SIL HIE Implementation Guide
0.1.0 - sil-hie-active

SIL HIE Implementation Guide, published by Kathurima Kimathi. 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/savannahghi/hie-fhir-ig-profile/ and changes regularly. See the Directory of published versions

: Example HIE Claim - JSON Representation

Raw json | Download

{
  "resourceType" : "Claim",
  "id" : "HIEClaim-example",
  "meta" : {
    "profile" : [
      🔗 "https://nshr.dha.go.ke/fhir/StructureDefinition/hie-claim"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>HIE Claim</b></p><p>Outpatient professional claim for Jane Patient, created 2025-11-12. Billed by Acme Health Center to PayerOne Insurance.</p><table><thead><tr><th align=\"left\">Section</th><th align=\"left\">Details</th></tr></thead><tbody><tr><td>Identifiers</td><td>Claim Number: CLM-2025-0001</td></tr><tr><td>Claim</td><td>Status: active, Use: claim, Type: professional, Priority: routine</td></tr><tr><td>Patient</td><td>Jane Patient (Patient/p-001)</td></tr><tr><td>Billable period</td><td>2025-11-10 to 2025-11-10</td></tr><tr><td>Provider</td><td>Acme Health Center (Organization/org-001)</td></tr><tr><td>Insurer</td><td>PayerOne Insurance (Organization/org-payer-001), Coverage cov-001, Focal: true</td></tr><tr><td>Diagnosis</td><td>Primary: Headache (R51.9 ICD-10-CM)</td></tr><tr><td>Items</td><td>1 x 99213, Office/outpatient visit est, UnitPrice 75.00 USD, Net 75.00 USD</td></tr><tr><td>Total</td><td>Category: submitted, Amount: 75.00 USD</td></tr></tbody></table></div>"
  },
  "identifier" : [
    {
      "use" : "official",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "ACSN",
            "display" : "Accession ID"
          }
        ]
      },
      "system" : "http://example.org/claims",
      "value" : "CLM-2025-0001"
    }
  ],
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "professional",
        "display" : "Professional"
      }
    ]
  },
  "use" : "claim",
  "patient" : {
    "reference" : "Patient/p-001",
    "display" : "Jane Patient"
  },
  "billablePeriod" : {
    "start" : "2025-11-10",
    "end" : "2025-11-10"
  },
  "created" : "2025-11-12T10:15:00+03:00",
  "insurer" : {
    "reference" : "Organization/org-payer-001",
    "display" : "PayerOne Insurance"
  },
  "provider" : {
    "reference" : "Organization/org-001",
    "display" : "Acme Health Center"
  },
  "priority" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
        "code" : "routine",
        "display" : "Routine"
      }
    ]
  },
  "diagnosis" : [
    {
      "sequence" : 1,
      "diagnosisCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/sid/icd-10-cm",
            "code" : "R51.9",
            "display" : "Headache, unspecified"
          }
        ]
      },
      "type" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/claim-diagnosis-type",
              "code" : "principal",
              "display" : "Principal Diagnosis"
            }
          ]
        }
      ]
    }
  ],
  "insurance" : [
    {
      "sequence" : 1,
      "focal" : true,
      "coverage" : {
        "reference" : "Coverage/cov-001",
        "display" : "Primary PPO Plan"
      }
    }
  ],
  "item" : [
    {
      "sequence" : 1,
      "revenue" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/ex-revenue-center",
            "code" : "100",
            "display" : "General Medical"
          }
        ]
      },
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/ex-benefitcategory",
            "code" : "professional-visit",
            "display" : "Professional Visit"
          }
        ]
      },
      "productOrService" : {
        "coding" : [
          {
            "system" : "http://www.ama-assn.org/go/cpt",
            "code" : "99213",
            "display" : "Office or other outpatient visit, established patient"
          }
        ]
      },
      "quantity" : {
        "value" : 1
      },
      "unitPrice" : {
        "value" : 75,
        "currency" : "USD"
      },
      "net" : {
        "value" : 75,
        "currency" : "USD"
      },
      "encounter" : [
        {
          "reference" : "Encounter/enc-001",
          "display" : "Ambulatory visit 2025-11-10"
        }
      ],
      "detail" : [
        {
          "sequence" : 1,
          "productOrService" : {
            "coding" : [
              {
                "system" : "http://www.ama-assn.org/go/cpt",
                "code" : "99213",
                "display" : "Office or other outpatient visit, established patient"
              }
            ]
          },
          "quantity" : {
            "value" : 1
          },
          "unitPrice" : {
            "value" : 75,
            "currency" : "USD"
          },
          "net" : {
            "value" : 75,
            "currency" : "USD"
          },
          "subDetail" : [
            {
              "sequence" : 1,
              "productOrService" : {
                "coding" : [
                  {
                    "system" : "http://www.ama-assn.org/go/cpt",
                    "code" : "99070",
                    "display" : "Supplies and materials"
                  }
                ]
              },
              "quantity" : {
                "value" : 1
              },
              "unitPrice" : {
                "value" : 5,
                "currency" : "USD"
              },
              "net" : {
                "value" : 5,
                "currency" : "USD"
              }
            }
          ]
        }
      ]
    }
  ],
  "total" : {
    "value" : 75,
    "currency" : "USD"
  }
}