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  1. <soap:Envelope xmlns:soap="http://www.w3.org/2003/05/soap-envelope" xmlns:ns="http://services.activus.com/claimsloadservice/messagecontracts/2011/05" xmlns:ns1="http://services.activus.com/common/datacontracts/2010/02" xmlns:ns2="http://schemas.activus.com/dispublicobject/claimsload/2011/05">
  2. <soap:Header>
  3. <ns:ActisureHeader>
  4. <!--Optional:-->
  5. <ns1:ExternalRefID>?</ns1:ExternalRefID>
  6. <!--Optional:-->
  7. <ns1:Source>?</ns1:Source>
  8. <!--Optional:-->
  9. <ns1:InternalRefID>?</ns1:InternalRefID>
  10. </ns:ActisureHeader>
  11. </soap:Header>
  12. <soap:Body>
  13. <ns:LoadClaimRequestMessage>
  14. <!--Optional:-->
  15. <ns:LoadClaimRequest>
  16. <Claim xmlns="http://schemas.activus.com/dispublicobject/claimsload/2011/05">
  17. <PolicyId>15465</PolicyId>
  18. <PolicyEffectiveDate>2018-05-01T00:00:00</PolicyEffectiveDate>
  19. <ClaimDate>2018-07-11T00:00:00</ClaimDate>
  20. <Beneficiary>
  21. <ActisureId>1363051</ActisureId>
  22. </Beneficiary>
  23. <PrimaryDiagnosisICD10Code>0001</PrimaryDiagnosisICD10Code>
  24. <FirstConsultationDate>2018-07-11T00:00:00</FirstConsultationDate>
  25. <ConditionStatus>Confirmed</ConditionStatus>
  26. <Treatments>
  27. <Treatment>
  28. <ProcedureCode>JIC0333</ProcedureCode>
  29. <TreatmentStatus>Confirmed</TreatmentStatus>
  30. <PrimarySpecialist>
  31. <ActisureId>11632010</ActisureId>
  32. </PrimarySpecialist>
  33. <!-- <CreatedByUsername>Livia</CreatedByUsername> -->
  34. <FacilityList />
  35. <Invoices>
  36. <Invoice>
  37. <InvoiceFrom>
  38. <ActisureId>11632010</ActisureId>
  39. </InvoiceFrom>
  40. <InvoiceStatus>Loaded</InvoiceStatus>
  41. <InvoiceReference>37</InvoiceReference>
  42. <InvoiceDate>2018-07-11T00:00:00</InvoiceDate>
  43. <InvoiceCurrencyCode>KES</InvoiceCurrencyCode>
  44. <ExchangeRateDate>2018-07-11T00:00:00</ExchangeRateDate>
  45. <ExchangeRateToProductBaseCurrency>0</ExchangeRateToProductBaseCurrency>
  46. <ExchangeRateToAccountingBaseCurrency>0</ExchangeRateToAccountingBaseCurrency>
  47. <Payee>
  48. <ActisureId>11632010</ActisureId>
  49. </Payee>
  50. <PaymentMethod>Cheque</PaymentMethod>
  51. <PaymentExchangeRateToProductBaseCurrency>0</PaymentExchangeRateToProductBaseCurrency>
  52. <PaymentExchangeRateToAccountingBaseCurrency>0</PaymentExchangeRateToAccountingBaseCurrency>
  53. <TreatmentDate>2018-07-11T00:00:00</TreatmentDate>
  54. <TreatmentCountryName>Kenya</TreatmentCountryName>
  55. <TreatmentTerritoryName>Kenya</TreatmentTerritoryName>
  56. <InvoiceLines>
  57. <InvoiceLine>
  58. <InvoiceLineStatus>Loaded</InvoiceLineStatus>
  59. <InvoiceLineUserStatus>I - Input</InvoiceLineUserStatus>
  60. <Amount>450</Amount>
  61. <Quantity>1</Quantity>
  62. <SettledAmount>450</SettledAmount>
  63. <Benefit>Outpatient Enhanced II Shared</Benefit>
  64. <SubBenefit>Illness Outpatient</SubBenefit>
  65. <BenefitDetail>Consultation</BenefitDetail>
  66. <AdmissionStatus>Day Case</AdmissionStatus>
  67. <AnalysisCodeDescription />
  68. <ReasonText>Consultation</ReasonText>
  69. </InvoiceLine>
  70. </InvoiceLines>
  71. </Invoice>
  72. </Invoices>
  73. </Treatment>
  74. </Treatments>
  75. </Claim>
  76. </ns:LoadClaimRequest>
  77. </ns:LoadClaimRequestMessage>
  78. </soap:Body>
  79. </soap:Envelope>
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