API documentation for HeyDonto API users
URL https://heydonto.com
HeyDonto services@heydonto.com
curl -i -X GET \ 'https://docs.heydonto.com/_mock/apis/fhir/openapi/fhir/explanation-of-benefit?_count=0&_page_token=string' \ -H 'Authorization: Bearer <YOUR_JWT_HERE>'
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
An identifier - identifies some entity uniquely and unambiguously. Typically this is used for business identifiers.
Indicates the purpose of this bundle - how it is intended to be used.
An instant in time - known at least to the second
A series of links that provide context to this bundle.
An entry in a bundle resource - will either contain a resource or information about a resource (transactions and history only).
A signature along with supporting context. The signature may be a digital signature that is cryptographic in nature, or some other signature acceptable to the domain. This other signature may be as simple as a graphical image representing a hand-written signature, or a signature ceremony Different signature approaches have different utilities.
{ "resourceType": "Bundle", "type": "searchset", "total": 100, "link": [ { … }, { … }, { … }, { … } ], "entry": [ { … } ] }
This is a ExplanationOfBenefit resource
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this explanation of benefit.
The status of the resource instance.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
This 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.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Reference from the Insurer which is used in later communications which refers to this adjudication.
The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.
The members of the team who provided the products and services.
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
This 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.
A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
The first-tier service adjudications for payor added product or service lines.
The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
Categorized monetary totals for the adjudication.
This 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.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A note that describes or explains adjudication results in a human readable form.
curl -i -X POST \ https://docs.heydonto.com/_mock/apis/fhir/openapi/fhir/explanation-of-benefit \ -H 'Authorization: Bearer <YOUR_JWT_HERE>' \ -H 'Content-Type: application/json' \ -d '{ "resourceType": "ExplanationOfBenefit", "id": "EB3500", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ExplanationOfBenefit</div>" }, "identifier": [ { "system": "http://www.BenefitsInc.com/fhir/explanationofbenefit", "value": "987654321" } ], "status": "active", "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/claim-type", "code": "oral" } ] }, "use": "claim", "patient": { "reference": "Patient/pat1" }, "created": "2014-08-16", "enterer": { "reference": "Practitioner/1" }, "insurer": { "reference": "Organization/3" }, "provider": { "reference": "Practitioner/1" }, "payee": { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/payeetype", "code": "provider" } ] }, "party": { "reference": "Organization/2" } }, "facility": { "reference": "Location/1" }, "claim": { "reference": "Claim/100150" }, "claimResponse": { "reference": "ClaimResponse/R3500" }, "outcome": "complete", "disposition": "Claim settled as per contract.", "careTeam": [ { "sequence": 1, "provider": { "reference": "Practitioner/example" } } ], "insurance": [ { "focal": true, "coverage": { "reference": "Coverage/9876B1" } } ], "item": [ { "sequence": 1, "careTeamSequence": [ 1 ], "productOrService": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/ex-USCLS", "code": "1205" } ] }, "servicedDate": "2014-08-16", "unitPrice": { "value": 135.57, "currency": "USD" }, "net": { "value": 135.57, "currency": "USD" }, "udi": [ { "reference": "Device/example" } ], "encounter": [ { "reference": "Encounter/example" } ], "adjudication": [ { "category": { "coding": [ { "code": "eligible" } ] }, "amount": { "value": 120, "currency": "USD" } }, { "category": { "coding": [ { "code": "eligpercent" } ] }, "value": 0.8 }, { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 96, "currency": "USD" } } ] }, { "sequence": 2, "careTeamSequence": [ 1 ], "productOrService": { "coding": [ { "code": "group" } ] }, "servicedDate": "2014-08-16", "net": { "value": 200, "currency": "USD" }, "adjudication": [ { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 180, "currency": "USD" } } ], "detail": [ { "sequence": 1, "productOrService": { "coding": [ { "code": "group" } ] }, "net": { "value": 200, "currency": "USD" }, "udi": [ { "reference": "Device/example" } ], "adjudication": [ { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 180, "currency": "USD" } } ], "subDetail": [ { "sequence": 1, "productOrService": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/ex-USCLS", "code": "1205" } ] }, "unitPrice": { "value": 200, "currency": "USD" }, "net": { "value": 200, "currency": "USD" }, "udi": [ { "reference": "Device/example" } ], "adjudication": [ { "category": { "coding": [ { "code": "eligible" } ] }, "amount": { "value": 200, "currency": "USD" } }, { "category": { "coding": [ { "code": "eligpercent" } ] }, "value": 0.9 }, { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 180, "currency": "USD" } } ] } ] } ] } ], "total": [ { "category": { "coding": [ { "code": "submitted" } ] }, "amount": { "value": 135.57, "currency": "USD" } }, { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 96, "currency": "USD" } } ] }'
This is a ExplanationOfBenefit resource
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this explanation of benefit.
The status of the resource instance.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
This 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.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Reference from the Insurer which is used in later communications which refers to this adjudication.
The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.
The members of the team who provided the products and services.
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
This 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.
A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
The first-tier service adjudications for payor added product or service lines.
The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
Categorized monetary totals for the adjudication.
This 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.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A note that describes or explains adjudication results in a human readable form.
{ "resourceType": "ExplanationOfBenefit", "id": "EB3500", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ExplanationOfBenefit</div>" }, "identifier": [ { … } ], "status": "active", "type": { "coding": [ … ] }, "use": "claim", "patient": { "reference": "Patient/pat1" }, "created": "2014-08-16", "enterer": { "reference": "Practitioner/1" }, "insurer": { "reference": "Organization/3" }, "provider": { "reference": "Practitioner/1" }, "payee": { "type": { … }, "party": { … } }, "facility": { "reference": "Location/1" }, "claim": { "reference": "Claim/100150" }, "claimResponse": { "reference": "ClaimResponse/R3500" }, "outcome": "complete", "disposition": "Claim settled as per contract.", "careTeam": [ { … } ], "insurance": [ { … } ], "item": [ { … }, { … } ], "total": [ { … }, { … } ] }
curl -i -X GET \ 'https://docs.heydonto.com/_mock/apis/fhir/openapi/fhir/explanation-of-benefit/{id}' \ -H 'Authorization: Bearer <YOUR_JWT_HERE>'
This is a ExplanationOfBenefit resource
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this explanation of benefit.
The status of the resource instance.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
This 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.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Reference from the Insurer which is used in later communications which refers to this adjudication.
The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.
The members of the team who provided the products and services.
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
This 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.
A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
The first-tier service adjudications for payor added product or service lines.
The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
Categorized monetary totals for the adjudication.
This 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.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A note that describes or explains adjudication results in a human readable form.
{ "resourceType": "ExplanationOfBenefit", "id": "EB3500", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ExplanationOfBenefit</div>" }, "identifier": [ { … } ], "status": "active", "type": { "coding": [ … ] }, "use": "claim", "patient": { "reference": "Patient/pat1" }, "created": "2014-08-16", "enterer": { "reference": "Practitioner/1" }, "insurer": { "reference": "Organization/3" }, "provider": { "reference": "Practitioner/1" }, "payee": { "type": { … }, "party": { … } }, "facility": { "reference": "Location/1" }, "claim": { "reference": "Claim/100150" }, "claimResponse": { "reference": "ClaimResponse/R3500" }, "outcome": "complete", "disposition": "Claim settled as per contract.", "careTeam": [ { … } ], "insurance": [ { … } ], "item": [ { … }, { … } ], "total": [ { … }, { … } ] }
This is a ExplanationOfBenefit resource
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this explanation of benefit.
The status of the resource instance.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
This 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.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Reference from the Insurer which is used in later communications which refers to this adjudication.
The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.
The members of the team who provided the products and services.
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
This 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.
A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
The first-tier service adjudications for payor added product or service lines.
The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
Categorized monetary totals for the adjudication.
This 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.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A note that describes or explains adjudication results in a human readable form.
curl -i -X PUT \ 'https://docs.heydonto.com/_mock/apis/fhir/openapi/fhir/explanation-of-benefit/{id}' \ -H 'Authorization: Bearer <YOUR_JWT_HERE>' \ -H 'Content-Type: application/json' \ -d '{ "resourceType": "ExplanationOfBenefit", "id": "EB3500", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ExplanationOfBenefit</div>" }, "identifier": [ { "system": "http://www.BenefitsInc.com/fhir/explanationofbenefit", "value": "987654321" } ], "status": "active", "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/claim-type", "code": "oral" } ] }, "use": "claim", "patient": { "reference": "Patient/pat1" }, "created": "2014-08-16", "enterer": { "reference": "Practitioner/1" }, "insurer": { "reference": "Organization/3" }, "provider": { "reference": "Practitioner/1" }, "payee": { "type": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/payeetype", "code": "provider" } ] }, "party": { "reference": "Organization/2" } }, "facility": { "reference": "Location/1" }, "claim": { "reference": "Claim/100150" }, "claimResponse": { "reference": "ClaimResponse/R3500" }, "outcome": "complete", "disposition": "Claim settled as per contract.", "careTeam": [ { "sequence": 1, "provider": { "reference": "Practitioner/example" } } ], "insurance": [ { "focal": true, "coverage": { "reference": "Coverage/9876B1" } } ], "item": [ { "sequence": 1, "careTeamSequence": [ 1 ], "productOrService": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/ex-USCLS", "code": "1205" } ] }, "servicedDate": "2014-08-16", "unitPrice": { "value": 135.57, "currency": "USD" }, "net": { "value": 135.57, "currency": "USD" }, "udi": [ { "reference": "Device/example" } ], "encounter": [ { "reference": "Encounter/example" } ], "adjudication": [ { "category": { "coding": [ { "code": "eligible" } ] }, "amount": { "value": 120, "currency": "USD" } }, { "category": { "coding": [ { "code": "eligpercent" } ] }, "value": 0.8 }, { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 96, "currency": "USD" } } ] }, { "sequence": 2, "careTeamSequence": [ 1 ], "productOrService": { "coding": [ { "code": "group" } ] }, "servicedDate": "2014-08-16", "net": { "value": 200, "currency": "USD" }, "adjudication": [ { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 180, "currency": "USD" } } ], "detail": [ { "sequence": 1, "productOrService": { "coding": [ { "code": "group" } ] }, "net": { "value": 200, "currency": "USD" }, "udi": [ { "reference": "Device/example" } ], "adjudication": [ { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 180, "currency": "USD" } } ], "subDetail": [ { "sequence": 1, "productOrService": { "coding": [ { "system": "http://terminology.hl7.org/CodeSystem/ex-USCLS", "code": "1205" } ] }, "unitPrice": { "value": 200, "currency": "USD" }, "net": { "value": 200, "currency": "USD" }, "udi": [ { "reference": "Device/example" } ], "adjudication": [ { "category": { "coding": [ { "code": "eligible" } ] }, "amount": { "value": 200, "currency": "USD" } }, { "category": { "coding": [ { "code": "eligpercent" } ] }, "value": 0.9 }, { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 180, "currency": "USD" } } ] } ] } ] } ], "total": [ { "category": { "coding": [ { "code": "submitted" } ] }, "amount": { "value": 135.57, "currency": "USD" } }, { "category": { "coding": [ { "code": "benefit" } ] }, "amount": { "value": 96, "currency": "USD" } } ] }'
This is a ExplanationOfBenefit resource
Any combination of letters, numerals, "-" and ".", with a length limit of 64 characters. (This might be an integer, an unprefixed OID, UUID or any other identifier pattern that meets these constraints.) Ids are case-insensitive.
The metadata about a resource. This is content in the resource that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A human-readable summary of the resource conveying the essential clinical and business information for the resource.
These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
A unique identifier assigned to this explanation of benefit.
The status of the resource instance.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A date, date-time or partial date (e.g. just year or year + month). If hours and minutes are specified, a time zone SHALL be populated. The format is a union of the schema types gYear, gYearMonth, date and dateTime. Seconds must be provided due to schema type constraints but may be zero-filled and may be ignored. Dates SHALL be valid dates.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A reference from one resource to another.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.
This 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.
A string which has at least one character and no leading or trailing whitespace and where there is no whitespace other than single spaces in the contents
Reference from the Insurer which is used in later communications which refers to this adjudication.
The timeframe during which the supplied preauthorization reference may be quoted on claims to obtain the adjudication as provided.
The members of the team who provided the products and services.
Additional information codes regarding exceptions, special considerations, the condition, situation, prior or concurrent issues.
Information about diagnoses relevant to the claim items.
Procedures performed on the patient relevant to the billing items with the claim.
Financial instruments for reimbursement for the health care products and services specified on the claim.
May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).
Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.
This 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.
A claim line. Either a simple (a product or service) or a 'group' of details which can also be a simple items or groups of sub-details.
The first-tier service adjudications for payor added product or service lines.
The adjudication results which are presented at the header level rather than at the line-item or add-item levels.
Categorized monetary totals for the adjudication.
This 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.
A concept that may be defined by a formal reference to a terminology or ontology or may be provided by text.
A note that describes or explains adjudication results in a human readable form.
{ "resourceType": "ExplanationOfBenefit", "id": "EB3500", "text": { "status": "generated", "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ExplanationOfBenefit</div>" }, "identifier": [ { … } ], "status": "active", "type": { "coding": [ … ] }, "use": "claim", "patient": { "reference": "Patient/pat1" }, "created": "2014-08-16", "enterer": { "reference": "Practitioner/1" }, "insurer": { "reference": "Organization/3" }, "provider": { "reference": "Practitioner/1" }, "payee": { "type": { … }, "party": { … } }, "facility": { "reference": "Location/1" }, "claim": { "reference": "Claim/100150" }, "claimResponse": { "reference": "ClaimResponse/R3500" }, "outcome": "complete", "disposition": "Claim settled as per contract.", "careTeam": [ { … } ], "insurance": [ { … } ], "item": [ { … }, { … } ], "total": [ { … }, { … } ] }
curl -i -X DELETE \ 'https://docs.heydonto.com/_mock/apis/fhir/openapi/fhir/explanation-of-benefit/{id}' \ -H 'Authorization: Bearer <YOUR_JWT_HERE>'
{ "statusText": "OK", "status": 200 }
curl -i -X GET \ 'https://docs.heydonto.com/_mock/apis/fhir/openapi/fhir/explanation-of-benefit/{id}/history' \ -H 'Authorization: Bearer <YOUR_JWT_HERE>'
A list of entries representing historical versions of the resource.
{ "resourceType": "Bundle", "type": "history", "entry": [ { … } ], "total": 2 }