Explanation Of Benefit

Examples & Testing

This resource summarizes information from claims and claim responses to inform a patient about their coverage for services provided.

See the FHIR documentation for more information about Explanation Of Benefit resources.

Explanation Of Benefit resources support the following interactions.

When searching for Explanation Of Benefit resources, the following search parameters are supported.

Name	Type	Prefixes Modifiers	Can be Chained?	Description
_id	Token			Resource id.
_lastUpdated	Date	lt le gt ge		When the resource last changed.
_source	Uri	:missing		Where the resource comes from.
care-team	Reference	:missing	yes	Member of the CareTeam.
coverage	Reference	:missing	yes	The plan under which the claim was adjudicated.
created	Date	ne lt le gt ge sa eb ap :missing		The creation date for the EOB.
encounter	Reference	:missing	yes	Encounters associated with a billed line item.
identifier	Token	:missing		The business identifier of the Explanation of Benefit.
patient	Reference	:missing	yes	The reference to the patient.
provenance-agent	Reference	:missing	yes	Search by provenance, specified by its author (aka originator) Organization.
provider	Reference	:missing	yes	The reference to the provider.
service-date	Date	ne lt le gt ge sa eb ap :missing		Date of the service for the EOB.
service-start-date	Date	ne lt le gt ge sa eb ap :missing		Starting Date of the service for the EOB.
type	Token	:missing		Claim type.

When searching Explanation Of Benefit resources, it is possible to sort the returned values by the following search parameters.

Only one sort parameter may be specified.

When searching Explanation Of Benefit resources, it is possible to include the resources referenced by the following field names.