eClaims and Preauth APIs

Interventions

Endpointhttps://ilm-dev.dha.go.ke/uat-middleware

Endpoints for managing interventions and their combinations.

Add a new intervention to claim

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/interventions

Adds a new intervention to an existing claim using the consent token from claim creation.

Add a new intervention to claim › Request Body

consent_token

string · required

intervention_code

string · required

facilityID

string

facilityIDType

string

Add a new intervention to claim › Responses

Intervention added successfully

accrued_per_diem_amount

number

accrued_per_diem_days

integer

active_for_uhc

boolean

bill_from

string

bill_to

string

id

string

intervention_code

string

intervention_fund

string

intervention_name

string

intervention_overall_tariff

number

intervention_payment_mechanism

string

is_switched_intervention

boolean

keph_level_tarrif

number

preauth_exist

boolean

requires_surgical_preauth

boolean

sub_benefit_code

string

supported_scheme

string

switched_intervention_id

integer

switched_lines_retained

boolean

workflow_state

string

POST/api/v1/claims/interventions

curl --request POST \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/interventions \
  --header 'Content-Type: application/json' \
  --data '
{
  "consent_token": "consent_token",
  "facilityID": "facilityID",
  "facilityIDType": "facilityIDType",
  "intervention_code": "intervention_code"
}
'

shell

Example Request Body

{
  "consent_token": "consent_token",
  "facilityID": "facilityID",
  "facilityIDType": "facilityIDType",
  "intervention_code": "intervention_code"
}

json

Example Responses

{
  "accrued_per_diem_amount": 0,
  "accrued_per_diem_days": 0,
  "active_for_uhc": true,
  "bill_from": "bill_from",
  "bill_to": "bill_to",
  "id": "id",
  "intervention_code": "intervention_code",
  "intervention_fund": "intervention_fund",
  "intervention_name": "intervention_name",
  "intervention_overall_tariff": 0,
  "intervention_payment_mechanism": "intervention_payment_mechanism",
  "is_switched_intervention": true,
  "keph_level_tarrif": 0,
  "preauth_exist": true,
  "requires_surgical_preauth": true,
  "sub_benefit_code": "sub_benefit_code",
  "supported_scheme": "supported_scheme",
  "switched_intervention_id": 0,
  "switched_lines_retained": true,
  "workflow_state": "workflow_state"
}

json

application/json

Restore Intervention

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/interventions/restore

Restore an intervention to a claim.

Restore Intervention › Request Body

consent_token

string · required

intervention_code

string · required

Restore Intervention › Responses

Intervention restored successfully

Standard success response format for all successful operations.

object

@Description Response data payload containing operation details @Example {"status": "success"}

message

string

@Description Success message describing the operation result @Example "Visit has been successfully started"

POST/api/v1/claims/interventions/restore

curl --request POST \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/interventions/restore \
  --header 'Content-Type: application/json' \
  --data '
{
  "consent_token": "consent_token",
  "intervention_code": "intervention_code"
}
'

shell

Example Request Body

{
  "consent_token": "consent_token",
  "intervention_code": "intervention_code"
}

json

Example Responses

{
  "data": {},
  "message": "message"
}

json

application/json

Retire Intervention

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/interventions/retire

Retire an intervention from a claim.

Retire Intervention › Request Body

consent_token

string · required

intervention_code

string · required

Retire Intervention › Responses

Intervention retired successfully

Standard success response format for all successful operations.

object

@Description Response data payload containing operation details @Example {"status": "success"}

message

string

@Description Success message describing the operation result @Example "Visit has been successfully started"

POST/api/v1/claims/interventions/retire

curl --request POST \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/interventions/retire \
  --header 'Content-Type: application/json' \
  --data '
{
  "consent_token": "consent_token",
  "intervention_code": "intervention_code"
}
'

shell

Example Request Body

{
  "consent_token": "consent_token",
  "intervention_code": "intervention_code"
}

json

Example Responses

{
  "data": {},
  "message": "message"
}

json

application/json

Switch intervention

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/interventions/switch

Switches an existing intervention to a new intervention using a valid consent token.

Switch intervention › Request Body

consent_token

string · required

existing_intervention_code

string · required

new_intervention_code

string · required

retain_bill_items

boolean · required

bill_from

string

bill_to

string

Switch intervention › Responses

Intervention switched successfully

Standard success response format for all successful operations.

object

@Description Response data payload containing operation details @Example {"status": "success"}

message

string

@Description Success message describing the operation result @Example "Visit has been successfully started"

POST/api/v1/claims/interventions/switch

curl --request POST \
  --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/interventions/switch \
  --header 'Content-Type: application/json' \
  --data '
{
  "bill_from": "bill_from",
  "bill_to": "bill_to",
  "consent_token": "consent_token",
  "existing_intervention_code": "existing_intervention_code",
  "new_intervention_code": "new_intervention_code",
  "retain_bill_items": true
}
'

shell

Example Request Body

{
  "bill_from": "bill_from",
  "bill_to": "bill_to",
  "consent_token": "consent_token",
  "existing_intervention_code": "existing_intervention_code",
  "new_intervention_code": "new_intervention_code",
  "retain_bill_items": true
}

json

Example Responses

{
  "data": {},
  "message": "message"
}

json

application/json

Start Visit Consent Preauths

Add a new intervention to claim

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/interventions

Adds a new intervention to an existing claim using the consent token from claim creation.

Add a new intervention to claim › Request Body

consent_token

string · required

intervention_code

string · required

facilityID

string

facilityIDType

string

Add a new intervention to claim › Responses

Intervention added successfully

accrued_per_diem_amount

number

accrued_per_diem_days

integer

active_for_uhc

boolean

bill_from

string

bill_to

string

id

string

intervention_code

string

intervention_fund

string

intervention_name

string

intervention_overall_tariff

number

intervention_payment_mechanism

string

is_switched_intervention

boolean

keph_level_tarrif

number

preauth_exist

boolean

requires_surgical_preauth

boolean

sub_benefit_code

string

supported_scheme

string

switched_intervention_id

integer

switched_lines_retained

boolean

workflow_state

string

curl --request POST \ --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/interventions \ --header 'Content-Type: application/json' \ --data ' { "consent_token": "consent_token", "facilityID": "facilityID", "facilityIDType": "facilityIDType", "intervention_code": "intervention_code" } '

{ "accrued_per_diem_amount": 0, "accrued_per_diem_days": 0, "active_for_uhc": true, "bill_from": "bill_from", "bill_to": "bill_to", "id": "id", "intervention_code": "intervention_code", "intervention_fund": "intervention_fund", "intervention_name": "intervention_name", "intervention_overall_tariff": 0, "intervention_payment_mechanism": "intervention_payment_mechanism", "is_switched_intervention": true, "keph_level_tarrif": 0, "preauth_exist": true, "requires_surgical_preauth": true, "sub_benefit_code": "sub_benefit_code", "supported_scheme": "supported_scheme", "switched_intervention_id": 0, "switched_lines_retained": true, "workflow_state": "workflow_state" }

Restore Intervention

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/interventions/restore

Restore an intervention to a claim.

Restore Intervention › Request Body

consent_token

string · required

intervention_code

string · required

Restore Intervention › Responses

Intervention restored successfully

Standard success response format for all successful operations.

object

@Description Response data payload containing operation details @Example {"status": "success"}

message

string

@Description Success message describing the operation result @Example "Visit has been successfully started"

Retire Intervention

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/interventions/retire

Retire an intervention from a claim.

Retire Intervention › Request Body

consent_token

string · required

intervention_code

string · required

Retire Intervention › Responses

Intervention retired successfully

Standard success response format for all successful operations.

object

@Description Response data payload containing operation details @Example {"status": "success"}

message

string

@Description Success message describing the operation result @Example "Visit has been successfully started"

Switch intervention

POST

https://ilm-dev.dha.go.ke/uat-middleware

/api/v1/claims/interventions/switch

Switches an existing intervention to a new intervention using a valid consent token.

Switch intervention › Request Body

consent_token

string · required

existing_intervention_code

string · required

new_intervention_code

string · required

retain_bill_items

boolean · required

bill_from

string

bill_to

string

Switch intervention › Responses

Intervention switched successfully

Standard success response format for all successful operations.

object

@Description Response data payload containing operation details @Example {"status": "success"}

message

string

@Description Success message describing the operation result @Example "Visit has been successfully started"

curl --request POST \ --url https://ilm-dev.dha.go.ke/uat-middleware/api/v1/claims/interventions/switch \ --header 'Content-Type: application/json' \ --data ' { "bill_from": "bill_from", "bill_to": "bill_to", "consent_token": "consent_token", "existing_intervention_code": "existing_intervention_code", "new_intervention_code": "new_intervention_code", "retain_bill_items": true } '

{ "bill_from": "bill_from", "bill_to": "bill_to", "consent_token": "consent_token", "existing_intervention_code": "existing_intervention_code", "new_intervention_code": "new_intervention_code", "retain_bill_items": true }