SGHI FHIR Profile Implementation Guide
0.1.0 - ci-build
SGHI FHIR Profile 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/sil_fhir_profile_ig/ and changes regularly. See the Directory of published versions
| Active as of 2026-09-15 |
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
<http://hl7.org/fhir/CodeSystem/payer-benefit-codesystem> a fhir:CodeSystem ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "payer-benefit-codesystem"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem payer-benefit-codesystem</b></p><a name=\"payer-benefit-codesystem\"> </a><a name=\"hcpayer-benefit-codesystem\"> </a><p><b>Properties</b></p><p><b>This code system defines the following properties for its concepts</b></p><table class=\"grid\"><tr><td><b>Name</b></td><td><b>Code</b></td><td><b>URI</b></td><td><b>Type</b></td><td><b>Description</b></td></tr><tr><td>requires-preauthorisation</td><td>requires-preauthorisation</td><td>https://fhir.slade360.co.ke/fhir/concept-properties#requires-preauthorisation</td><td>boolean</td><td>True where the payer requires pre-authorisation before the intervention is delivered.</td></tr><tr><td>emergency-benefit</td><td>emergency-benefit</td><td>https://fhir.slade360.co.ke/fhir/concept-properties#emergency-benefit</td><td>boolean</td><td>True where the intervention is funded from the emergency fund rather than a benefit package.</td></tr></table><p><b>Concepts</b></p><p>This case-sensitive code system <code>https://fhir.slade360.co.ke/fhir/CodeSystem/payer-benefit-codesystem</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td><td><b>requires-preauthorisation</b></td><td><b>emergency-benefit</b></td></tr><tr><td style=\"white-space:nowrap\">sha<a name=\"payer-benefit-codesystem-sha\"> </a></td><td>Social Health Authority</td><td>A public scheme capped in bed-days per household per year, pooled across the household.</td><td/><td/></tr><tr><td style=\"white-space:nowrap\">private<a name=\"payer-benefit-codesystem-private\"> </a></td><td>Private insurance</td><td>A private scheme capped in shillings.</td><td/><td/></tr><tr><td style=\"white-space:nowrap\">benefit-inpatient<a name=\"payer-benefit-codesystem-benefit-inpatient\"> </a></td><td>Inpatient management</td><td>The SHA inpatient benefit package.</td><td/><td/></tr><tr><td style=\"white-space:nowrap\">benefit-corporate-inpatient<a name=\"payer-benefit-codesystem-benefit-corporate-inpatient\"> </a></td><td>Corporate inpatient</td><td>A private corporate inpatient benefit package.</td><td/><td/></tr><tr><td style=\"white-space:nowrap\">per-night<a name=\"payer-benefit-codesystem-per-night\"> </a></td><td>Per night</td><td>The tariff is claimed for each night of stay.</td><td/><td/></tr><tr><td style=\"white-space:nowrap\">per-episode<a name=\"payer-benefit-codesystem-per-episode\"> </a></td><td>Per episode</td><td>The tariff is claimed once for the episode.</td><td/><td/></tr><tr><td style=\"white-space:nowrap\">SHA-IP-MED-01<a name=\"payer-benefit-codesystem-SHA-IP-MED-01\"> </a></td><td>Medical inpatient management</td><td>General medical inpatient management, claimed per night.</td><td>true</td><td>false</td></tr><tr><td style=\"white-space:nowrap\">SHA-IP-HDU-02<a name=\"payer-benefit-codesystem-SHA-IP-HDU-02\"> </a></td><td>High dependency care</td><td>High dependency inpatient care, claimed per night.</td><td>true</td><td>false</td></tr><tr><td style=\"white-space:nowrap\">SHA-MAT-ND-01<a name=\"payer-benefit-codesystem-SHA-MAT-ND-01\"> </a></td><td>Normal delivery</td><td>Normal delivery, claimed per episode.</td><td>false</td><td>false</td></tr><tr><td style=\"white-space:nowrap\">SHA-MAT-CS-02<a name=\"payer-benefit-codesystem-SHA-MAT-CS-02\"> </a></td><td>Caesarean section</td><td>Caesarean section, claimed per episode.</td><td>true</td><td>false</td></tr><tr><td style=\"white-space:nowrap\">SHA-EMC-STB-01<a name=\"payer-benefit-codesystem-SHA-EMC-STB-01\"> </a></td><td>Emergency stabilisation and treatment</td><td>Emergency stabilisation, claimed per episode from the emergency fund.</td><td>false</td><td>true</td></tr><tr><td style=\"white-space:nowrap\">SHA-EMC-CRIT-02<a name=\"payer-benefit-codesystem-SHA-EMC-CRIT-02\"> </a></td><td>Emergency critical care, first 24 hours</td><td>Emergency critical care for the first 24 hours, claimed per night from the emergency fund.</td><td>false</td><td>true</td></tr></table></div>"^^rdf:XMLLiteral ]
] ; #
fhir:url [ fhir:v "https://fhir.slade360.co.ke/fhir/CodeSystem/payer-benefit-codesystem"^^xsd:anyURI] ; #
fhir:version [ fhir:v "0.1.0"] ; #
fhir:name [ fhir:v "SGHIPayerBenefitCodeSystem"] ; #
fhir:title [ fhir:v "SGHI Payer Benefit Code System"] ; #
fhir:status [ fhir:v "active"] ; #
fhir:experimental [ fhir:v false] ; #
fhir:date [ fhir:v "2026-09-15T11:40:24+00:00"^^xsd:dateTime] ; #
fhir:publisher [ fhir:v "Kathurima Kimathi"] ; #
fhir:contact ( [
fhir:name [ fhir:v "Kathurima Kimathi" ] ;
fhir:telecom ( [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "https://www.linkedin.com/in/kathurima-kimathi/" ]
] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "kathurimakimathi415@gmail.com" ]
] )
] [
fhir:name [ fhir:v "Oscar John" ] ;
fhir:telecom ( [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "oscarjohnotieno@gmail.com" ] ;
fhir:use [ fhir:v "work" ]
] )
] [
fhir:name [ fhir:v "Kennedy Omondi" ] ;
fhir:telecom ( [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "kennankole@gmail.com" ] ;
fhir:use [ fhir:v "work" ]
] )
] ) ; #
fhir:description [ fhir:v "Payer schemes, benefit packages, tariff rules and the Social Health Authority intervention codes read when admitting an insured patient."] ; #
fhir:caseSensitive [ fhir:v true] ; #
fhir:content [ fhir:v "complete"] ; #
fhir:count [ fhir:v "12"^^xsd:nonNegativeInteger] ; #
fhir:property ( [
fhir:code [ fhir:v "requires-preauthorisation" ] ;
fhir:uri [ fhir:v "https://fhir.slade360.co.ke/fhir/concept-properties#requires-preauthorisation"^^xsd:anyURI ] ;
fhir:description [ fhir:v "True where the payer requires pre-authorisation before the intervention is delivered." ] ;
fhir:type [ fhir:v "boolean" ]
] [
fhir:code [ fhir:v "emergency-benefit" ] ;
fhir:uri [ fhir:v "https://fhir.slade360.co.ke/fhir/concept-properties#emergency-benefit"^^xsd:anyURI ] ;
fhir:description [ fhir:v "True where the intervention is funded from the emergency fund rather than a benefit package." ] ;
fhir:type [ fhir:v "boolean" ]
] ) ; #
fhir:concept ( [
fhir:code [ fhir:v "sha" ] ;
fhir:display [ fhir:v "Social Health Authority" ] ;
fhir:definition [ fhir:v "A public scheme capped in bed-days per household per year, pooled across the household." ]
] [
fhir:code [ fhir:v "private" ] ;
fhir:display [ fhir:v "Private insurance" ] ;
fhir:definition [ fhir:v "A private scheme capped in shillings." ]
] [
fhir:code [ fhir:v "benefit-inpatient" ] ;
fhir:display [ fhir:v "Inpatient management" ] ;
fhir:definition [ fhir:v "The SHA inpatient benefit package." ]
] [
fhir:code [ fhir:v "benefit-corporate-inpatient" ] ;
fhir:display [ fhir:v "Corporate inpatient" ] ;
fhir:definition [ fhir:v "A private corporate inpatient benefit package." ]
] [
fhir:code [ fhir:v "per-night" ] ;
fhir:display [ fhir:v "Per night" ] ;
fhir:definition [ fhir:v "The tariff is claimed for each night of stay." ]
] [
fhir:code [ fhir:v "per-episode" ] ;
fhir:display [ fhir:v "Per episode" ] ;
fhir:definition [ fhir:v "The tariff is claimed once for the episode." ]
] [
fhir:code [ fhir:v "SHA-IP-MED-01" ] ;
fhir:display [ fhir:v "Medical inpatient management" ] ;
fhir:definition [ fhir:v "General medical inpatient management, claimed per night." ] ;
fhir:property ( [
fhir:code [ fhir:v "requires-preauthorisation" ] ;
fhir:value [
a fhir:boolean ;
fhir:v true
]
] [
fhir:code [ fhir:v "emergency-benefit" ] ;
fhir:value [
a fhir:boolean ;
fhir:v false
]
] )
] [
fhir:code [ fhir:v "SHA-IP-HDU-02" ] ;
fhir:display [ fhir:v "High dependency care" ] ;
fhir:definition [ fhir:v "High dependency inpatient care, claimed per night." ] ;
fhir:property ( [
fhir:code [ fhir:v "requires-preauthorisation" ] ;
fhir:value [
a fhir:boolean ;
fhir:v true
]
] [
fhir:code [ fhir:v "emergency-benefit" ] ;
fhir:value [
a fhir:boolean ;
fhir:v false
]
] )
] [
fhir:code [ fhir:v "SHA-MAT-ND-01" ] ;
fhir:display [ fhir:v "Normal delivery" ] ;
fhir:definition [ fhir:v "Normal delivery, claimed per episode." ] ;
fhir:property ( [
fhir:code [ fhir:v "requires-preauthorisation" ] ;
fhir:value [
a fhir:boolean ;
fhir:v false
]
] [
fhir:code [ fhir:v "emergency-benefit" ] ;
fhir:value [
a fhir:boolean ;
fhir:v false
]
] )
] [
fhir:code [ fhir:v "SHA-MAT-CS-02" ] ;
fhir:display [ fhir:v "Caesarean section" ] ;
fhir:definition [ fhir:v "Caesarean section, claimed per episode." ] ;
fhir:property ( [
fhir:code [ fhir:v "requires-preauthorisation" ] ;
fhir:value [
a fhir:boolean ;
fhir:v true
]
] [
fhir:code [ fhir:v "emergency-benefit" ] ;
fhir:value [
a fhir:boolean ;
fhir:v false
]
] )
] [
fhir:code [ fhir:v "SHA-EMC-STB-01" ] ;
fhir:display [ fhir:v "Emergency stabilisation and treatment" ] ;
fhir:definition [ fhir:v "Emergency stabilisation, claimed per episode from the emergency fund." ] ;
fhir:property ( [
fhir:code [ fhir:v "requires-preauthorisation" ] ;
fhir:value [
a fhir:boolean ;
fhir:v false
]
] [
fhir:code [ fhir:v "emergency-benefit" ] ;
fhir:value [
a fhir:boolean ;
fhir:v true
]
] )
] [
fhir:code [ fhir:v "SHA-EMC-CRIT-02" ] ;
fhir:display [ fhir:v "Emergency critical care, first 24 hours" ] ;
fhir:definition [ fhir:v "Emergency critical care for the first 24 hours, claimed per night from the emergency fund." ] ;
fhir:property ( [
fhir:code [ fhir:v "requires-preauthorisation" ] ;
fhir:value [
a fhir:boolean ;
fhir:v false
]
] [
fhir:code [ fhir:v "emergency-benefit" ] ;
fhir:value [
a fhir:boolean ;
fhir:v true
]
] )
] ) . #
IG © 2025+ Kathurima Kimathi. Package silfhirprofileig#0.1.0 based on FHIR 5.0.0. Generated 2026-09-15
Links: Table of Contents |
QA Report