xCaliber healthCare Data Mesh

ExplanationOfBenefit-GET

Description

Retrieves detailed information on insurance claims, enabling healthcare developers to access and display real-time data regarding the financial details and coverage outcomes associated with specific patient encounters for streamlined reimbursement tracking within clinical workflows.

Use Cases

  • Retrieve Claim Details: Obtain information on a specific claim
  • Access Reimbursement Data: Retrieve reimbursement details
  • Query Adjudication Results: Obtain results of claim adjudication
  • Review Benefit Explanations: Access explanations for benefits
  • Examine Payment Information: Retrieve payment details for a claim

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Athena
Elation
Canvas
cURL
JavaScript
Java
Python
Source Specific Details
EHRAPIsmandatory filtersoptional filters
Athena
  • ${url}/v1/${practiceId}/patients/${patient}/referralauths
  • patient
  • include
  • _count
  • _offset
  • insurance-id
Filters
FilterNameDescriptionDefault ValueAllowed Values
_countPagination params
_offsetPagination params. Athena: Starting point of entries; 0-indexed
departmentIdIdentifier for the department
includeList of fields which needed to be shown in result
insuranceIdThe insurance ID.
patientPatient reference for any fhir resource
practitionerPractitioner reference for the any fhir resource
quorumsets sync/async modetrue
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