eClaims and Preauth APIs
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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 via OTP. Includes service type, intervention codes, and beneficiary details.
Create new virtual claim › Request Body
admission_date[Only for INPATIENT claims] Date of admission for the patient in ISO format
Example: 2025-08-26T15:30:00+03:00
estimated_days_of_admission[Only for INPATIENT claims] Estimated number of days for the patient's admission
Example: 5
intervention_codesIntervention code(s) for the service scheduled to be offered
Example: ["SHA-12-001"]
otpOne time Password sent to the beneficiary contact
Example: 12345
patient_idClient registry identifier of the beneficiary associated with the patient
Example: CR69364****4997-0
service_typeType of service
Enum values:
CAPITATION
OUTPATIENT
INPATIENT
EMERGENCY
Example: CAPITATION
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_interventionintervention_copay_dataobject[]
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