Interface / 3.0.1 (STU3) / Explanation Of Benefit

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.

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
_count	Special			The maximum number of resources to return in a result page.
_elements	Special			Used to request a specific set of elements be returned as part of a resource.
_id	Token			Resource id.
_lastUpdated	Date	lt le gt ge		When the resource last changed.
_source	Uri	:missing		Where the resource comes from.
_summary	Special			Used to return only a portion of the resouces. Defaults to 'false', which returns the whole resource.
_total	Special			Use the value 'estimate' to populate the result bundle's 'total' element with an estimate of the matching number of resources.
care-team	Reference	:missing	yes	Member of the CareTeam.
coverage	Reference	:missing	yes	The plan under which the claim was adjudicated.
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.
service-date	Date	ne lt le gt ge sa eb ap :missing		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.