eClaims and Preauth APIs
Properties for OTP Visit:
Endpoints for managing visit consent and OTP verification.
Create new virtual claim
POST
https://ilm-dev.dha.go.ke/uat-middleware
/api/v1/claims/visit
Creates a new virtual claim for a beneficiary after verifying their consent. Use the OTP strategy when consent was captured via a one-time password, or the biometrics strategy when consent was captured via eKYC or fingerprint — in which case the authorization GUID from POST /api/v1/claims/authorize is passed instead of an OTP.
Create new virtual claim › Request Body
oneOf
Exactly one variant must match.
Decision Table
| Variant | Matching Criteria |
|---|---|
| type = object · requires: intervention_codes, patient_id, service_type +1 more | |
| type = object · requires: intervention_codes, patient_id, service_type +1 more |
Request payload for starting a visit using OTP-based consent. The patient's one-time password is provided to confirm consent before the claim is created.
intervention_codesIntervention code(s) for the service scheduled to be offered.
Example: ["SHA-12-001"]
patient_idClient Registry identifier of the beneficiary associated with the patient.
Example: 3-4538-5219
service_typeType of service being initiated.
Enum values:
CAPITATION
OUTPATIENT
INPATIENT
EMERGENCY
Example: OUTPATIENT
otpOne-time password sent to the beneficiary's registered contact.
Example: 123456
Create new virtual claim › Responses
Visit started successfully
admitted_onappointment_numberattributesauthorization_codeauthorization_guidbeneficiary_guidbeneficiary_idbeneficiary_is_fuzzy_matchedcancel_reason_textcancel_reason_typeclaim_attachments_countclaim_auth_statusobject[]
claim_idcreated_by_namecurrencydiagnoses_countdischarge_cancel_datedischarge_cancel_remarksdischarge_reasondischarged_onedi_claim_guidemergency_visit_expiryestimate_ip_daysexpected_discharge_datehas_reviewed_claimidinitial_interventionobject[]
invoice_attachments_countinvoice_idinvoice_numberobject[]
is_charge_master_mappedis_negativeis_resubmittedis_zerolast_retrylocation_codelocation_namemember_namemember_numbermember_number_has_tokenmode_of_arrivalnhif_numbernotesnumber_of_invoicespatient_namepatient_numberpayer_codepayer_namepayer_slade_codepolicy_numberpolicy_valid_frompolicy_valid_toprovider_nameprovider_slade_codereason_for_unknown_patientreference_numberresubmission_workflow_stateretry_countscheme_codescheme_nameservice_typetotal_claim_amounttotal_claim_copaytotal_claim_discounttotal_claim_net_amounttotal_claim_splitsupdated_by_namevisit_endvisit_numbervisit_startworkflow_state