ExplanationOfBenefit
The ExplanationOfBenefit resource provides the "claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided." (HL7 FHIR R4 ExplanationOfBenefit)
Supported Profiles
This API supports the following FHIR profiles:
- HL7 FHIR R4 ExplanationOfBenefit
- CARIN-BB ExplanationOfBenefit
- CARIN-BB ExplanationOfBenefit-Inpatient-Institutional
- CARIN-BB ExplanationOfBenefit-Outpatient-Institutional
- CARIN-BB ExplanationOfBenefit-Pharmacy
- CARIN-BB ExplanationOfBenefit-Professional-NonClinician
Operations
The Certified and Regulated Patient Access API ExplanationOfBenefit resource supports the following standard operations. However, support varies by the targeted CareRecord or solution.
| CareRecord / Solution | Create | Read | Update | Search |
|---|---|---|---|---|
| GEHRIMED | - | - | - | - |
| myAvatar | - | Yes | - | Yes |
| myEvolv | - | - | - | - |
| myUnity | - | - | - | - |
| TheraOffice | - | Yes | - | Yes |
Search
Not all Netsmart solutions support ExplanationOfBenefit search. See supported operations table above and consult your target solution's documentation for more information.
This resource supports standard search parameters in addition to the common parameters.
Standard Parameters
| Name | Type | Description |
|---|---|---|
| patient | reference | REQUIRED The reference to the patient |
| created | date | The creation date for the EOB |
| identifier | token | The business identifier of the explanation of benefit |
| page | string | Zero-based page index |
| status | token | Status of the instance |
| _revinclude | special | Include Provenance resource(s) that reference the matched search results. Allowed: "Provenance:target" |
Search Examples
Via POST
The POST method is recommended as it keeps health information out of the URL.
- Production
- Preview
curl -X POST https://fhir.netsmartcloud.com/uscore/v1/ExplanationOfBenefit/_search \
-H "Authorization: {Bearer Token}" \
-H "Accept: application/fhir+json" \
-H "Content-Type: application/x-form-urlencoded" \
-d "patient=Patient/123"
curl -X POST https://fhirtest.netsmartcloud.com/uscore/v1/ExplanationOfBenefit/_search \
-H "Authorization: {Bearer Token}" \
-H "Accept: application/fhir+json" \
-H "Content-Type: application/x-form-urlencoded" \
-d "patient=Patient/123"
Via GET
- Production
- Preview
curl -X POST https://fhir.netsmartcloud.com/uscore/v1/ExplanationOfBenefit?patient=Patient/123 \
-H "Authorization: {Bearer Token}" \
-H "Accept: application/fhir+json"
curl -X POST https://fhirtest.netsmartcloud.com/uscore/v1/ExplanationOfBenefit?patient=Patient/123 \
-H "Authorization: {Bearer Token}" \
-H "Accept: application/fhir+json"