Kenya Patient Summary FHIR IG - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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: Claims status - JSON Representation

Draft as of 2025-12-09

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{
  "resourceType" : "ValueSet",
  "id" : "ClaimsStatusVS",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet ClaimsStatusVS</b></p><a name=\"ClaimsStatusVS\"> </a><a name=\"hcClaimsStatusVS\"> </a><ul><li>Include these codes as defined in <a href=\"CodeSystem-KNHTS.CLMSTS.html\"><code>https://example.org/fhir/CodeSystem/KNHTS.CLMSTS</code></a><span title=\"Version is not explicitly stated, which means it is fixed to the version provided in this specification\"> version &#x1F4E6;0.1.0</span><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS01\">STS01</a></td><td style=\"color: #cccccc\">NEW</td><td>Active</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS02\">STS02</a></td><td style=\"color: #cccccc\">NOTIFIED</td><td>Identification done and payor notified</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS03\">STS03</a></td><td style=\"color: #cccccc\">PREAUTHORIZED</td><td>Pre-authorization done.*</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS04\">STS04</a></td><td style=\"color: #cccccc\">COMPLETE</td><td>Provider has checked that all requirements are met and the claim is ready for submission. Done at the end of a visit / after discharge.</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS05\">STS05</a></td><td style=\"color: #cccccc\">CANCELLED</td><td>Cancelled at provider, before submission.</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS06\">STS06</a></td><td style=\"color: #cccccc\">SUBMITTED</td><td>Submitted to payer.</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS07\">STS07</a></td><td style=\"color: #cccccc\">RECEIVED</td><td>Received at payer.</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS08\">STS08</a></td><td style=\"color: #cccccc\">APPROVED</td><td>Approved</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS09\">STS09</a></td><td style=\"color: #cccccc\">REJECTED</td><td>The payer has indicated that the claim will not be paid.</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS10\">STS10</a></td><td style=\"color: #cccccc\">PAID</td><td>The claim has been paid and the payee should expect to receive or have received  a remittance.</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS11\">STS11</a></td><td style=\"color: #cccccc\">EXPIRED</td><td>Expired</td></tr><tr><td><a href=\"CodeSystem-KNHTS.CLMSTS.html#KNHTS.CLMSTS-STS12\">STS12</a></td><td style=\"color: #cccccc\">QA</td><td>The claim is undergoing review.</td></tr></table></li></ul></div>"
  },
  "url" : "https://example.org/fhir/ValueSet/ClaimsStatusVS",
  "version" : "0.1.0",
  "name" : "KNHTSCLMVS",
  "title" : "Claims status",
  "status" : "draft",
  "experimental" : false,
  "date" : "2025-12-09T10:36:20+00:00",
  "publisher" : "IntelliSOFT Consulting",
  "contact" : [
    {
      "name" : "IntelliSOFT Consulting",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://.com/fhir/example-publisher"
        }
      ]
    },
    {
      "name" : "KPS Team Kenya.",
      "telecom" : [
        {
          "system" : "email",
          "value" : "info@example.com",
          "use" : "work"
        }
      ]
    }
  ],
  "description" : "Claims status",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "KE",
          "display" : "Kenya"
        }
      ]
    }
  ],
  "compose" : {
    "include" : [
      {
        "system" : "https://example.org/fhir/CodeSystem/KNHTS.CLMSTS",
        "concept" : [
          {
            "code" : "STS01"
          },
          {
            "code" : "STS02"
          },
          {
            "code" : "STS03"
          },
          {
            "code" : "STS04"
          },
          {
            "code" : "STS05"
          },
          {
            "code" : "STS06"
          },
          {
            "code" : "STS07"
          },
          {
            "code" : "STS08"
          },
          {
            "code" : "STS09"
          },
          {
            "code" : "STS10"
          },
          {
            "code" : "STS11"
          },
          {
            "code" : "STS12"
          }
        ]
      }
    ]
  }
}