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
{
"resourceType": "Bundle",
"id": "ClaimsForm1-2",
"type": "transaction",
"identifier": {
"system": "http://nhdr.gov.ph/fhir/ValueSet-form-type",
"value": "CF1"
},
"entry": [
{
"fullUrl": "urn:uuid:CF1-RelatedPerson-2",
"resource": {
"resourceType": "RelatedPerson",
"meta": {
"profile": [
"https://nhdr.gov.ph/fhir/StructureDefinition/PH-RelatedPerson"
]
},
"identifier": [
{
"type": {
"coding": [
{
"code": "NIIP"
}
],
"text": "PhilHealth Identification Number"
},
"value": "PH54321"
}
],
"patient": {
"reference": "urn:uuid:CF1-Patient-2"
},
"name": [
{
"family": "Bautista",
"given": [
"Lorna Mae",
"Santos"
],
"suffix": [
"Mrs."
]
}
],
"birthDate": "1971-02-11",
"address": [
{
"line": [
"Fordham Road"
],
"extension": [
{
"url": "https://nhdr.gov.ph/fhir/StructureDefinition/Barangay",
"valueCoding": {
"code": "0123456789",
"display": "Blue Ridge"
}
},
{
"url": "https://nhdr.gov.ph/fhir/StructureDefinition/CityMunicipality",
"valueCoding": {
"code": "0123456",
"display": "Quezon City"
}
},
{
"url": "https://nhdr.gov.ph/fhir/StructureDefinition/Province",
"valueCoding": {
"code": "01234",
"display": "Metro Manila"
}
}
],
"country": "PH",
"postalCode": "1110"
}
],
"extension": [
{
"url": "https://nhdr.gov.ph/fhir/StructureDefinition/Sex",
"valueCode": "F"
}
],
"telecom": [
{
"system": "phone",
"value": "912-00-00"
},
{
"system": "phone",
"value": "0927-000-0000"
},
{
"system": "email",
"value": "lmbautista@email.com"
}
]
},
"request": {
"method": "POST",
"url": "RelatedPerson"
}
},
{
"fullUrl": "urn:uuid:CF1-Patient-2",
"resource": {
"resourceType": "Patient",
"meta": {
"profile": [
"https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient"
]
},
"identifier": [
{
"type": {
"coding": [
{
"code": "NIIP"
}
],
"text": "PhilHealth Identification Number"
},
"value": "PH12345"
}
],
"name": [
{
"family": "Manipol",
"given": [
"Antonio Jerome",
"Morales"
],
"suffix": [
"Mr."
]
}
],
"birthDate": "1994-02-25",
"contact": [
{
"telecom": [
{
"system": "phone",
"value": "09171234567"
}
],
"relationship": [
{
"text": "Employer"
}
]
}
],
"extension": [
{
"url": "https://nhdr.gov.ph/fhir/StructureDefinition/Sex",
"valueCode": "M"
}
]
},
"request": {
"method": "POST",
"url": "Patient"
}
},
{
"fullUrl": "urn:uuid:CF1-Organization-2",
"resource": {
"resourceType": "Organization",
"meta": {
"profile": [
"https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization"
]
},
"identifier": [
{
"type": {
"coding": [
{
"code": "EN"
}
],
"text": "PhilHealth Employer Number (PEN)"
},
"value": "EN15243"
}
],
"name": "PhilHealth",
"telecom": [
{
"value": "080-00-00"
}
]
},
"request": {
"method": "POST",
"url": "Organization"
}
},
{
"fullUrl": "urn:uuid:CF1-Coverage-2",
"resource": {
"resourceType": "Coverage",
"meta": {
"profile": [
"https://nhdr.gov.ph/fhir/StructureDefinition/PH-Coverage"
]
},
"status": "active",
"policyHolder": {
"reference": "urn:uuid:CF1-Organization-2"
},
"beneficiary": {
"reference": "urn:uuid:CF1-Patient-2"
},
"payor": [
{
"reference": "urn:uuid:CF1-Organization-2"
}
]
},
"request": {
"method": "POST",
"url": "Coverage"
}
},
{
"fullUrl": "urn:uuid:CF1-Provenance-2",
"resource": {
"resourceType": "Provenance",
"meta": {
"profile": [
"https://nhdr.gov.ph/fhir/StructureDefinition/PH-Provenance"
]
},
"target": [
{
"reference": "urn:uuid:CF1-Claim-2"
}
],
"recorded": "2026-02-03T09:00:00+08:00",
"agent": [
{
"who": {
"reference": "urn:uuid:CF1-Organization-2"
}
}
],
"signature": [
{
"type": [
{
"system": "urn:iso-astm:E1762-95:2013",
"code": "1.2.840.10065.1.12.1.20",
"display": "Electronic Signature"
}
],
"when": "2026-02-03T10:30:00+08:00",
"who": {
"reference": "urn:uuid:CF1-RelatedPerson-2"
},
"data": "QkFTRTY0X1NJR05BVFVSRV9QQVRJRU5U",
"extension": [
{
"url": "https://nhdr.gov.ph/fhir/StructureDefinition/SignatureReason",
"valueString": "Claim Approval"
}
]
},
{
"type": [
{
"system": "urn:iso-astm:E1762-95:2013",
"code": "1.2.840.10065.1.12.1.20",
"display": "Electronic Signature"
}
],
"when": "2026-02-03T10:30:00+08:00",
"who": {
"reference": "urn:uuid:CF1-Organization-2"
},
"data": "QkFTRTY0X1NJR05BVFVSRV9PUkdBTklaVElPTg=="
}
]
},
"request": {
"method": "POST",
"url": "Provenance"
}
},
{
"fullUrl": "urn:uuid:CF1-Questionnaire-2",
"resource": {
"resourceType": "Questionnaire",
"meta": {
"profile": [
"https://nhdr.gov.ph/fhir/StructureDefinition/PH-Questionnaire"
]
},
"status": "active",
"item": [
{
"linkId": "CF1-Q1",
"text": "Patient is the member?",
"type": "boolean"
}
]
},
"request": {
"method": "POST",
"url": "Questionnaire"
}
},
{
"fullUrl": "urn:uuid:CF1-QuestionnaireResponse-2",
"resource": {
"resourceType": "QuestionnaireResponse",
"meta": {
"profile": [
"https://nhdr.gov.ph/fhir/StructureDefinition/PH-QuestionnaireResponse"
]
},
"status": "completed",
"item": [
{
"linkId": "CF1-Q1",
"answer": [
{
"valueBoolean": false
}
]
}
]
},
"request": {
"method": "POST",
"url": "QuestionnaireResponse"
}
},
{
"fullUrl": "urn:uuid:CF1-Claim-2",
"resource": {
"resourceType": "Claim",
"meta": {
"profile": [
"https://nhdr.gov.ph/fhir/StructureDefinition/PH-Claim"
]
},
"identifier": [
{
"system": "https://philhealth.gov.ph/claim",
"value": "CF1-CLM-00001"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "institutional",
"display": "Institutional"
}
]
},
"use": "claim",
"created": "2026-02-03T08:00:00+08:00",
"provider": {
"reference": "urn:uuid:CF1-Organization-2"
},
"priority": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal",
"display": "Normal"
}
]
},
"payee": {
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/payeetype",
"code": "subscriber",
"display": "Subscriber"
}
]
},
"party": {
"reference": "urn:uuid:CF1-RelatedPerson-2"
}
},
"patient": {
"reference": "urn:uuid:CF1-Patient-2"
},
"insurance": [
{
"sequence": 1,
"focal": true,
"coverage": {
"reference": "urn:uuid:CF1-Coverage-2"
}
}
]
},
"request": {
"method": "POST",
"url": "Claim"
}
}
]
}