Tanzania NHIF → ZHSF Claims Submission FHIR IG
0.1.0 - ci-build
Tanzania
Tanzania NHIF → ZHSF Claims Submission FHIR IG, published by Speedykom GmbH. 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/Speedykom/tanzania-nhif-zhsf-claims-ig/ and changes regularly. See the Directory of published versions
| Active as of 2026-01-12 |
Definitions for the tz-claim-submission-request logical model.
Guidance on how to interpret the contents of this table can be foundhere
| 0. tz-claim-submission-request | |
| Definition | Logical model representing the ZHSF Claim Submission JSON request payload. This model defines the facade contract and is validated before transformation to FHIR R5 resources. Base definition for all types defined in FHIR type system. |
| Short | TZ Claim Submission Request (ZHSF JSON)Base for all types and resources |
| Control | 0..* |
| Is Modifier | false |
| Logical Model | Instances of this logical model are not marked to be the target of a Reference |
| 2. tz-claim-submission-request.facilityCode | |
| Definition | ZHSF facility identifier code |
| Short | Facility code |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 4. tz-claim-submission-request.practitionerRegistrationNo | |
| Definition | Registered practitioner identifier |
| Short | Practitioner registration number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 6. tz-claim-submission-request.authorizationNumber | |
| Definition | Authorization number issued during eligibility/approval |
| Short | Authorization number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 8. tz-claim-submission-request.clinicalNotes | |
| Definition | Optional free-text clinical notes |
| Short | Clinical notes |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 10. tz-claim-submission-request.referralNo | |
| Definition | Referral number if applicable (often 0) |
| Short | Referral number |
| Control | 0..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 12. tz-claim-submission-request.isAdmited | |
| Definition | Admission flag (true if inpatient) |
| Short | Is admitted |
| Control | 1..1 |
| Type | boolean |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 14. tz-claim-submission-request.mrn | |
| Definition | Facility medical record number |
| Short | Medical Record Number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 16. tz-claim-submission-request.claimsItems | |
| Definition | List of claim line items |
| Short | Claim items |
| Control | 1..* |
| Type | BackboneElement |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 18. tz-claim-submission-request.claimsItems.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | idstring |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 20. tz-claim-submission-request.claimsItems.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on tz-claim-submission-request.claimsItems.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 22. tz-claim-submission-request.claimsItems.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists()) |
| 24. tz-claim-submission-request.claimsItems.itemCode | |
| Definition | Service, medication, or procedure code |
| Short | Item code |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 26. tz-claim-submission-request.claimsItems.itemQuantity | |
| Definition | Quantity for the claim item |
| Short | Item quantity |
| Control | 1..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 28. tz-claim-submission-request.claimsItems.frequency | |
| Definition | Optional frequency information |
| Short | Frequency |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 30. tz-claim-submission-request.claimsItems.issuedNo | |
| Definition | Issued number when pre-approval is required |
| Short | Issued number |
| Control | 0..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 32. tz-claim-submission-request.preliminaryDiagnosisCode | |
| Definition | Diagnosis codes captured during encounter |
| Short | Preliminary diagnosis codes |
| Control | 0..* |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 34. tz-claim-submission-request.finalDiagnosisCode | |
| Definition | Diagnosis codes confirmed after encounter |
| Short | Final diagnosis codes |
| Control | 0..* |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Guidance on how to interpret the contents of this table can be foundhere
| 0. tz-claim-submission-request | |
| Definition | Logical model representing the ZHSF Claim Submission JSON request payload. This model defines the facade contract and is validated before transformation to FHIR R5 resources. |
| Short | TZ Claim Submission Request (ZHSF JSON) |
| Logical Model | Instances of this logical model are not marked to be the target of a Reference |
| 2. tz-claim-submission-request.facilityCode | |
| Definition | ZHSF facility identifier code |
| Short | Facility code |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 4. tz-claim-submission-request.practitionerRegistrationNo | |
| Definition | Registered practitioner identifier |
| Short | Practitioner registration number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 6. tz-claim-submission-request.authorizationNumber | |
| Definition | Authorization number issued during eligibility/approval |
| Short | Authorization number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 8. tz-claim-submission-request.clinicalNotes | |
| Definition | Optional free-text clinical notes |
| Short | Clinical notes |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 10. tz-claim-submission-request.referralNo | |
| Definition | Referral number if applicable (often 0) |
| Short | Referral number |
| Control | 0..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 12. tz-claim-submission-request.isAdmited | |
| Definition | Admission flag (true if inpatient) |
| Short | Is admitted |
| Control | 1..1 |
| Type | boolean |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 14. tz-claim-submission-request.mrn | |
| Definition | Facility medical record number |
| Short | Medical Record Number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 16. tz-claim-submission-request.claimsItems | |
| Definition | List of claim line items |
| Short | Claim items |
| Control | 1..* |
| Type | BackboneElement |
| 18. tz-claim-submission-request.claimsItems.itemCode | |
| Definition | Service, medication, or procedure code |
| Short | Item code |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 20. tz-claim-submission-request.claimsItems.itemQuantity | |
| Definition | Quantity for the claim item |
| Short | Item quantity |
| Control | 1..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 22. tz-claim-submission-request.claimsItems.frequency | |
| Definition | Optional frequency information |
| Short | Frequency |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 24. tz-claim-submission-request.claimsItems.issuedNo | |
| Definition | Issued number when pre-approval is required |
| Short | Issued number |
| Control | 0..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 26. tz-claim-submission-request.preliminaryDiagnosisCode | |
| Definition | Diagnosis codes captured during encounter |
| Short | Preliminary diagnosis codes |
| Control | 0..* |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 28. tz-claim-submission-request.finalDiagnosisCode | |
| Definition | Diagnosis codes confirmed after encounter |
| Short | Final diagnosis codes |
| Control | 0..* |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
Guidance on how to interpret the contents of this table can be foundhere
| 0. tz-claim-submission-request | |
| Definition | Logical model representing the ZHSF Claim Submission JSON request payload. This model defines the facade contract and is validated before transformation to FHIR R5 resources. |
| Short | TZ Claim Submission Request (ZHSF JSON) |
| Control | 0..* |
| Is Modifier | false |
| Logical Model | Instances of this logical model are not marked to be the target of a Reference |
| 2. tz-claim-submission-request.facilityCode | |
| Definition | ZHSF facility identifier code |
| Short | Facility code |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 4. tz-claim-submission-request.practitionerRegistrationNo | |
| Definition | Registered practitioner identifier |
| Short | Practitioner registration number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 6. tz-claim-submission-request.authorizationNumber | |
| Definition | Authorization number issued during eligibility/approval |
| Short | Authorization number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 8. tz-claim-submission-request.clinicalNotes | |
| Definition | Optional free-text clinical notes |
| Short | Clinical notes |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 10. tz-claim-submission-request.referralNo | |
| Definition | Referral number if applicable (often 0) |
| Short | Referral number |
| Control | 0..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 12. tz-claim-submission-request.isAdmited | |
| Definition | Admission flag (true if inpatient) |
| Short | Is admitted |
| Control | 1..1 |
| Type | boolean |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 14. tz-claim-submission-request.mrn | |
| Definition | Facility medical record number |
| Short | Medical Record Number |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 16. tz-claim-submission-request.claimsItems | |
| Definition | List of claim line items |
| Short | Claim items |
| Control | 1..* |
| Type | BackboneElement |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count())) |
| 18. tz-claim-submission-request.claimsItems.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Short | Unique id for inter-element referencing |
| Control | 0..1 This element is affected by the following invariants: ele-1 |
| Type | id |
| Is Modifier | false |
| XML Format | In the XML format, this property is represented as an attribute. |
| Summary | false |
| 20. tz-claim-submission-request.claimsItems.extension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
| Short | Additional content defined by implementations |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | false |
| Summary | false |
| Alternate Names | extensions, user content |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on tz-claim-submission-request.claimsItems.extension. The slices areUnordered and Open, and can be differentiated using the following discriminators: |
| 22. tz-claim-submission-request.claimsItems.modifierExtension | |
| Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
| Short | Extensions that cannot be ignored even if unrecognized |
| Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
| Control | 0..* |
| Type | Extension |
| Is Modifier | true because Modifier extensions are expected to modify the meaning or interpretation of the element that contains them |
| Summary | true |
| Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
| Alternate Names | extensions, user content, modifiers |
| Invariants | ele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))ext-1: Must have either extensions or value[x], not both ( extension.exists() != value.exists()) |
| 24. tz-claim-submission-request.claimsItems.itemCode | |
| Definition | Service, medication, or procedure code |
| Short | Item code |
| Control | 1..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 26. tz-claim-submission-request.claimsItems.itemQuantity | |
| Definition | Quantity for the claim item |
| Short | Item quantity |
| Control | 1..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 28. tz-claim-submission-request.claimsItems.frequency | |
| Definition | Optional frequency information |
| Short | Frequency |
| Control | 0..1 |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 30. tz-claim-submission-request.claimsItems.issuedNo | |
| Definition | Issued number when pre-approval is required |
| Short | Issued number |
| Control | 0..1 |
| Type | integer |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 32. tz-claim-submission-request.preliminaryDiagnosisCode | |
| Definition | Diagnosis codes captured during encounter |
| Short | Preliminary diagnosis codes |
| Control | 0..* |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |
| 34. tz-claim-submission-request.finalDiagnosisCode | |
| Definition | Diagnosis codes confirmed after encounter |
| Short | Final diagnosis codes |
| Control | 0..* |
| Type | string |
| Primitive Value | This primitive element may be present, or absent, or replaced by an extension |