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/nhdr-fhir-ig-review-project-2/ and changes regularly. See the Directory of published versions

## Example Bundle: ClaimsForm2

Bundle ClaimsForm2 of type transaction

Entry 1 - fullUrl = urn:uuid:patient

Resource Patient:

> Generated Narrative: Patient CF2-Patient

> Profile: PH Patient

> John Harris Doe (no stated gender), DoB Unknown

Request:

    POST Patient

Entry 2 - fullUrl = urn:uuid:relatedperson

Resource RelatedPerson:

> Generated Narrative: RelatedPerson CF2-RelatedPerson

> Profiles: PH RelatedPerson, `https://nhdr.gov.ph/fhir/StructureDefinition/PH_RelatedPerson`

> patient: Patient

> relationship: mother

> name: Maria Dela Cruz

Request:

    POST RelatedPerson

Entry 3 - fullUrl = urn:uuid:organization

Resource Organization:

> Generated Narrative: Organization CF2-Organization

> Profile: PH Organization

> identifier: PhilHealth Accreditation Number (PAN)/AN199513893

> name: 6th General Hospital

> address:

> - San Roque
> - Tarlac City
> - Tarlac

> ### Contacts

> - | Name
> * | Dr. Maria Santos

Request:

    POST Organization

Entry 4 - fullUrl = urn:uuid:encounter

Resource Encounter:

> Generated Narrative: Encounter CF2-Encounter

> Profile: PH Encounter

> status: booked

> class: ActCode: AMB (ambulatory)

> period: 2024-07-18 08:00:00+0800 --> 2024-07-18 10:00:00+0800

> ### Hospitalizations

> - | DischargeDisposition
> * | Discharged to home

> serviceProvider: Organization

Request:

    POST Encounter

Entry 5 - fullUrl = urn:uuid:procedure

Resource Procedure:

> Generated Narrative: Procedure CF2-Procedure

> Profile: PH Procedure

> status: Completed

> code: INCISION AND DRAINAGE OF ABSCESS (E.G., CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR PARONYCHIA)

> subject: Patient

> bodySite: Appendix structure

Request:

    POST Procedure

Entry 6 - fullUrl = urn:uuid:servicerequest

Resource ServiceRequest:

> Generated Narrative: ServiceRequest CF2-ServiceRequest

> Profile: PH ServiceRequest

> status: Completed

> intent: Order

> subject: Patient

> requester: Organization

> performer: Organization

> reasonReference: Observation

Request:

    POST ServiceRequest

Entry 7 - fullUrl = urn:uuid:observation

Resource Observation:

> Generated Narrative: Observation CF2-Observation

> Profile: PH Observation

> status: Final

> code: Preoperative assessment

> subject: Patient

> value: Subject for Surgery

Request:

    POST Observation

Entry 8 - fullUrl = urn:uuid:practitioner

Resource Practitioner:

> Generated Narrative: Practitioner CF2-Practitioner

> Profile: PH Practitioner

> identifier: `https://prc.gov.ph`/1234567

> name: Maria Santos

Request:

    POST Practitioner

Entry 9 - fullUrl = urn:uuid:coverage

Resource Coverage:

> Generated Narrative: Coverage CF2-Coverage

> Profile: PH Coverage

> status: Active

> type: extended healthcare

> beneficiary: Patient

> payor: Organization

> ### CostToBeneficiaries

> - | Type | Value[x]
> * | Copayment | ₱500.00 (PHP)

Request:

    POST Coverage

Entry 10 - fullUrl = urn:uuid:questionnaire

Resource Questionnaire:

> Generated Narrative: Questionnaire CF2-Questionnaire

> Profile: PH Questionnaire

> LinkID | Text | Cardinality | Type | Description & Constraints
> --- | --- | --- | --- | ---
> |  |  | Questionnaire |
> CF2-Q1 | A. Certification of Consumption of Benefits (Y/N) | 0..1 | boolean |
> Documentation for this format

Request:

    POST Questionnaire

Entry 11 - fullUrl = urn:uuid:questionnaireResponse

Resource QuestionnaireResponse:

> Generated Narrative: QuestionnaireResponse CF2-QuestionnaireResponse

> Profile: PH QuestionnaireResponse

> LinkID | Text | Definition | Answer
> --- | --- | --- | ---
> CF2-QuestionnaireResponse |  |  | Questionnaire:None specified
> CF2-Q1 |  |  | true
> Documentation for this format

Request:

    POST QuestionnaireResponse

Entry 12 - fullUrl = urn:uuid:provenance

Resource Provenance:

> Generated Narrative: Provenance CF2-Provenance

> Profile: PH Provenance

> Provenance for Claim

> Summary

> Recorded | 2026-02-03 09:00:00+0800

> Agents

> who
> Practitioner

Request:

    POST Provenance

Entry 13 - fullUrl = urn:uuid:claim

Resource Claim:

> Generated Narrative: Claim CF2-Claim

> Profile: PH Claim

> Encounter (Extension): Encounter

> identifier: `https://philhealth.gov.ph/claim`/CLM-2026-00001

> status: Active

> type: Institutional

> use: Claim

> patient: Patient

> created: 2026-02-03 08:00:00+0800

> provider: Organization

> priority: Normal

> referral: ServiceRequest

> ### SupportingInfos

> - | Sequence | Category | Value[x]
> * | 1 | Supporting Information | Practitioner

> ### Diagnoses

> - | Sequence | Diagnosis[x]
> * | 1 | Essential (primary) hypertension

> ### Procedures

> - | Sequence | Date | Procedure[x]
> * | 1 | 2026-02-03 09:00:00+0800 | Procedure

> ### Insurances

> - | Sequence | Focal | Coverage
> * | 1 | true | Coverage

> > item

> > sequence: 1

> > productOrService: Appendectomy

> > serviced: 2026-02-03

> > ### Nets

> > - | Value | Currency
> > * | 15000 | Philippine piso

> > > detail

> > > sequence: 1

> > > productOrService: Appendectomy Procedure Fee

> > > ### Nets

> > > - | Value | Currency
> > > * | 15000 | Philippine piso

> ### Totals

> - | Value | Currency
> * | 15000 | Philippine piso

Request:

    POST Claim