Explanation Of Benefit
This resource summarizes information from claims and claim responses to inform a patient about their coverage for services provided.
Overview
See the FHIR documentation for more information about Explanation Of Benefit resources.
Mapped Concepts in HIEBus
Supported Interactions
Explanation Of Benefit resources support the following interactions.
Search Parameters
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 patient the ExplanationOfBenefit is about.
|
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.
|
Sortable Parameters
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.
Supported Includes
When searching Explanation Of Benefit resources, it is possible to include the resources referenced by the following field names.
- Care Team
- Coverage
- Encounter
- Patient
- Provenance Agent
- Provider
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