eClaims and Preauth APIs
stringstringstringstringstringstringstringstringstringintegerstring
internal_domain_claims.ClaimAttachment
attachmentattachment_typeclaimdatadebug_datadescriptionidintervention_codelast_retryretry_counttitlegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.ErrorResponse
Standard error response format for all error conditions.
error@Description HTTP status text from the standard HTTP status codes @Example "Bad Request"
message@Description Detailed error message explaining what went wrong @Example "token missing required tenant_id claim"
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RemoveClaimAttachmentRequest
Request payload for removing an attachment from a virtual claim.
attachment_idconsent_tokenintervention_codegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.SuccessResponse
Standard success response format for all successful operations.
object
@Description Response data payload containing operation details @Example {"status": "success"}
message@Description Success message describing the operation result @Example "Visit has been successfully started"
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.ClaimCancelReason
string · enum
Enum values:
WRONG_PATIENT
NO_SERVICE_GIVEN
WRONG_BENEFIT
EXPIRED_VISIT
EXHAUSTED_BENEFIT
TIME_BARRED
OTHER_REASONS
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.CloseClaimRequest
cancel_reason_textcancel_reason_typeEnum values:
WRONG_PATIENT
NO_SERVICE_GIVEN
WRONG_BENEFIT
EXPIRED_VISIT
EXHAUSTED_BENEFIT
TIME_BARRED
OTHER_REASONS
consent_tokeninternal_domain_claims.ClaimDiagnosis
claimclaim_diagnosis_iddiagnosisdiagnosis_codediagnosis_nameedi_claim_diagnosis_guidedi_claim_diagnosis_replicatedintervention_codeis_flagged_diagnosisis_inpatientoriginal_visit_datepatient_numberrecorded_onsite_codesite_code_typevisit_numberinternal_domain_claims.ClaimIntervention
accrued_per_diem_amountaccrued_per_diem_daysactive_for_uhcapplicable_document_typesbill_frombill_toidintervention_codeintervention_fundintervention_nameintervention_overall_tariffintervention_payment_mechanismis_switched_interventionkeph_level_tarrifneeds_preauthoptional_document_typeoptional_preauth_document_typespreauth_existrequired_preauth_document_typesrequires_oncology_preauthrequires_optical_preauthrequires_radiology_preauthrequires_renal_preauthrequires_surgical_preauthsub_benefit_codesupported_schemeswitched_intervention_idswitched_lines_retainedworkflow_stateinternal_domain_claims.doctorReviewStatus
string · enum
Enum values:
PENDING
APPROVED
REJECTED
PENDING_DOCTOR_REVIEW
internal_domain_claims.ClaimDoctor
doctor_request_statusEnum values:
PENDING
APPROVED
REJECTED
PENDING_DOCTOR_REVIEW
slade_codeinternal_domain_claims.InvoiceFlag
codedescriptionedi_flag_guidedi_flag_idexistingflag_typeinvoiceis_resolvedmessagepayloadresponsetimestamptracebackinternal_domain_claims.InvoiceLine
attributesbill_frombill_tocharge_datediscountdiscount_reasondoctor_codedoctor_nameidintervention_codeinvoiceis_activeis_cancellationis_returnitem_codeitem_nameline_copayline_net_amountline_numberline_total_amountlinked_invoice_linemap_requestmap_request_descriptionmapped_slade_codenhif_rebate_amountpatient_discount_amountpatient_net_pricepmf_line_statusquantityscheme_codescheme_namesponsor_net_priceuhc_exceededunitunit_priceinternal_domain_claims.Invoice
created_by_namedepartmentdiscount_amountdispatch_batch_numberdispatch_statusobject[]
edi_invoice_guidedi_invoice_ididinvoice_dateobject[]
invoice_numberinvoice_typeobject[]
linked_invoicelinked_invoice_linemember_namepatient_namepatient_numberprovider_invoice_refprovider_namescheme_codescheme_namescu_branch_idscu_dispatch_timestampscu_receipt_signatureservice_typetotal_inv_amounttotal_inv_copaytotal_inv_discounttotal_inv_net_amountvisit_endvisit_startworkflow_stateinternal_domain_claims.ClaimAuthorization
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_stategitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.AddDiagnosisRequest
consent_tokenicd_codeintervention_codefacilityIDfacilityIDTypegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RemoveClaimDiagnosisRequest
Request payload for removing a diagnosis from a virtual claim.
consent_tokenicd_codeintervention_codegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.PatientDischargeReason
string · enum
Enum values:
RECOVERED
REFERRED
DECEASED
ABSCONDED
OTHER
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.PatientDischargeRequest
consent_tokendischarge_datedischarge_reasonEnum values:
RECOVERED
REFERRED
DECEASED
ABSCONDED
OTHER
invoice_numberotpgitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.PractitionerIdentificationType
string · enum
Enum values:
registration_number
National ID
Alien ID
Refugee ID
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.RegulationBody
string · enum
Enum values:
KMPDC
COC
NCK
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.DoctorConsentRequestType
string · enum
Enum values:
PREAUTH_DOCTOR_APPROVAL_REQUEST
EMERGENCY_CLAIM_DOCTOR_APPROVAL_REQUEST
PRESCRIPTION_REQUEST
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.DoctorConsentRequest
intervention_coderequest_typeEnum values:
PREAUTH_DOCTOR_APPROVAL_REQUEST
EMERGENCY_CLAIM_DOCTOR_APPROVAL_REQUEST
PRESCRIPTION_REQUEST
consent_tokencreatedemergency_claim_ididentification_numberidentification_typeEnum values:
registration_number
National ID
Alien ID
Refugee ID
practitioner_registration_numberregulation_bodyEnum values:
KMPDC
COC
NCK
service_typegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.AddEmergencyClaimDoctorRequest
consent_tokenidentification_numberidentification_typeEnum values:
registration_number
National ID
Alien ID
Refugee ID
regulation_bodyEnum values:
KMPDC
COC
NCK
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RemoveEmergencyClaimDoctorRequest
consent_tokengitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.EmergencyBroughtBy
string · enum
Enum values:
RELATIVE
UNKNOWN
SAMARITAN
PARAMEDICS
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.EmergencyModeOfArrival
string · enum
Enum values:
AMBULANCE
WALK-IN
OTHER
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.CreateEmergencyClaimRequest
brought_byEnum values:
RELATIVE
UNKNOWN
SAMARITAN
PARAMEDICS
identification_numberidentification_typeEnum values:
registration_number
National ID
Alien ID
Refugee ID
interventionsmode_of_arrivalEnum values:
AMBULANCE
WALK-IN
OTHER
reference_numberregulation_bodyEnum values:
KMPDC
COC
NCK
beneficiary_cr_idnotesotpinternal_domain_claims.Intervention
accessPointactiveannualQuantityLimitannualQuantityLimitChoiceannualQuantityLimitTypeapplicableDocumentTypesapplicableFacilityOwnershipapplicableGenderbenefitcodecommentcomplexitycoverageLeveldiagnosisBlockdiagnosisListguididinvestigationTariffHasLimitisIntraMetrokephLevelTarriflevelsApplicablelowerAgeLimitmanagementTariffHasLimitnameneedApprovalBeforeClaimSubmissionneedsDoctorAuthorizationneedsManualPreauthApprovalneedsMemberAuthorizationneedsPreauthoptionalDocumentTypeoptionalPreauthDocumentTypesoverallTariffoverallTariffHasLimitpaymentMechanismpreauthFinalisedprotocolUsedrequiredPreauthDocumentTypesrequiresOncologyPreauthrequiresOpticalPreauthrequiresRadiologyPreauthrequiresRenalPreauthrequiresSurgicalPreauthstatusupperAgeLimitusageFrequencyLimitusageFrequencyTypeinternal_domain_claims.Protocol
applicableTariffguididobject[]
nameprotocolClassificationTypeprotocolCodeprotocolTypestatusinternal_domain_claims.ProtocolResponse
countcurrentPageendIndexnextpageSizepreviousobject[]
startIndextotalPagesgitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.AddInterventionInput
consent_tokenintervention_codefacilityIDfacilityIDTypegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RestoreInterventionInput
consent_tokenintervention_codegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RetireInterventionInput
consent_tokenintervention_codegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RemoveClaimLineRequest
Request payload for removing a line item from a virtual claim.
consent_tokenline_guidgitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.EditClaimLineRequest
Request payload for editing an existing line item in a virtual claim.
line_idquantityscheme_codeunit_pricegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.ResubmitClaimLineRequest
Request payload for resubmitting a claim line that was previously rejected or failed.
consent_tokeninternal_domain_claims.ResubmitClaimLineResponse
line_idmessageresubmitted_atstatusgitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.OTPDischarge
consent_tokenpatient_idgitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.PreviewClaimRequest
Request payload for previewing a virtual claim before submission. Requires consent token.
consent_tokeninternal_domain_claims.ClaimPreview
authorization_codeobject[]
claim_attachments_countclaim_auth_statusobject[]
created_by_namediagnoses_countidobject[]
invoice_attachments_countobject[]
is_negativeis_zeromember_numbernumber_of_invoicespatient_namepatient_numberprovider_namescheme_codescheme_nameservice_typetotal_claim_amounttotal_claim_copaytotal_claim_discounttotal_claim_net_amounttotal_claim_splitsvisit_endvisit_startworkflow_stateinternal_domain_preauth.Intervention
activeForUhcarray
applicableSchemesauthInterventionIdcodedispenseMedicationfallBackKephLevelTarifffundidarray
kephLevelTarrifnameneedsPreauthnumberOfDaysToFallbackoverallTariffarray
paymentMechanismpreauthFinalisedprescriptionMedicationrequiresSurgicalPreautharray
subBenefitCodesupportedSchemeinternal_domain_preauth.MinimalAuthorizationDetails
authorizingDeviceOsbeneficiaryCodebeneficiaryNamebeneficiaryNumberbiometricMatchLogIdekycTokenguidobject[]
isBiometricsDischargeAuthorizationisElectiveisOpenparentAuthorizationparentTypeobject
sessionTypeshaGuidshaVerificationRequestIdstatustokenworkStationIdinternal_domain_preauth.ElectivePreauth
doctorReviewStatusisElectivememberNamepreauthTypeserviceEndserviceStartstatusinternal_domain_preauth.Member
agebeneficiaryCodegendergroupidNoidNoTypeisAliveisMinorisPrincipalnamesprincipalMemberprincipalRelationshipinternal_domain_preauth.ShaVerificationRequest
EmbedExpiryembededTokenrequestIdrequestUrlinternal_domain_preauth.AuthorizationDetails
authCodeauthorizationReasonauthorizationTypeauthorizingDeviceOsbeneficiarybeneficiaryCodebeneficiaryNamebeneficiaryNumberbeneficiarySchemebenefitTypebiometricMatchLogIdobject[]
createdByNamedateAuthorizedekycTokenobject
eligibilityobject
endDateendedViaexpiryguardianguididinterventionsinternal_domain_preauth.Intervention (circular)isBiometricsDischargeAuthorizationisCompleteisElectiveisOpenlabelneedsPreauthnotesoverallPreauthFinalisedparentAuthorizationparentPreauthcircularparentTypepayerNamepayerSladeCodepreauthIdsobject
providerproviderFidproviderNamerequestedBysessionTypeshaGuidobject
shaVerificationRequestIdstatustokenworkStationIdgitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.SchemeCode
string · enum
Enum values:
UHC
PMF
BOTH
internal_domain_preauth.BeneficiaryDetails
DoBbeneficiaryCodebeneficiaryIdcategoryCodecategoryNamefirstNamegenderguidobject[]
lastNameotherNamesschemeCodeEnum values:
UHC
PMF
BOTH
schemeNameinternal_domain_preauth.InterventionData
codefallBackKephLevelTariffguididkephLevelTarrifnamenumberOfDaysToFallbackoverallTariffpaymentMechanismstatusgitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.DocumentType
string · enum
Enum values:
DISCHARGE_SUMMARY
FINAL_BILL
INTERIM_BILL
LOU
MEDICAL_REPORT
PRESCRIPTION
RADIOLOGY_REQUEST
RADIOLOGICAL_EXAM
internal_domain_preauth.PreauthAttachment
attachmentattachmentTypeEnum values:
DISCHARGE_SUMMARY
FINAL_BILL
INTERIM_BILL
LOU
MEDICAL_REPORT
PRESCRIPTION
RADIOLOGY_REQUEST
RADIOLOGICAL_EXAM
authorauthorEmailauthorNamecontentTypedescriptionguididinterventionCodeorganisationNamesourcetitleuploadedFileinternal_domain_preauth.PreauthDiagnosis
authorizationInterventiondescriptionguididinterventionCodeinterventionNamenamepreauthDiagnosisTyperequestedByrequestedByNamerequestedOnrespondedByrespondedByNamerespondedOnresponseNotesiteCodesiteCodeTypestatusinternal_domain_preauth.Contact
activebusinessPartnercanSendCommcontactNamecontactTypecontactValuedeactivationReasonguididisConfirmedroleinternal_domain_preauth.DoctorProfile
activeobject[]
countrycurrencyCodeguididobject[]
namenationalIdentifierpractitionerCadrepractitionerDisciplineNamepractitionerGenderpractitionerIdNumberpractitionerIdTypepractitionerInHealthWorkerRegistrypractitionerLicenceNumberpractitionerLicenceStartpractitionerLicenceTypepractitionerLicenceValiditypractitionerLicenseBodypractitionerLicenseStatuspractitionerPostalAddresspractitionerQualificationspractitionerRegistrationNumberpractitionerRegistryIdpractitionerSpecialtypractitionerSubSpecialtypractitionerTypesladeCodespecialtysuspendedsuspensionReasoninternal_domain_preauth.PreauthDoctor
object
doctorReviewStatusdoctorTypeguidhospitalDoctorNameidisHospitalDoctornamenotesrequestedByrequestedByNamerequestedOnrespondedByrespondedByNamerespondedOnresponseNotesladeCodestatusinternal_domain_preauth.PreauthItem
approvedAmountapprovedByapprovedByNameapprovedQuantityapprovedUnitPricecategorychargeDatecmCodedescriptionestimatedAmountguididinterventioninterventionCodeinterventionNamenamepayerInvoiceLineNoproviderCurrencyquantityrequestedByrequestedByNamerequestedOnrespondedByrespondedByNamerespondedOnresponseNoteschemeCodeEnum values:
UHC
PMF
BOTH
schemeNamestatusunitPriceinternal_domain_preauth.PreauthNote
authorauthorEmailauthorNameguididnoteorganisationNamesourceinternal_domain_preauth.ProviderDetails
activebpLevelbusinessPartnerIdguidobject[]
namenationalIdentifiersladeCodegitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.CarcinomaStage
string · enum
Enum values:
STAGE_1
STAGE_2
STAGE_3
STAGE_4
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.Metastasis
string · enum
Enum values:
LUNG
LIVER
BRAIN
BONE
OTHER
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.TreatmentSetting
string · enum
Enum values:
DAY_WARD
SIDE_ROOM
RECLINING_CHAIR
internal_domain_preauth.RequestExtraData
anaesthesiaTypecarcinomaStagingEnum values:
STAGE_1
STAGE_2
STAGE_3
STAGE_4
chiefComplaintclinicalIndicationscoinsuranceDetailscomorbidityconditionEmploymentRelatedconditionOtherRelatedconsultationDescriptioncostPerSessioneyeExaminationAmounteyeExaminationDescriptionframeAmountframeDescriptionhasCoinsurancehpiinvestigationslensAmountlensDescriptionlensPrescriptionmetastasesEnum values:
LUNG
LIVER
BRAIN
BONE
OTHER
physicalExaminationprogressReportreasonForServicereplacementsessionExpectedDatesessionsFrequencysessionsRequiredsubTypetreatmentSettingEnum values:
DAY_WARD
SIDE_ROOM
RECLINING_CHAIR
vitalSignsinternal_domain_preauth.Preauth
accessPointanaesthesiaTypeauthorizationobject
object
carcinomaStagingclinicalIndicationscomorbidityconditionCauseconditionEmploymentRelatedconditionOtherRelatedcostPerSessioncountdowncreatedByNamedescriptiondoctorApproveddoctorReviewStatusfinalApprovedAmountguididinterventionCodeobject
isElectiveisEmergencyisHmisPreauthisOncologyisOpticalisRadiologyisRenalisRequestPhaseisResponsePhaseisSurgicallengthOfStaymemberIdentifiermemberIsVipmemberIsVvipmemberNamememberSchememetastasesneedsDoctorApprovalnumberOfPreauthDoctorsRequiredotherMetastasespayerIdentifierpayerInvoiceNopayerNameobject[]
object[]
object[]
array
object[]
object[]
preauthTypeproviderConsentproviderCurrencyobject
providerNameproviderNotificationEmailreasonForAcuteDialysisreasonForSelectingOtherobject
responseExtraDataserviceEndserviceStartsessionExpectedDatesessionTypesessionsFrequencysessionsRequiredstatussubmissionDateIn_EATtokentotalEstimatedAmountForPreauthtotalInterimApprovedAmountForPreauthupdatedByNameinternal_domain_claims.PayerAuthorization
guididauthCodeauthorizationReasonauthorizationTypebeneficiaryCodebeneficiaryJoinDatebeneficiaryNamebeneficiaryNumberbeneficiarySchemebenefitTypecreatedcreatedByNamecurrentAvailableBalanceexpiryobject[]
isCompleteisElectiveisOpenlabelneedsPreauthnotesoverallPreauthFinalisedownerparentAuthorizationobject
parentTypepolicyEffectiveDatepreauthIdsproviderNamerequestedBysessionTypestatustokentotalAuthorizedAmountinternal_domain_claims.ClaimFlag
codedescriptionflagTypeguididisResolvedmessageworkflowStateinternal_domain_claims.PayerClaimLine
approvedLineTotalbillFrombillTobillingCodechargeDateclaimLineGrossTotalclaimLineTotalguididinterventioninterventionCodeinterventionNamenameproviderClaimLineNoquantityrejectedLineTotalschemeCodeschemeNameunitunitPriceworkflowStateinternal_domain_claims.ClaimNote
authorguididnotesourceworkflowStateinternal_domain_claims.ClaimTransition
guididtransitionDateworkflowStateFromworkflowStateTointernal_domain_claims.Diagnosis
encounterencounterGuidguidinterventionnamesiteCodesiteCodeTypeinternal_domain_claims.PayerClaim
object · required
guididactualDeductableCopayauthTokenbillFrombillToobject[]
object[]
object[]
object[]
object[]
claimTypecreatedobject[]
encounterencounter ID
isCreditNoteisInpatientmemberNamememberNumberownerproposedValueproposedValueLessCopaysproviderClaimNoproviderNameschemeNametotalCopayValuetrackingNumberworkflowDisplayNameworkflowStategitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.SubmitVirtualClaimRequest
consent_tokenConsent token for authorization. This is the authorization_code received from the Create Virtual Claim endpoint.
Example: J6LAFNBPZN
invoice_numberUnique invoice number (as used by the provider internally) for the claim being submitted.
Example: INV/5513/70340
reason_for_unknown_patientOTPVisitRequest
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
BiometricsVisitRequest
Request payload for starting a visit using biometrics-based consent. The authorization GUID from the preceding biometric authorization is provided in place of an OTP.
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: INPATIENT
auth_guidUnique authorization identifier issued when the patient's biometric consent was captured. Obtained from the response of POST /api/v1/claims/authorize.
Example: 233e623d-9193-40e3-ac87-352752fe1f96
device_idIdentifier of the device that captured the biometric consent (e.g. biometric terminal serial number).
device_nameHuman-readable name of the device used to initiate the visit.
is_biometricsIndicates that biometric verification was used to confirm the patient's identity.
Example: true
request_user_national_idNational ID of the staff member who initiated the visit request.
workstation_idIdentifier of the workstation from which the visit was initiated.
internal_domain_patients.Benefit
countcurrentPageendIndexnextpageSizepreviousobject[]
startIndextotalPagesgitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.ErrorResponse
errormessageinternal_domain_patients.Intervention
accessPointactiveannualLimitValueannualQuantityLimitannualQuantityLimitChoiceannualQuantityLimitTypeapplicableDocumentTypesapplicableFacilityOwnershipapplicableGenderapplicableSchemesbenefitbenefitCodebenefitNamecodecommentcomplexitycoverageLeveldiagnosisBlockdiagnosisListfallBackLevel2TarifffallBackLevel3TarifffallBackLevel4TarifffallBackLevel5TarifffallBackLevel6TarifffallBackOverallTarifffundguididinvestigationTariffinvestigationTariffHasLimitisIntraMetrolevel2Tarifflevel3Tarifflevel4Tarifflevel5Tarifflevel6TarifflevelsApplicablelowerAgeLimitmanagementTariffmanagementTariffHasLimitnameneedApprovalBeforeClaimSubmissionneedsDoctorAuthorizationneedsManualPreauthApprovalneedsMemberAuthorizationneedsPreauthnumberOfDaysToFallbacknumberOfDoctorsRequiredoptionalDocumentTypesoptionalPreauthDocumentTypesoverallTariffoverallTariffHasLimitparentBenefitCodeparentBenefitNamepaymentMechanismpreauthFinalisedprotocolUsedrequiredPreauthDocumentTypesrequiresOncologyPreauthrequiresOpticalPreauthrequiresRadiologyPreauthrequiresRenalPreauthrequiresSurgicalPreauthstatussupportedSchemetariffLimitPerIndividualtariffPerAdditionalKilometerupperAgeLimitusageFrequencyLimitusageFrequencyTypekephLevelTarriffinternal_domain_patients.InterventionResponse
countcurrentPageendIndexnextpageSizepreviousobject[]
startIndextotalPagesinternal_domain_patients.Coverage
endDatemessagepossibleSolutionreasonstartDatestatusinternal_domain_patients.PrincipalContributor
crNumberobject
employmentTypeidNumberidTypenamerelationshipinternal_domain_patients.CoverageScheme
schemeIdschemeNameobject
memberTypeobject
object
internal_domain_patients.CoverageResult
requestIdNumberrequestIdTypeagedateOfBirthfullNamegendermemberCrNumberobject[]
statusCodestatusDescwhitelistedForOTPgitlab_slade360emr_com_sha-edi_hie-middleware_internal_shared.PatientIdentificationType
string · enum
Enum values:
National ID
ClientRegistry ID
Birth Notification
Birth Certificate
Alien ID
Refugee ID
Mandate Number
Temporary ID
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.NextOfKinContactRequest
consent_tokencontact_valuenext_of_kin_full_namenext_of_kin_id_numbernext_of_kin_id_number_typeEnum values:
National ID
ClientRegistry ID
Birth Notification
Birth Certificate
Alien ID
Refugee ID
Mandate Number
Temporary ID
internal_domain_patients.NextOfKinContact
activebeneficiarybeneficiaryCodebeneficiaryIdbeneficiaryNamecapturedAtNamecapturedAtSladeCodecontactTypecontactValuedeactivationReasonguididisConfirmedisMainContactisVerifiednextOfKinFullNamenextOfKinIdNumberownerTypeEnum values:
NEXT_OF_KIN
BENEFICIARY
pushedToCrmreplicatedtriggeredByUserBasePreauthRequest
Base schema for preauthorization requests. Contains common fields required for all types of preauthorizations.
consent_tokenConsent token for authorization. This is the authorization_code received from the Create Virtual Claim endpoint.
Example: J6LAFNBPZN
intervention_codeIntervention code for the service offered
Example: SHA-11-001
service_startISO timestamp for when the service started
Example: 2025-08-18T15:30:00+03:00
service_endISO timestamp for when the service ended
Example: 2025-08-19T15:30:00+03:00
object[] · required
List of billed items
Example: [{"unit_price":"1500.00"}]
object[] · required
List of diagnoses
Example: [{"consent_token":"J6LAFNBPZN","icd_code":"ca07.0"}]
object[] · required
List of doctors
Example: [{"identification_number":"A8691","identification_type":"registration_number","regulation_body":"KMPDC","intervention_code":"SHA-11-001"}]
object[] · required
List of attachments
Example: [{"document_title":"Lab Results","document_type":"LAB_TESTS","file_field_name":"attachments_0_file_blob"}]
provider_notification_emailEmail to notify the provider of any updates on the preauthorization request
Example: clifford.ouma@savannahinformatics.com
NormalPreauthRequest
Normal preauthorization request. Contains only the base fields for any normal preauthorisations.
consent_tokenConsent token for authorization. This is the authorization_code received from the Create Virtual Claim endpoint.
Example: J6LAFNBPZN
intervention_codeIntervention code for the service offered
Example: SHA-11-001
service_startISO timestamp for when the service started
Example: 2025-08-18T15:30:00+03:00
service_endISO timestamp for when the service ended
Example: 2025-08-19T15:30:00+03:00
object[] · required
List of billed items
Example: [{"unit_price":"1500.00"}]
object[] · required
List of diagnoses
Example: [{"consent_token":"J6LAFNBPZN","icd_code":"ca07.0"}]
object[] · required
List of doctors
Example: [{"identification_number":"A8691","identification_type":"registration_number","regulation_body":"KMPDC","intervention_code":"SHA-11-001"}]
object[] · required
List of attachments
Example: [{"document_title":"Lab Results","document_type":"LAB_TESTS","file_field_name":"attachments_0_file_blob"}]
provider_notification_emailEmail to notify the provider of any updates on the preauthorization request
Example: clifford.ouma@savannahinformatics.com
SurgicalPreauthRequest
Surgical preauthorization request. Contains surgical-specific fields.
consent_tokenConsent token for authorization. This is the authorization_code received from the Create Virtual Claim endpoint.
Example: J6LAFNBPZN
intervention_codeIntervention code for the service offered
Example: SHA-11-001
service_startISO timestamp for when the service started
Example: 2025-08-18T15:30:00+03:00
service_endISO timestamp for when the service ended
Example: 2025-08-19T15:30:00+03:00
object[] · required
List of billed items
Example: [{"unit_price":"1500.00"}]
object[] · required
List of diagnoses
Example: [{"consent_token":"J6LAFNBPZN","icd_code":"ca07.0"}]
object[] · required
List of doctors
Example: [{"identification_number":"A8691","identification_type":"registration_number","regulation_body":"KMPDC","intervention_code":"SHA-11-001"}]
object[] · required
List of attachments
Example: [{"document_title":"Lab Results","document_type":"LAB_TESTS","file_field_name":"attachments_0_file_blob"}]
provider_notification_emailEmail to notify the provider of any updates on the preauthorization request
Example: clifford.ouma@savannahinformatics.com
chief_complaintPatient's chief complaint
Example: Clifford Ouma
vital_signsPatient's vital signs
Example: 110 BP
history_of_present_illnessHistory of present illness
Example: None
physical_examinationPhysical examination findings
Example: Looks pale and weak
investigation_report_detailsInvestigation report details
Example: None
type_of_anaesthesiaType of anaesthesia to be used
Enum values:
GENERAL
LOCAL
SPINAL_BLOCK
SEDATION
Example: GENERAL
surgery_dateScheduled surgery date and time
Example: 2025-09-08T15:30:00+03:00
RenalPreauthRequest
Renal preauthorization request. Contains renal-specific fields
consent_tokenConsent token for authorization. This is the authorization_code received from the Create Virtual Claim endpoint.
Example: J6LAFNBPZN
intervention_codeIntervention code for the service offered
Example: SHA-11-001
service_startISO timestamp for when the service started
Example: 2025-08-18T15:30:00+03:00
service_endISO timestamp for when the service ended
Example: 2025-08-19T15:30:00+03:00
object[] · required
List of billed items
Example: [{"unit_price":"1500.00"}]
object[] · required
List of diagnoses
Example: [{"consent_token":"J6LAFNBPZN","icd_code":"ca07.0"}]
object[] · required
List of doctors
Example: [{"identification_number":"A8691","identification_type":"registration_number","regulation_body":"KMPDC","intervention_code":"SHA-11-001"}]
object[] · required
List of attachments
Example: [{"document_title":"Lab Results","document_type":"LAB_TESTS","file_field_name":"attachments_0_file_blob"}]
provider_notification_emailEmail to notify the provider of any updates on the preauthorization request
Example: clifford.ouma@savannahinformatics.com
number_of_sessions_requiredcost_per_sessionfrequency_of_sessionsEnum values:
DAILY
WEEKLY
ONCE_A_MONTH
Example: ONCE_A_MONTH
clinical_indicationsstart_dateOncologyPreauthRequest
Oncology preauthorization request. Contains extra oncology-specific fields.
consent_tokenConsent token for authorization. This is the authorization_code received from the Create Virtual Claim endpoint.
Example: J6LAFNBPZN
intervention_codeIntervention code for the service offered
Example: SHA-11-001
service_startISO timestamp for when the service started
Example: 2025-08-18T15:30:00+03:00
service_endISO timestamp for when the service ended
Example: 2025-08-19T15:30:00+03:00
object[] · required
List of billed items
Example: [{"unit_price":"1500.00"}]
object[] · required
List of diagnoses
Example: [{"consent_token":"J6LAFNBPZN","icd_code":"ca07.0"}]
object[] · required
List of doctors
Example: [{"identification_number":"A8691","identification_type":"registration_number","regulation_body":"KMPDC","intervention_code":"SHA-11-001"}]
object[] · required
List of attachments
Example: [{"document_title":"Lab Results","document_type":"LAB_TESTS","file_field_name":"attachments_0_file_blob"}]
provider_notification_emailEmail to notify the provider of any updates on the preauthorization request
Example: clifford.ouma@savannahinformatics.com
carcinoma_stagingStage of carcinoma
Enum values:
STAGE_1
STAGE_2
STAGE_3
STAGE_4
Example: STAGE_1
comorbidityPatient comorbidities
Example: The comorbidity
treatment_settingTreatment setting
Enum values:
DAY_WARD
RECLINING_CHAIR
SIDE_ROOM
Example: ["DAY_WARD"]
number_of_sessions_requiredNumber of treatment sessions required
Example: 20
cost_per_sessionCost per treatment session
Example: 2500
metastasesSites of metastases
Enum values:
LUNG
LIVER
BRAIN
BONE
OTHER
Example: ["LUNG"]
start_dateTreatment start date
Example: 2025-09-08T15:30:00+03:00
OpticalPreauthRequest
Optical preauthorization request. Contains optical-specific fields.
consent_tokenConsent token for authorization. This is the authorization_code received from the Create Virtual Claim endpoint.
Example: J6LAFNBPZN
intervention_codeIntervention code for the service offered
Example: SHA-11-001
service_startISO timestamp for when the service started
Example: 2025-08-18T15:30:00+03:00
service_endISO timestamp for when the service ended
Example: 2025-08-19T15:30:00+03:00
object[] · required
List of billed items
Example: [{"unit_price":"1500.00"}]
object[] · required
List of diagnoses
Example: [{"consent_token":"J6LAFNBPZN","icd_code":"ca07.0"}]
object[] · required
List of doctors
Example: [{"identification_number":"A8691","identification_type":"registration_number","regulation_body":"KMPDC","intervention_code":"SHA-11-001"}]
object[] · required
List of attachments
Example: [{"document_title":"Lab Results","document_type":"LAB_TESTS","file_field_name":"attachments_0_file_blob"}]
provider_notification_emailEmail to notify the provider of any updates on the preauthorization request
Example: clifford.ouma@savannahinformatics.com
necessity_of_serviceNecessity of the optical service
Example: To help patient see clearly
lens_prescriptionType of lens prescription
Enum values:
FRAMES_LENSES
CONTACT_LENSES
Example: FRAMES_LENSES
lens_amountCost of lenses
Example: 10000
eye_examination_amountCost of eye examination
Example: 2000
frame_amountCost of frames
Example: 10000
new_or_replacementWhether this is for new glasses or replacement
Enum values:
NEW
REPLACEMENT
Example: REPLACEMENT
ImagingPreauthRequest
Imaging preauthorization request. Contains imaging-specific fields
consent_tokenConsent token for authorization. This is the authorization_code received from the Create Virtual Claim endpoint.
Example: J6LAFNBPZN
intervention_codeIntervention code for the service offered
Example: SHA-11-001
service_startISO timestamp for when the service started
Example: 2025-08-18T15:30:00+03:00
service_endISO timestamp for when the service ended
Example: 2025-08-19T15:30:00+03:00
object[] · required
List of billed items
Example: [{"unit_price":"1500.00"}]
object[] · required
List of diagnoses
Example: [{"consent_token":"J6LAFNBPZN","icd_code":"ca07.0"}]
object[] · required
List of doctors
Example: [{"identification_number":"A8691","identification_type":"registration_number","regulation_body":"KMPDC","intervention_code":"SHA-11-001"}]
object[] · required
List of attachments
Example: [{"document_title":"Lab Results","document_type":"LAB_TESTS","file_field_name":"attachments_0_file_blob"}]
provider_notification_emailEmail to notify the provider of any updates on the preauthorization request
Example: clifford.ouma@savannahinformatics.com
clinical_indicationsClinical indications for imaging
Example: Prescence of head pains
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RemovePreauthDiagnosisRequest
consent_tokenicd_codeintervention_codegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RemovePreauthDoctorRequest
consent_tokenintervention_codepractitioner_registration_numberinternal_domain_prescriptions.Authorization
authCodebeneficiaryCodebeneficiaryNamebeneficiaryNumberexpiryguididpayerNameproviderNamereplicatedstatustokeninternal_domain_prescriptions.Contact
activecontactTypecontactValueidisMainContactownerTypeinternal_domain_prescriptions.Identifier
ididentifieridentifierTypeisMainIdentifierinternal_domain_prescriptions.Beneficiary
agebeneficiaryCodeobject[]
dobgenderguididobject[]
isPrincipalmainIdentifiernamesinternal_domain_prescriptions.Dosage
doseQuantitydoseUnitdurationdurationUnitendDatefrequencyguididmedicationmedicationIdentifiermedicationPricepatientInstructionperiodUnitpractitionerIdprescriptionreplicatedrouterouteCodestartDateinternal_domain_prescriptions.Intervention
accessPointactiveactiveForUhcapplicableFacilityOwnershipapplicableGenderapplicableSchemesbenefitbenefitCodebenefitNamecodecoverageLevelfundguididlevelsApplicablenamepackageCombinationsparentBenefitCodeparentBenefitNamepaymentMechanismreplicatedstatussupportedSchemeinternal_domain_prescriptions.Prescription
object
object
codedoctorReviewStatusobject[]
guididobject
replicatedstatusgitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.MedicationItem
additional_instructionOptional additional instructions or notes for the patient or pharmacist. e.g. 'Take with food'
dose_quantityAmount of medication per dose (e.g., '1' for one tablet).
dose_unitUnit for dosage quantity (e.g., 'Tablet', 'mL', 'patch').
durationLength of time treatment should run.
duration_unitUnit of duration (e.g., 'd' = days, 'wk' = weeks).
end_dateThe date the medication regimen is expected to end (Optional).
frequencyHow many times per day (or per period unit) the dose should be taken. e.g., 2 if 'period_unit' is 'd' (twice a day).
generic_concept_codeStandardized medicine identifier of the active generic concept. e.g. 'GE12047'
needs_refillBoolean indicating if a refill is needed (Optional).
patient_instructionRequired instruction for the patient. Must be one of ['TAKE_AS_PRESCRIBED', 'TAKE_AS_NEEDED'].
period_unitMeasurement unit for frequency periodicity (e.g., 'h' [hours], 'd' [days]).
refill_countThe number of allowed refills (Optional).
start_dateThe date the medication regimen started (Required). Format should be ISO 8601 (e.g., 'YYYY-MM-DD').
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.CreatePrescriptionRequest
consent_tokenConsent token
intervention_codeIntervention code
object[] · minItems: 1 · required
List of prescribed medication items
identification_numberDoctor's ID number
identification_typeIdentification type e.g. 'registration_number', 'National ID', 'Alien ID', 'Refugee ID'
regulation_bodyRegulation body e.g. 'KMPDC', 'COC', 'NCK'
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.ActualProduct
actual_product_codeObtained from searching the AMP for dispense. Usually found in etcdProductId field of the AMP
medication_priceprice of the medication
total_quantitynumber of medications given
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.DispenseDoctor
identification_numberDoctor's ID number
identification_typee.g 'National ID', 'registration_number', 'Alien ID', 'Refugee ID'
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.CreateDispenseRequest
object[] · required
List of actual products dispensed
consent_tokenConsent token
object[] · required
Information from the healthcare professional dispensing the drug
intervention_codeIntervention code
internal_domain_prescriptions.DispenseDosage
dispensedoseQuantitydoseUnitdurationdurationUnitendDatefrequencygenericDosageInstructionguididmedicationmedicationIdentifiermedicationPricemedicationRequestIdperiodUnitpractitionerIdrouterouteCodestartDatestatustotalQuantitygitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.RemovePrescriptionDoctorRequest
consent_tokenConsent token
intervention_codeIntervention code
practitioner_registration_numberRegistration number of the practitioner to remove
internal_domain_claims.EKYCResponse
embedExpiryembededTokenrequestIdrequestUrlinternal_domain_claims.Authorization
authCodeauthorizationReasonauthorizationTypeauthorizingDeviceOsbeneficiarybeneficiaryCodebeneficiaryJoinDatebeneficiaryNamebeneficiaryNumberbeneficiarySchemebenefitTypebiometricMatchLogIdcreatedByNamecreated_bydateAuthorizedekycTokenendDateendedViaexpiryguardianguididisBiometricsDischargeAuthorizationisCompleteisElectiveisEmergencyisOpenlabelneedsPreauthnotesoverallPreauthFinalisedparentAuthorizationparentTypepayerNamepayerSladeCodeproviderproviderFidproviderNamerequestedBysessionTypeshaGuidobject
shaVerificationRequestIdstatustokenupdated_byworkStationIdOTPAuthorizationRequest
Authorization request using a one-time password (OTP) sent to the patient's registered phone number. Use this strategy for outpatient or inpatient consent where OTP verification is available.
patient_idThe patient's Client Registry identifier.
Example: 3-4538-5219
service_typeType of service being authorized.
Enum values:
OUTPATIENT
INPATIENT
Example: OUTPATIENT
otpOne-time password delivered to the patient's registered phone number.
Example: 123456
interventionsList of intervention codes for the services being requested in this visit.
Example: ["INPATIENT_ADMISSION"]
BiometricsAuthorizationRequest
Authorization request using biometric verification via a registered hardware agent. Supports eKYC (SHA flow) and fingerprint (Under-18 patient flow). All fields are required for biometric consent.
agent_idID number of the registered biometrics agent. Obtained from the user logged into the hardware server application.
Example: 37915050
authorizing_device_osOperating system of the device making the biometrics request.
Enum values:
windows
android
Example: windows
ekyc_provider_idName of the healthcare facility initiating the eKYC verification.
Example: Nairobi West
factorsBiometric verification flow(s) to use. SHA triggers the eKYC flow; fingerprint is used for Under-18 patient consent.
Enum values:
SHA
fingerprint
Example: ["SHA"]
interventionsList of intervention codes for the services being requested in this visit.
Example: ["INPATIENT_ADMISSION"]
is_biometrics_discharge_authorizationSet to true only when this authorization is for a patient's discharge. false for all other consent scenarios.
Example: false
is_emergencySet to true if this authorization is for an emergency claim.
Example: false
is_integrationIndicates an integration with external systems. Always true for system-to-system integrations.
Example: true
patient_idThe patient's Client Registry identifier.
Example: 3-4538-5219
providerThe healthcare facility's Facility Registry (FR) code.
Example: 13023
service_typeType of service being authorized.
Enum values:
OUTPATIENT
INPATIENT
Example: INPATIENT
work_station_idWorkstation identifier obtained from the hardware server application running in the background on the authorizing device.
Example: 790bf760-08e6-4fbe-b892-7b877dd52f2b-F406692C85F3
gitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.SwitchInterventionRequest
consent_tokenexisting_intervention_codenew_intervention_coderetain_bill_itemsbill_frombill_tointernal_domain_patients.IntermediatePeriodUsage
individualMaxDuringPeriodindividualUtilisedDuringPeriodlastUsageDateperiodinternal_domain_patients.ComputationalDetail
coverageEndDatecoverageStartDateeligibilityhouseholdLimitAvailableCountindividualLimitAvailableCountobject
limitAvailableAmountnextAvailableDateinternal_domain_patients.FundUtilization
availableAmountfundTypemaxAmountutilisedAmountinternal_domain_patients.PatientUtilizationResponse
codeobject
crIdobject[]
householdMaxLimithouseholdUtilisedLimitindividualMaxLimitindividualUtilisedLimitlimitScopenextAvailabilityutilizationDaysinternal_domain_patients.Cover
categorycategoryCodeeffectivePolicyNumbergroupgroupCodegroupTypeisEmployerGroupjobGrouppolicyNumbervalidFromvalidTointernal_domain_patients.SubBenefit
accessPointactiveallowedInterventionsapplicableLimitcodeobject
fundguididinterventionCombinationnamepackageCombinationparentBenefitparentBenefitCodestandaloneInterventionsstatusinternal_domain_patients.SubBenefitResponse
countcurrentPageendIndexnextpageSizepreviousobject[]
startIndextotalPagesinternal_domain_patients.FamilyMember
dateOfBirthConsider using time.Time
emailfirstNamegenderhouseholdIdisActivelastNamememberNumbermiddleNamenationalIdparentNumberphonephoneCoderelationshipTypeschemeCountshaNumbertitleinternal_domain_patients.PMFSubBenefit
object[]
descriptionlimitnamesubBenefitCodesubBenefitGendersubBenefitIdsubBenefitRelationsubBenefitSharedsubBenefitWaitingPeriodtypeinternal_domain_patients.PMFBenefit
object[]
benefitCodebenefitGenderbenefitIdbenefitRelationbenefitShareddescriptionlimitnameobject[]
typeinternal_domain_patients.PMFPolicy
PolicyYearactiveDatecompanyNamedescriptionendDatehasHospitalCodeshasICD10CodehasImagingServiceshasIncludeandExcludehasLabtestshasMedicalprocedureshasMedicineshasOpticalServicesiCD10TypemedicalproceduresTypenamepolicyCodepolicyGrouppolicyIdschemeCodeschemeNamestatusterminationDatetotalBenefittypeinternal_domain_patients.MemberPolicy
object[]
dependentCountjoinDateleaveDatememberOriginalJoinDateparentMemberNumberobject
policyJoinDatespouseCountstatusinternal_domain_patients.POMSFBalance
dateOfBirthemailobject[]
firstNamegenderhouseholdIdidlastNamememberNumberobject[]
middleNamenationalIdparentNumberphonephoneCodepolicyCountregisteredOnrelationshipTypeschemeCountshaNumbertitlegitlab_slade360emr_com_sha-edi_hie-middleware_internal_dto.CancelPreauthRequest
Request payload for canceling a preauthorization. Requires consent token and intervention code.
consent_tokenintervention_codeinternal_domain_tenants.BedOccupancyRate
dialysis_visitshdu_visitsicu_visitsnewborn_visitsnormal_ip_visitsnumber_of_baby_cotnumber_of_dialysis_bednumber_of_hdu_bednumber_of_icu_bednumber_of_normal_bedtotal_ip_visitstotal_number_of_bed