visits

Retrieve ExplanationOfBenefits (for paid claims), Encounters, and ServiceRequests (for authorizations) resources for a specific patient/member within a given time period.

The visit operation requires you to specify a patient id in the REST resource segment. For example:

/Patient/:patientID/$visits

Output is contained within a Parameters resource. Each visit has multiple parts which include a name, the resource itself, a visit-type (and optionally a visit-subtype), and a visit-grouping.

Input Parameters

Name Cardinality Type Description
start 1..1

date

Starting date for query range in form YYYY-MM-DD.

end 1..1

date

Ending date for query range in form YYYY-MM-DD.

include-groups 0..1

boolean

Set =true to include visit-grouping in results.

include-practitioners 0..1

boolean

Set =true to include Reference(Practitioner) in results (Optional). See the Provider List Use Case Guide for where to find these in response.

include-locations 0..1

boolean

Set =true to include Reference(Location) in results.

include-conditions 0..1

boolean

Set =true to include Reference(Condition) in results (Optional) See the Problem List Use Case Guide for where to find these in response.

Output Parameters

Name Cardinality Type Description
name 1..N
(1 per visit)

string

Can be encounter-visit, claim-visit, or service-request-visit.

resource 1..N
(1 per visit)

ExplanationOfBenefits (for paid claims), Encounters, and/or ServiceRequests.

Contains each resource.

visit-type 1..N
(1 per visit)

string

Contains the healthcare setting (see the Visits Use Case Guide for a listing of available setting names).

visit-sub-type 0..N
(1 per visit)

string

Contains the healthcare setting (see the Visits Use Case Guide for a listing of available setting names).

visit-grouping/[REFERENCE] 1..N
(1 per visit)

Reference

List of references to one of the ExplanationOfBenefits (for paid claims), Encounters, and/or ServiceRequests included above.


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