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/UP-Manila-SILab/PhilHealth-NHDR-IG-Review/ and changes regularly. See the Directory of published versions
/ Target Element |
(if any) |
|||
|---|---|---|---|---|
| Series # | Claim.identifier | Identifier | 0..* | — |
| Part I - Member Information | ||||
| PhilHealth Identification Number (PIN) of Member | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.identifier | Identifier | — | ||
| Name of Member (Last Name) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.name.family | string | — | ||
| Name of Member (First Name) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.name.given[0] | string | 0..1 | — | |
| Name of Member (Name Extension) | Claim.payee.party | Reference(PH RelatedPerson) | 0..* | — |
| RelatedPerson.name.suffix | string | 0..* | — | |
| Name of Member (Middle Name) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.name.given[1] | string | 0..1 | — | |
| Date of Birth | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.birthDate | date | 0..1 | — | |
| Mailing Address (Unit/Room No./Floor) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.line | string | 0..1 | — | |
| Mailing Address (Building Name) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.line | string | 0..1 | — | |
| Mailing Address (Lot/Blk/House/Bldg. No.) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.line | string | 0..1 | — | |
| Mailing Address (Street) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.line | string | 0..1 | — | |
| Mailing Address (Subdivision/Village) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.line | string | 0..1 | — | |
| Mailing Address (Barangay) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.extension:barangay | Coding | 0..1 | Barangay | |
| Mailing Address (City/Municipality) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.extension:cityMunicipality | Coding | 0..1 | CityMunicipality | |
| Mailing Address (Province) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.extension:province | Coding | 0..1 | Province | |
| Mailing Address (Country) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.country | Coding | 0..1 | ||
| Mailing Address (Zip Code) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.address.postalCode | Coding | 0..1 | ||
| Sex | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.extension:sex | CodeableConcept | 0..1 | Sex | |
| Contact Information Landline # (Area Code + Tel. No.) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.telecom.value | string | 0..1 | — | |
| Contact Information (Mobile #) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.telecom.value | string | 0..1 | — | |
| Contact Information (Email Address) | Claim.payee.party | Reference(PH RelatedPerson) | 0..1 | — |
| RelatedPerson.telecom.value | string | 0..1 | — | |
| Patient is the member? [Yes, Proceed to Part III / No, Proceed to Part II] |
Questionnaire.item.text | string | 0..1 | — |
| Part II - Patient Information | (To be filled-out only if the patient is a dependent) | |||
| PhilHealth Identification Number (PIN) of Dependent | Claim.patient | Reference(PH Patient) | 1..1 | — |
| Patient.identifier | Identifier | — | — | |
| Name of Patient (Last Name) | Claim.patient | Reference(PH Patient) | 1..1 | — |
| Patient.name.family | string | 0..1 | — | |
| Name of Patient (First Name) | Claim.patient | Reference(PH Patient) | 1..1 | — |
| Patient.name.given[0] | string | 0..* | — | |
| Name of Patient (Name Extension) | Claim.patient | Reference(PH Patient) | 1..1 | — |
| Patient.name.suffix | string | 0..* | — | |
| Name of Patient (Middle Name) | Claim.patient | Reference(PH Patient) | 1..1 | — |
| Patient.name.given[1] | string | 0..* | — | |
| Date of Birth | Claim.patient | Reference(PH Patient) | 1..1 | — |
| Patient.birthDate | date | 0..1 | — | |
| Relationship to Member | Claim.patient | Reference(PH Patient) | 1..1 | — |
| Patient.contact.relationship | CodeableConcept | 0..1 | Contact Relationship | |
| Sex | Claim.patient | Reference(PH Patient) | 1..1 | — |
| Patient.extension:sex | CodeableConcept | 0..1 | Sex | |
| Part III - Member Certification | ||||
| Signature Type | Provenance.signature.type | Coding | 1..* | — |
| Signature Over Printed Name of Member | Provenance.signature.data | base64Binary | 0..1 | — |
| Signature Over Printed Name of Member | Provenance.signature.who | Reference(PH Patient or PH RelatedPerson) | 1..1 | — |
| Patient.name RelatedPerson.name |
HumanName | 0..1 | — | |
| Date Signed (MM-DD-YYYY) | Provenance.signature.when | instant | 1..1 | — |
| Signature Over Printed Name of Member's Representative | Provenance.signature.data | base64Binary | 0..1 | — |
| Signature Over Printed Name of Member's Representative | Provenance.signature.who | Reference(PH RelatedPerson) | 1..1 | — |
| RelatedPerson.name | HumanName | — | — | |
| 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.who | Reference(PH RelatedPerson) | 1..1 | — |
| RelatedPerson.relationship | CodeableConcept | 0..1 | Contact Relationship | |
| 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) | Claim.payee.party | Reference(PH Organization) | 0..1 | — |
| Organization.identifier | Identifier | 0..1 | — | |
| Contact No. | Claim.payee.party | Reference(PH Organization) | 0..1 | — |
| Organization.telecom.value | string | 0..1 | — | |
| Business Name (Business Name of Employer) | Claim.payee.party | Reference(PH Organization) | 0..1 | — |
| Organization.name | string | 0..1 | — | |
| Signature Type | Provenance.signature.type | Coding | 1..* | — |
| Signature Over Printed Name of Employer/Authorized Representative | Provenance.signature.data | base64Binary | 0..1 | — |
| Signature Over Printed Name of Employer/Authorized Representative | Provenance.signature.who | Reference(PH Organization) | 1..1 | — |
| Organization.contact.name | HumanName | 0..1 | — | |
| Official Capacity / Designation | Provenance.signature.extension:position | CodeableConcept | 0..* | — |
| CERTIFICATION OF EMPLOYER (Date Signed MM-DD-YYYY) | Provenance.signature.when | instant | 1..1 | — |
| Part V - For PhilHealth Use Only | ||||
| Signature Type | Provenance.signature.type | Coding | 1..* | — |
| Date Received | Provenance.recorded | instant | 1..1 | — |
| LHIO / PRO Signature Over Printed Name | Provenance.signature.data | base64Binary | 0..1 | — |
| LHIO / PRO Signature Over Printed Name | Provenance.signature.who | Reference(PH Organization) | 1..1 | — |
| Organization.contact.name | HumanName | 0..1 | — |