Number | Coverage.identifier | Identifier | — | — | — |
ICD10 or RVS Code | Condition.code / Procedure.code | CodeableConcept | — | — | ICD-10 / RVS Codes |
Accreditation No. | Practitioner.identifier | Identifier(OtherIDs) | 0..1 | 12 | #AN "Accreditation Number" |
Practitioner Name (Last Name) | Practitioner.name.family | string | 0..1 | 60 | — |
Practitioner Name (First Name) | Practitioner.name.given[0] | string | — | — | — |
Practitioner Name (Name Extension) | Practitioner.name.suffix | string | — | — | — |
Practitioner Name (Middle Name) | Practitioner.name.given[1] | string | — | — | — |
Practitioner Signature | Practitioner.extension:signature.data | — | — | — | |
Date Signed (MM-DD-YYYY) | Practitioner.extension:signature.when | — | — | — | |
Co-Pay Details | Coverage.costToBeneficiary.type | CodeableConcept | 0..1 | Coverage Co-Pay Type | |
Co-Pay Amount | Coverage.costToBeneficiary.value[x] | Money | 1 | — | |
Part III - Certification of Consumption of Benefits and Consent to Access Patient Record/s | |||||
Certification of Consumption of Benefits | CoverageEligibilityRequest.identifier | CodeableConcept | — | 1 | — |
A0 Total Health Care Institution Fees (Total Actual Charges) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
A0 Total Professional Fees (Total Actual Charges) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
A0 Grand Total (Total Actual Charges) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
B0 Total HCI Fees (Total Actual Charges) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
B0 Total HCI Fees (Amount after Application of Discount) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
B0 Total HCI Fees (Amount after PhilHealth Deduction) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
B0 Total HCI Fees (Amount after PhilHealth Deduction) Paid By: | Coverage.payor | Reference(PH_Patient or PH_Organization) | 1..* | 1 | — |
B0 Total Professional Fees (Total Actual Charges) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
B0 Total Professional Fees (Amount after Application of Discount) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
B0 Total Professional Fees (PhilHealth Benefit) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
B0 Total Professional Fees (Amount after PhilHealth Deduction) | Coverage.costToBeneficiary.value[x] | Money | 1..1 | 12 | — |
B0 Total Professional Fees (Amount after PhilHealth Deduction) Paid By: | Coverage.payor | Reference(PH_Patient or PH_Organization) | 1..* | 1 | — |
B1 Total cost of purchase/s for drugs/medicines and/or medical supplies bought by the patient.member within/outside the HCI during confinement | Claim.item.net | Money | 0..1 | 12 | — |
B1 Total cost of diagnostic/laboratory examinations paid by the patient/member done within/outside the HCI during confinement | Claim.item.net | Money | 0..1 | 12 | — |
Signature Type | Claim.extension:signature.type | CodeableConcept | — | — | Signature Type |
Signature SubType | Claim.extension:signature.extension:signatureSubType | CodeableConcept | — | — | — |
Claim.extension:signature.when | 1..1 | — | — | ||
Signature Image | Claim.extension:signature.data | 1..1 | — | — | |
Signature Name | Claim.extension:signature.who | 0..* | — | — | |
~~Designation | Claim.extension:signature.extension:signaturePosition | 0..* | — | —~~ | |
Relationship of the representative to the member/patient: | 0..* | — | — | ||
Reason for signing on behalf of the member/patient: | Claim.extension:signature.extension:signatureReason | CodeableConcept | 0..1 | — | — |
Thumbmark Validation (Patient or Representative?) | Questionnaire.Response.item.answer.value[x] | boolean? | 0..1 | — | — |
Printed Thumbmark | Claim.extension:signature.extension:signatureThumbmark | — | — | — | |
Part IV - Certification of Consumption of Health Care Institution | |||||
Signature Type | Claim.extension:signature.type | CodeableConcept | — | — | Signature Type |
Signature SubType | Claim.extension:signature.extension:signatureSubType | CodeableConcept | — | — | — |
Claim.extension:signature.when | 1..1 | — | — | ||
Signature Image | Claim.extension:signature.data | 1..1 | — | — | |
Signature Name | Claim.extension:signature.who | 0..* | — | — | |
Designation | Claim.extension:signature.extension:signaturePosition | 0..* | — | — |