openapi: 3.2.0 info: title: Patient Access Explanation Of Benefit API description: Patient Access Endpoints for FHIR Resources version: '1.0' servers: - url: https://dev-int-api-gw.centene.com/fhir/v4/patientaccess tags: - name: ExplanationOfBenefit paths: /ExplanationOfBenefit: get: tags: - ExplanationOfBenefit summary: Search all resources of type ExplanationOfBenefit based on a set of criteria operationId: searchExplanationOfBenefit parameters: - name: service-date in: query schema: type: string format: date - name: patient in: query description: The reference to the patient schema: type: string - name: _id in: query description: The ID of the resource schema: type: string - name: type in: query schema: type: string - name: _lastUpdated in: query schema: type: string - name: identifier in: query description: The business identifier of the Explanation of Benefit schema: type: string - name: service-start-date in: query description: Starting Date of the service for the EOB. The service-start-date search parameter simplifies search, since a client doesn't need to know that for inpatient and outpatient institutional EOB dates they need to search by billablePeriod.start, for a pharmacy EOB by item.servicedDate, for a professional and non-clinician EOB - by item.servicedPeriod.start and for an oral EOB - by item.servicedPeriod.start. schema: type: string format: date - name: billable-period-start description: Starting Date of the service for the EOB using billablePeriod.period.start. The billable-period-start search parameter using the billablePeriod.period.start provides results with the earliest billablePeriod.start from a professional and non-clinician EOB or an oral EOB. in: query schema: type: string format: date - name: _include in: query schema: type: string x-consoleDefault: application/json x-consoleDefault: application/json - name: _page in: query schema: type: number responses: '200': description: Success content: '*/*': schema: $ref: '#/components/schemas/ExplanationOfBenefit-search' '400': description: Bad request content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: invalid details: text: Invalid or badly formed ExplanationOfBenefit ID . '401': description: Unauthorized content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Unauthorized details: text: You are not authorized to view this ExplanationOfBenefit. '403': description: Forbidden content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: forbidden details: text: You are not allowed to view this ExplanationOfBenefit. '404': description: Not Found content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Not Found details: text: No ExplanationOfBenefit found with the provided ID. '500': description: InternalServerError content: '*/*': example: resourceType: OperationOutcome issue: severity: fatal code: exception details: text: Internal server error. Please try again later '429': description: Too Many Requests content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Too Many Requests details: text: Too Many Requests for Explanation of benefit with the provided ID. '501': description: Not Implemented content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Not Implemented details: text: The request for Explanation of benefit is Not Implemented '502': description: Bad gateway content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Bad gateway details: text: Bad gateway '503': description: Service Unavailable content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Service Unavailable details: text: Service Unavailable '504': description: Gateway Timeout content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Gateway Timeout details: text: Gateway Timeout security: - Bearer: [] /ExplanationOfBenefit/{id}: get: tags: - ExplanationOfBenefit summary: Read the current state of the resource operationId: readExplanationOfBenefit parameters: - name: id in: path required: true schema: type: string - name: _page in: query schema: type: number responses: '200': description: Success content: '*/*': schema: $ref: '#/components/schemas/ExplanationOfBenefit' '400': description: Bad request content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: invalid details: text: Invalid or badly formed ExplanationOfBenefit ID . '401': description: Unauthorized content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Unauthorized details: text: You are not authorized to view this ExplanationOfBenefit. '403': description: Forbidden content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: forbidden details: text: You are not allowed to view this ExplanationOfBenefit. '404': description: Not Found content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Not Found details: text: No ExplanationOfBenefit found with the provided ID. '500': description: InternalServerError content: '*/*': example: resourceType: OperationOutcome issue: severity: fatal code: exception details: text: Internal server error. Please try again later '429': description: Too Many Requests content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Too Many Requests details: text: Too Many Requests for explanation of benefit with the provided ID. '501': description: Not Implemented content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Not Implemented details: text: The request for explanation of benefit is Not Implemented '502': description: Bad gateway content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Bad gateway details: text: Bad gateway '503': description: Service Unavailable content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Service Unavailable details: text: Service Unavailable '504': description: Gateway Timeout content: '*/*': example: resourceType: OperationOutcome issue: severity: error code: Gateway Timeout details: text: Gateway Timeout security: - Bearer: [] components: schemas: ExplanationOfBenefit: required: - adjudication - billablePeriod - created - diagnosis - id - identifier - insurance - insurer - language - meta - outcome - patient - provider - resourceType - status - subType - supportingInfo - text - total - type - use type: object properties: resourceType: minLength: 1 type: string id: minLength: 1 type: string meta: required: - lastUpdated - profile type: object properties: lastUpdated: minLength: 1 type: string profile: type: array items: type: object properties: {} language: minLength: 1 type: string text: required: - div - status type: object properties: status: minLength: 1 type: string div: minLength: 1 type: string identifier: minItems: 1 uniqueItems: true type: array items: required: - system - value type: object properties: type: required: - coding type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string system: minLength: 1 type: string value: minLength: 1 type: string status: minLength: 1 type: string type: required: - coding - text type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string text: minLength: 1 type: string subType: required: - coding - text type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string text: minLength: 1 type: string use: minLength: 1 type: string patient: required: - reference type: object properties: reference: minLength: 1 type: string billablePeriod: required: - end - start type: object properties: start: minLength: 1 type: string end: minLength: 1 type: string created: minLength: 1 type: string insurer: required: - display - reference type: object properties: reference: minLength: 1 type: string display: minLength: 1 type: string provider: required: - display - reference type: object properties: reference: minLength: 1 type: string display: minLength: 1 type: string outcome: minLength: 1 type: string supportingInfo: minItems: 1 uniqueItems: true type: array items: required: - sequence type: object properties: sequence: type: number category: required: - coding type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string timingPeriod: required: - end - start type: object properties: start: minLength: 1 type: string end: minLength: 1 type: string diagnosis: minItems: 1 uniqueItems: true type: array items: required: - sequence type: object properties: sequence: type: number diagnosisCodeableConcept: required: - coding type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string type: minItems: 1 uniqueItems: true type: array items: type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string insurance: minItems: 1 uniqueItems: true type: array items: required: - focal type: object properties: focal: type: boolean coverage: required: - reference type: object properties: reference: minLength: 1 type: string adjudication: minItems: 1 uniqueItems: true type: array items: type: object properties: category: required: - coding - text type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string text: minLength: 1 type: string amount: required: - currency - value type: object properties: value: type: number currency: minLength: 1 type: string total: minItems: 1 uniqueItems: true type: array items: type: object properties: category: required: - coding - text type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string text: minLength: 1 type: string amount: required: - currency - value type: object properties: value: type: number currency: minLength: 1 type: string description: '' ExplanationOfBenefit-search: required: - entry - id - link - meta - resourceType - total - type type: object properties: resourceType: minLength: 1 type: string id: minLength: 1 type: string meta: required: - lastUpdated type: object properties: lastUpdated: minLength: 1 type: string type: minLength: 1 type: string total: type: number link: minItems: 1 uniqueItems: true type: array items: required: - relation - url type: object properties: relation: minLength: 1 type: string url: minLength: 1 type: string entry: minItems: 1 uniqueItems: true type: array items: required: - fullUrl type: object properties: fullUrl: minLength: 1 type: string resource: required: - adjudication - billablePeriod - created - diagnosis - id - identifier - insurance - insurer - language - meta - outcome - patient - provider - resourceType - status - subType - supportingInfo - text - total - type - use type: object properties: resourceType: minLength: 1 type: string id: minLength: 1 type: string meta: required: - lastUpdated - profile type: object properties: lastUpdated: minLength: 1 type: string profile: type: array items: type: object properties: {} language: minLength: 1 type: string text: required: - div - status type: object properties: status: minLength: 1 type: string div: minLength: 1 type: string identifier: minItems: 1 uniqueItems: true type: array items: required: - system - value type: object properties: type: required: - coding type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string system: minLength: 1 type: string value: minLength: 1 type: string status: minLength: 1 type: string type: required: - coding - text type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string text: minLength: 1 type: string subType: required: - coding - text type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string text: minLength: 1 type: string use: minLength: 1 type: string patient: required: - reference type: object properties: reference: minLength: 1 type: string billablePeriod: required: - end - start type: object properties: start: minLength: 1 type: string end: minLength: 1 type: string created: minLength: 1 type: string insurer: required: - display - reference type: object properties: reference: minLength: 1 type: string display: minLength: 1 type: string provider: required: - display - reference type: object properties: reference: minLength: 1 type: string display: minLength: 1 type: string outcome: minLength: 1 type: string supportingInfo: minItems: 1 uniqueItems: true type: array items: required: - sequence type: object properties: sequence: type: number category: required: - coding type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string timingPeriod: required: - end - start type: object properties: start: minLength: 1 type: string end: minLength: 1 type: string diagnosis: minItems: 1 uniqueItems: true type: array items: required: - sequence type: object properties: sequence: type: number diagnosisCodeableConcept: required: - coding type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string type: minItems: 1 uniqueItems: true type: array items: type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string insurance: minItems: 1 uniqueItems: true type: array items: required: - focal type: object properties: focal: type: boolean coverage: required: - reference type: object properties: reference: minLength: 1 type: string adjudication: minItems: 1 uniqueItems: true type: array items: type: object properties: category: required: - coding - text type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string text: minLength: 1 type: string amount: required: - currency - value type: object properties: value: type: number currency: minLength: 1 type: string total: minItems: 1 uniqueItems: true type: array items: type: object properties: category: required: - coding - text type: object properties: coding: minItems: 1 uniqueItems: true type: array items: required: - code - system type: object properties: system: minLength: 1 type: string code: minLength: 1 type: string text: minLength: 1 type: string amount: required: - currency - value type: object properties: value: type: number currency: minLength: 1 type: string description: '' securitySchemes: Bearer: type: http scheme: bearer