Kenya ePrescription FHIR Implementation Guide
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Extension: Insurance Pre-Authorization

Official URL: https://nshr-uat.sha.go.ke/StructureDefinition/insurance-pre-authorization Version: 0.1.0
Active as of 2026-04-24 Computable Name: InsurancePreAuthorizationExtension

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Captures an insurance pre-authorization number issued by NHIF, SHIF, or a private insurer for a specific medication or treatment, enabling claim adjudication downstream.

Context of Use

Usage info

Usages:

  • This Extension is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Insurance Pre-Authorization
... extension 2..* Extension Extension
... Slices for extension Content/Rules for all slices
.... extension:authorizationNumber 1..1 Extension Pre-authorization reference number from insurer
..... extension 0..0 Extension
..... url 1..1 uri "authorizationNumber"
..... value[x] 0..1 string Value of extension
.... extension:insurerName 1..1 Extension Name of insurer (e.g. NHIF, SHA, APA Insurance)
..... extension 0..0 Extension
..... url 1..1 uri "insurerName"
..... value[x] 0..1 string Value of extension
.... extension:validFrom 0..1 Extension Start date of the authorization period
..... extension 0..0 Extension
..... url 1..1 uri "validFrom"
..... value[x] 0..1 date Value of extension
.... extension:validTo 0..1 Extension Expiry date of the authorization period
..... extension 0..0 Extension
..... url 1..1 uri "validTo"
..... value[x] 0..1 date Value of extension
... url 1..1 uri "https://nshr-uat.sha.go.ke/StructureDefinition/insurance-pre-authorization"

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Insurance Pre-Authorization
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 2..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:authorizationNumber 1..1 Extension Pre-authorization reference number from insurer
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorizationNumber"
..... value[x] 0..1 string Value of extension
.... extension:insurerName 1..1 Extension Name of insurer (e.g. NHIF, SHA, APA Insurance)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "insurerName"
..... value[x] 0..1 string Value of extension
.... extension:validFrom 0..1 Extension Start date of the authorization period
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "validFrom"
..... value[x] 0..1 date Value of extension
.... extension:validTo 0..1 Extension Expiry date of the authorization period
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "validTo"
..... value[x] 0..1 date Value of extension
... url 1..1 uri "https://nshr-uat.sha.go.ke/StructureDefinition/insurance-pre-authorization"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Captures an insurance pre-authorization number issued by NHIF, SHIF, or a private insurer for a specific medication or treatment, enabling claim adjudication downstream.

  • authorizationNumber: string: An Extension
  • insurerName: string: An Extension
  • validFrom: date: An Extension
  • validTo: date: An Extension

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Insurance Pre-Authorization
... extension 2..* Extension Extension
... Slices for extension Content/Rules for all slices
.... extension:authorizationNumber 1..1 Extension Pre-authorization reference number from insurer
..... extension 0..0 Extension
..... url 1..1 uri "authorizationNumber"
..... value[x] 0..1 string Value of extension
.... extension:insurerName 1..1 Extension Name of insurer (e.g. NHIF, SHA, APA Insurance)
..... extension 0..0 Extension
..... url 1..1 uri "insurerName"
..... value[x] 0..1 string Value of extension
.... extension:validFrom 0..1 Extension Start date of the authorization period
..... extension 0..0 Extension
..... url 1..1 uri "validFrom"
..... value[x] 0..1 date Value of extension
.... extension:validTo 0..1 Extension Expiry date of the authorization period
..... extension 0..0 Extension
..... url 1..1 uri "validTo"
..... value[x] 0..1 date Value of extension
... url 1..1 uri "https://nshr-uat.sha.go.ke/StructureDefinition/insurance-pre-authorization"

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Insurance Pre-Authorization
... id 0..1 string Unique id for inter-element referencing
... Slices for extension 2..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:authorizationNumber 1..1 Extension Pre-authorization reference number from insurer
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "authorizationNumber"
..... value[x] 0..1 string Value of extension
.... extension:insurerName 1..1 Extension Name of insurer (e.g. NHIF, SHA, APA Insurance)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "insurerName"
..... value[x] 0..1 string Value of extension
.... extension:validFrom 0..1 Extension Start date of the authorization period
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "validFrom"
..... value[x] 0..1 date Value of extension
.... extension:validTo 0..1 Extension Expiry date of the authorization period
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..0 Extension
Slice: Unordered, Open by value:url
..... url 1..1 uri "validTo"
..... value[x] 0..1 date Value of extension
... url 1..1 uri "https://nshr-uat.sha.go.ke/StructureDefinition/insurance-pre-authorization"

doco Documentation for this format

This structure is derived from Extension

Summary

Complex Extension: Captures an insurance pre-authorization number issued by NHIF, SHIF, or a private insurer for a specific medication or treatment, enabling claim adjudication downstream.

  • authorizationNumber: string: An Extension
  • insurerName: string: An Extension
  • validFrom: date: An Extension
  • validTo: date: An Extension

 

Other representations of profile: CSV, Excel, Schematron

Constraints

Id Grade Path(s) Description Expression
ele-1 error **ALL** elements All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error **ALL** extensions Must have either extensions or value[x], not both extension.exists() != value.exists()