ExplanationOfBenefit
Introduction
Scope and Usage
The ExplanationOfBenefit (EOB) resource combines key information from a Claim, a ClaimResponse and optional Account information to inform a patient of the goods and services rendered by a provider and the settlement made under the patient's coverage in respect of that Claim. The ExplanationOfBenefit resource may also be used as a resource for data exchange for bulk data analysis, as the resource encompasses Claim, ClaimResponse and Coverage/Eligibility information.
This is the logical combination of the Claim, ClaimResponse and some Coverage accounting information in respect of a single payer prepared for consumption by the subscriber and/or patient. It is not simply a series of pointers to referred-to content models, is a physical subset scoped to the adjudication by a single payer which details the services rendered, the amounts to be settled and to whom, and optionally the coverage allowed under the policy and the amounts used to date.
Typically the EOB is only used to convey Claim (use=claim) and the associated ClaimResponse information to patients or subscribers. It may also be used to convey consolidated predetermination and preauthorization request and response information to patients or subscribers. An EOB will never be created for patient or subscriber information exchange if an error was detected in the Claim.
It is also recognized that "EOB" is a term that carries additional meaning in certain areas of the industry. When the resource was originally being developed there was substantial discussion about the adoption of an alternative name for the resource but after much discussion it was resolved that the ExplanationOfBenefit name has the advantage of familiarity that has been proven through the early adoption of the resource for multiple purposes.
Note: when creating profiles for EOB as a patient focused information exchange the payment details, other than date, should be excluded if the payee is the provider as that would leak business confidential information.
Note: the EOB SHALL NOT be used as a replacement for a ClaimResponse when responding to Claims. Only the ClaimResponse contains the appropriate adjudication information for a payer response to a Claim.
The ExplanationOfBenefit resource is an "event" resource from a FHIR workflow perspective - see Workflow Event.
Additional Information
Additional information regarding electronic claims content and usage may be found at:
- Financial Resource Status Lifecycle: how .status is used in the financial resources.
- Secondary Use of Resources: how resources such as Claim and ExplanationOfBenefit may used for reporting and data exchange for analytics, not just for eClaims exchange between providers and payers.
- Subrogation: how eClaims may handle patient insurance coverages when another insurer rather than the provider will settle the claim and potentially recover costs against specified coverages.
- Coordination of Benefit: how eClaims may handle multiple patient insurance coverages.
- RealTime Exchange and Obtaining EOBs: EOBs may be obtained using Polling or FHIR REST (SEARCH).
- Attachments and Supporting Information: how eClaims may handle the provision of supporting information, whether provided by content or reference, within the eClaim resource when submitted to the payer or later in a resource which refers to the subject eClaim resource. This also includes how payers may request additional supporting information from providers.
- 3-Tier Line Item Hierarchy: 3-tier hierarchy of Goods, products, and Services, to support simple to complex billing.
- Tax: Tax handling of Goods, products, and Services.
Boundaries and Relationships
The ExplanationOfBenefit resource is for reporting out to patients or transferring data to patient centered applications, such as patient health Record (PHR) application, the ExplanationOfBenefit should be used instead of the Claim and ClaimResponse resources as those resources may contain provider and payer specific information which is not appropriate for sharing with the patient.
When using the resources for reporting and transferring claims data, which may have originated in some standard other than FHIR, the Claim resource is useful if only the request side of the information exchange is of interest. If, however, both the request and the adjudication information is to be reported then the ExplanationOfBenefit should be used instead.
The Claim resource is used to request the adjudication and/or authorization of a set of healthcare-related goods and services for a patient against the patient's insurance coverages, or to request what the adjudication would be for a supplied set of goods or services should they be actually supplied to the patient.
When requesting whether the patient's coverage is inforce, whether it is valid at this or a specified date, or requesting the benefit details or preauthorization requirements associated with a coverage CoverageEligibilityRequest should be used instead.
The eClaim domain includes a number of related resources
| ExplanationOfBenefit | This resource combines the information from the Claim and the ClaimResponse, stripping out any provider or payer proprietary information, into a unified information model suitable for use for: patient reporting; transferring information to a Patient Health Record system; and, supporting complete claim and adjudication information exchange with regulatory and analytics organizations and other parts of the provider's organization. |
|---|---|
| Claim | A suite of goods and services and insurances coverages under which adjudication or authorization is requested. |
| ClaimResponse | A payer's adjudication and/or authorization response to the suite of services provided in a Claim. Typically the ClaimResponse references the Claim but does not duplicate the clinical or financial information provided in the claim. |
| CoverageEligibilityRequest | A request to a payer to: ascertain whether a coverage is in-force at the current or at a specified time; list the table of benefits; determine whether coverage is provided for specified categories or specific services; and whether preauthorization is required, and if so what supporting information would be required. |
Background and Context
Provides additional detail on exactly how the resource is to be used
Notes
Additional Information
The information presented in different backbone elements, such as .supportingInfo or .adjudication, has a different context based on the .category code presented in each, for example, adjudication occurrence may represent an amount paid by the patient while another may represent the amount paid to the provider.
Additionally, there are several places in the resource which point to other sections of the resource via the use of a .sequence number in the referred-to element and an ._element_Sequence in the referring element. Sequence numbers appear in such element as .careTeam referred to by .careTeamSequence, .diagnosis referred to by .diagnosisSequence, .procedure referred to by .procedureSequence, .supportingInfo referred to by .informationSequence and .item referred to by .itemSequence.
The .noteNumber element, which appears at the .item, .detail and .subDetail levels in the .item and .addItem structures, contains a list of numbers which match the value of the .number element in the .processNote structure. The process notes are indivdual chunks of text describing a situation associated with insurer explanation of adjudication results. Rather than repeating the same text in the adjudication of line item or detail, the insurer can provide the text once in the .processNote structure then include the associated number value in the list of .noteNumbers for each of the appropriate line items or details.
StructureDefinition
Elements (Simplified)
- ExplanationOfBenefit [0..*]: - Explanation of Benefit resource
- ExplanationOfBenefit.identifier [0..*]: Identifier Business Identifier for the resource
- ExplanationOfBenefit.traceNumber [0..*]: Identifier Number for tracking
- ExplanationOfBenefit.status [1..1]: code required:explanationofbenefit-status active | cancelled | draft | entered-in-error
- ExplanationOfBenefit.statusReason [0..1]: string Reason for status change
- ExplanationOfBenefit.type [1..1]: CodeableConcept extensible:claim-type Category or discipline
- ExplanationOfBenefit.subType [0..1]: CodeableConcept example:claim-subtype More granular claim type
- ExplanationOfBenefit.use [1..1]: code required:claim-use claim | preauthorization | predetermination
- ExplanationOfBenefit.subject [1..1]: [Reference(Patient](/Reference(Patient), Group)) The recipient(s) of the products and services
- ExplanationOfBenefit.billablePeriod [0..1]: Period Relevant time frame for the claim
- ExplanationOfBenefit.created [1..1]: dateTime Response creation date
- ExplanationOfBenefit.enterer [0..1]: [Reference(Practitioner](/Reference(Practitioner), PractitionerRole, Patient, RelatedPerson)) Author of the claim
- ExplanationOfBenefit.insurer [0..1]: Reference(Organization) Party responsible for reimbursement
- ExplanationOfBenefit.provider [0..1]: [Reference(Practitioner](/Reference(Practitioner), PractitionerRole, Organization)) Party responsible for the claim
- ExplanationOfBenefit.priority [0..1]: CodeableConcept preferred:process-priority Desired processing urgency
- ExplanationOfBenefit.fundsReserveRequested [0..1]: CodeableConcept preferred:fundsreserve For whom to reserve funds
- ExplanationOfBenefit.fundsReserve [0..1]: CodeableConcept preferred:fundsreserve Funds reserved status
- ExplanationOfBenefit.related [0..*]: BackboneElement Prior or corollary claims
- ExplanationOfBenefit.related.claim [0..1]: [Reference(Claim](/Reference(Claim), ExplanationOfBenefit)) Reference to the related claim
- ExplanationOfBenefit.related.relationship [0..1]: CodeableConcept example:related-claim-relationship How the reference claim is related
- ExplanationOfBenefit.related.reference [0..1]: Identifier File or case reference
- ExplanationOfBenefit.prescription [0..1]: [Reference(DeviceRequest](/Reference(DeviceRequest), MedicationRequest, ServiceRequest, VisionPrescription)) Prescription authorizing services or products
- ExplanationOfBenefit.originalPrescription [0..1]: [Reference(DeviceRequest](/Reference(DeviceRequest), MedicationRequest, ServiceRequest, VisionPrescription)) Original prescription if superceded by fulfiller
- ExplanationOfBenefit.event [0..*]: BackboneElement Event information
- ExplanationOfBenefit.event.type [1..1]: CodeableConcept example:datestype Specific event
- ExplanationOfBenefit.event.when[x] [1..1]: dateTime, Period Occurance date or period
- ExplanationOfBenefit.payee [0..1]: BackboneElement Recipient of benefits payable
- ExplanationOfBenefit.payee.type [0..1]: CodeableConcept example:payeetype Category of recipient
- ExplanationOfBenefit.payee.party [0..1]: [Reference(Practitioner](/Reference(Practitioner), PractitionerRole, Organization, Patient, RelatedPerson)) Recipient reference
- ExplanationOfBenefit.referral [0..1]: Reference(ServiceRequest) Treatment Referral
- ExplanationOfBenefit.encounter [0..*]: Reference(Encounter) Encounters associated with the listed treatments
- ExplanationOfBenefit.facility [0..1]: [Reference(Location](/Reference(Location), Organization)) Servicing Facility
- ExplanationOfBenefit.claim [0..1]: Reference(Claim) Claim reference
- ExplanationOfBenefit.claimResponse [0..1]: Reference(ClaimResponse) Claim response reference
- ExplanationOfBenefit.outcome [1..1]: code required:claim-outcome queued | complete | error | partial
- ExplanationOfBenefit.decision [0..1]: CodeableConcept preferred:claim-decision Result of the adjudication
- ExplanationOfBenefit.disposition [0..1]: string Disposition Message
- ExplanationOfBenefit.preAuthRef [0..*]: string Preauthorization reference
- ExplanationOfBenefit.preAuthRefPeriod [0..*]: Period Preauthorization in-effect period
- ExplanationOfBenefit.diagnosisRelatedGroup [0..1]: CodeableConcept example:ex-diagnosisrelatedgroup Package billing code
- ExplanationOfBenefit.careTeam [0..*]: BackboneElement Care Team members
- ExplanationOfBenefit.careTeam.sequence [1..1]: positiveInt Order of care team
- ExplanationOfBenefit.careTeam.provider [1..1]: [Reference(Practitioner](/Reference(Practitioner), PractitionerRole, Organization)) Practitioner or organization
- ExplanationOfBenefit.careTeam.role [0..1]: CodeableConcept preferred:claim-careteamrole Function within the team
- ExplanationOfBenefit.careTeam.specialty [0..1]: CodeableConcept example:provider-qualification Practitioner or provider specialization
- ExplanationOfBenefit.supportingInfo [0..*]: BackboneElement Supporting information
- ExplanationOfBenefit.supportingInfo.sequence [1..1]: positiveInt Information instance identifier
- ExplanationOfBenefit.supportingInfo.category [1..1]: CodeableConcept preferred:claim-informationcategory Classification of the supplied information
- Claim.supportingInfo.subCategory [0..1]: CodeableConcept Finer-grained classification of the supplied information
- ExplanationOfBenefit.supportingInfo.code [0..1]: CodeableConcept example:claim-exception Type of information
- ExplanationOfBenefit.supportingInfo.timing[x] [0..1]: dateTime, Period, Timing When it occurred
- ExplanationOfBenefit.supportingInfo.value[x] [0..1]: * Data to be provided
- ExplanationOfBenefit.supportingInfo.reason [0..1]: Coding example:missing-tooth-reason Explanation for the information
- ExplanationOfBenefit.diagnosis [0..*]: BackboneElement Pertinent diagnosis information
- ExplanationOfBenefit.diagnosis.sequence [1..1]: positiveInt Diagnosis instance identifier
- ExplanationOfBenefit.diagnosis.diagnosis[x] [1..1]: CodeableConcept, Reference(Condition) example:icd-10 Nature of illness or problem
- ExplanationOfBenefit.diagnosis.type [0..*]: CodeableConcept preferred:ex-diagnosistype Timing or nature of the diagnosis
- ExplanationOfBenefit.diagnosis.onAdmission [0..1]: CodeableConcept preferred:ex-diagnosis-on-admission Present on admission
- ExplanationOfBenefit.procedure [0..*]: BackboneElement Clinical procedures performed
- ExplanationOfBenefit.procedure.sequence [1..1]: positiveInt Procedure instance identifier
- ExplanationOfBenefit.procedure.type [0..*]: CodeableConcept preferred:ex-procedure-type Category of Procedure
- ExplanationOfBenefit.procedure.date [0..1]: dateTime When the procedure was performed
- ExplanationOfBenefit.procedure.procedure[x] [1..1]: CodeableConcept, Reference(Procedure) example:icd-10-procedures Specific clinical procedure
- ExplanationOfBenefit.procedure.udi [0..*]: Reference(Device) Unique device identifier
- ExplanationOfBenefit.precedence [0..1]: positiveInt Precedence (primary, secondary, etc.)
- ExplanationOfBenefit.insurance [0..*]: BackboneElement Patient insurance information
- ExplanationOfBenefit.insurance.focal [1..1]: boolean Coverage to be used for adjudication
- ExplanationOfBenefit.insurance.coverage [1..1]: Reference(Coverage) Insurance information
- ExplanationOfBenefit.insurance.preAuthRef [0..*]: string Prior authorization reference number
- ExplanationOfBenefit.accident [0..1]: BackboneElement Details of the event
- ExplanationOfBenefit.accident.date [0..1]: date When the incident occurred
- ExplanationOfBenefit.accident.type [0..1]: CodeableConcept extensible:v3-ActIncidentCode The nature of the accident
- ExplanationOfBenefit.accident.location[x] [0..1]: Address, Reference(Location) Where the event occurred
- ExplanationOfBenefit.patientPaid [0..1]: Money Paid by the patient
- ExplanationOfBenefit.item [0..*]: BackboneElement Product or service provided
- ExplanationOfBenefit.item.sequence [1..1]: positiveInt Item instance identifier
- ExplanationOfBenefit.item.careTeamSequence [0..*]: positiveInt Applicable care team members
- ExplanationOfBenefit.item.diagnosisSequence [0..*]: positiveInt Applicable diagnoses
- ExplanationOfBenefit.item.procedureSequence [0..*]: positiveInt Applicable procedures
- ExplanationOfBenefit.item.informationSequence [0..*]: positiveInt Applicable exception and supporting information
- ExplanationOfBenefit.item.traceNumber [0..*]: Identifier Number for tracking
- ExplanationOfBenefit.item.subject [0..1]: [Reference(Patient](/Reference(Patient), Group)) The recipient of the products and services
- ExplanationOfBenefit.item.revenue [0..1]: CodeableConcept example:ex-revenue-center Revenue or cost center code
- ExplanationOfBenefit.item.category [0..1]: CodeableConcept example:ex-benefitcategory Benefit classification
- ExplanationOfBenefit.item.productOrService [0..1]: CodeableConcept example:service-uscls Billing, service, product, or drug code
- ExplanationOfBenefit.item.productOrServiceEnd [0..1]: CodeableConcept example:service-uscls End of a range of codes
- ExplanationOfBenefit.item.request [0..*]: [Reference(DeviceRequest](/Reference(DeviceRequest), MedicationRequest, NutritionOrder, ServiceRequest, VisionPrescription)) Request or Referral for Service
- ExplanationOfBenefit.item.modifier [0..*]: CodeableConcept example:claim-modifiers Product or service billing modifiers
- ExplanationOfBenefit.item.programCode [0..*]: CodeableConcept example:ex-program-code Program the product or service is provided under
- ExplanationOfBenefit.item.serviced[x] [0..1]: date, Period Date or dates of service or product delivery
- ExplanationOfBenefit.item.location[x] [0..1]: CodeableConcept, Address, Reference(Location) example:service-place Place of service or where product was supplied
- ExplanationOfBenefit.item.patientPaid [0..1]: Money Paid by the patient
- ExplanationOfBenefit.item.quantity [0..1]: Quantity(SimpleQuantity) Count of products or services
- ExplanationOfBenefit.item.unitPrice [0..1]: Money Fee, charge or cost per item
- ExplanationOfBenefit.item.factor [0..1]: decimal Price scaling factor
- ExplanationOfBenefit.item.tax [0..1]: Money Total tax
- ExplanationOfBenefit.item.net [0..1]: Money Total item cost
- ExplanationOfBenefit.item.udi [0..*]: Reference(Device) Unique device identifier
- ExplanationOfBenefit.item.bodySite [0..*]: BackboneElement Anatomical location
- ExplanationOfBenefit.item.bodySite.site [1..*]: CodeableReference example:tooth Location
- ExplanationOfBenefit.item.bodySite.subSite [0..*]: CodeableConcept example:surface Sub-location
- ExplanationOfBenefit.item.encounter [0..*]: Reference(Encounter) Encounters associated with the listed treatments
- ExplanationOfBenefit.item.noteNumber [0..*]: positiveInt Applicable note numbers
- ExplanationOfBenefit.item.reviewOutcome [0..1]: BackboneElement Adjudication results
- ExplanationOfBenefit.item.reviewOutcome.decision [0..1]: CodeableConcept preferred:claim-decision Result of the adjudication
- ExplanationOfBenefit.item.reviewOutcome.reason [0..*]: CodeableConcept example:claim-decision-reason Reason for result of the adjudication
- ExplanationOfBenefit.item.reviewOutcome.preAuthRef [0..1]: string Preauthorization reference
- ExplanationOfBenefit.item.reviewOutcome.preAuthPeriod [0..1]: Period Preauthorization reference effective period
- ExplanationOfBenefit.item.adjudication [0..*]: BackboneElement Adjudication details
- ExplanationOfBenefit.item.adjudication.category [1..1]: CodeableConcept preferred:adjudication Type of adjudication information
- ExplanationOfBenefit.item.adjudication.reason [0..1]: CodeableConcept example:adjudication-reason Explanation of adjudication outcome
- ExplanationOfBenefit.item.adjudication.amount [0..1]: Money Monetary amount
- ExplanationOfBenefit.item.adjudication.quantity [0..1]: Quantity Non-monitary value
- ExplanationOfBenefit.item.adjudication.decisionDate [0..1]: dateTime When was adjudication performed
- ExplanationOfBenefit.item.detail [0..*]: BackboneElement Additional items
- ExplanationOfBenefit.item.detail.sequence [1..1]: positiveInt Product or service provided
- ExplanationOfBenefit.item.detail.traceNumber [0..*]: Identifier Number for tracking
- ExplanationOfBenefit.item.detail.revenue [0..1]: CodeableConcept example:ex-revenue-center Revenue or cost center code
- ExplanationOfBenefit.item.detail.category [0..1]: CodeableConcept example:ex-benefitcategory Benefit classification
- ExplanationOfBenefit.item.detail.productOrService [0..1]: CodeableConcept example:service-uscls Billing, service, product, or drug code
- ExplanationOfBenefit.item.detail.productOrServiceEnd [0..1]: CodeableConcept example:service-uscls End of a range of codes
- ExplanationOfBenefit.item.detail.modifier [0..*]: CodeableConcept example:claim-modifiers Service/Product billing modifiers
- ExplanationOfBenefit.item.detail.programCode [0..*]: CodeableConcept example:ex-program-code Program the product or service is provided under
- ExplanationOfBenefit.item.detail.patientPaid [0..1]: Money Paid by the patient
- ExplanationOfBenefit.item.detail.quantity [0..1]: Quantity(SimpleQuantity) Count of products or services
- ExplanationOfBenefit.item.detail.unitPrice [0..1]: Money Fee, charge or cost per item
- ExplanationOfBenefit.item.detail.factor [0..1]: decimal Price scaling factor
- ExplanationOfBenefit.item.detail.tax [0..1]: Money Total tax
- ExplanationOfBenefit.item.detail.net [0..1]: Money Total item cost
- ExplanationOfBenefit.item.detail.udi [0..*]: Reference(Device) Unique device identifier
- ExplanationOfBenefit.item.detail.noteNumber [0..*]: positiveInt Applicable note numbers
- ExplanationOfBenefit.item.detail.reviewOutcome [0..1]: - Detail level adjudication results
- ExplanationOfBenefit.item.detail.adjudication [0..*]: - Detail level adjudication details
- ExplanationOfBenefit.item.detail.subDetail [0..*]: BackboneElement Additional items
- ExplanationOfBenefit.item.detail.subDetail.sequence [1..1]: positiveInt Product or service provided
- ExplanationOfBenefit.item.detail.subDetail.traceNumber [0..*]: Identifier Number for tracking
- ExplanationOfBenefit.item.detail.subDetail.revenue [0..1]: CodeableConcept example:ex-revenue-center Revenue or cost center code
- ExplanationOfBenefit.item.detail.subDetail.category [0..1]: CodeableConcept example:ex-benefitcategory Benefit classification
- ExplanationOfBenefit.item.detail.subDetail.productOrService [0..1]: CodeableConcept example:service-uscls Billing, service, product, or drug code
- ExplanationOfBenefit.item.detail.subDetail.productOrServiceEnd [0..1]: CodeableConcept example:service-uscls End of a range of codes
- ExplanationOfBenefit.item.detail.subDetail.modifier [0..*]: CodeableConcept example:claim-modifiers Service/Product billing modifiers
- ExplanationOfBenefit.item.detail.subDetail.programCode [0..*]: CodeableConcept example:ex-program-code Program the product or service is provided under
- ExplanationOfBenefit.item.detail.subDetail.patientPaid [0..1]: Money Paid by the patient
- ExplanationOfBenefit.item.detail.subDetail.quantity [0..1]: Quantity(SimpleQuantity) Count of products or services
- ExplanationOfBenefit.item.detail.subDetail.unitPrice [0..1]: Money Fee, charge or cost per item
- ExplanationOfBenefit.item.detail.subDetail.factor [0..1]: decimal Price scaling factor
- ExplanationOfBenefit.item.detail.subDetail.tax [0..1]: Money Total tax
- ExplanationOfBenefit.item.detail.subDetail.net [0..1]: Money Total item cost
- ExplanationOfBenefit.item.detail.subDetail.udi [0..*]: Reference(Device) Unique device identifier
- ExplanationOfBenefit.item.detail.subDetail.noteNumber [0..*]: positiveInt Applicable note numbers
- ExplanationOfBenefit.item.detail.subDetail.reviewOutcome [0..1]: - Subdetail level adjudication results
- ExplanationOfBenefit.item.detail.subDetail.adjudication [0..*]: - Subdetail level adjudication details
- ExplanationOfBenefit.addItem [0..*]: BackboneElement Insurer added line items
- ExplanationOfBenefit.addItem.itemSequence [0..*]: positiveInt Item sequence number
- ExplanationOfBenefit.addItem.detailSequence [0..*]: positiveInt Detail sequence number
- ExplanationOfBenefit.addItem.subDetailSequence [0..*]: positiveInt Subdetail sequence number
- ExplanationOfBenefit.addItem.traceNumber [0..*]: Identifier Number for tracking
- ExplanationOfBenefit.addItem.subject [0..1]: [Reference(Patient](/Reference(Patient), Group)) The recipient of the products and services
- ExplanationOfBenefit.addItem.informationSequence [0..*]: positiveInt Applicable exception and supporting information
- ExplanationOfBenefit.addItem.provider [0..*]: [Reference(Practitioner](/Reference(Practitioner), PractitionerRole, Organization)) Authorized providers
- ExplanationOfBenefit.addItem.revenue [0..1]: CodeableConcept example:ex-revenue-center Revenue or cost center code
- ExplanationOfBenefit.addItem.category [0..1]: CodeableConcept example:ex-benefitcategory Benefit classification
- ExplanationOfBenefit.addItem.productOrService [0..1]: CodeableConcept example:service-uscls Billing, service, product, or drug code
- ExplanationOfBenefit.addItem.productOrServiceEnd [0..1]: CodeableConcept example:service-uscls End of a range of codes
- ExplanationOfBenefit.addItem.request [0..*]: [Reference(DeviceRequest](/Reference(DeviceRequest), MedicationRequest, NutritionOrder, ServiceRequest, VisionPrescription)) Request or Referral for Service
- ExplanationOfBenefit.addItem.modifier [0..*]: CodeableConcept example:claim-modifiers Service/Product billing modifiers
- ExplanationOfBenefit.addItem.programCode [0..*]: CodeableConcept example:ex-program-code Program the product or service is provided under
- ExplanationOfBenefit.addItem.serviced[x] [0..1]: date, Period Date or dates of service or product delivery
- ExplanationOfBenefit.addItem.location[x] [0..1]: CodeableConcept, Address, Reference(Location) example:service-place Place of service or where product was supplied
- ExplanationOfBenefit.addItem.patientPaid [0..1]: Money Paid by the patient
- ExplanationOfBenefit.addItem.quantity [0..1]: Quantity(SimpleQuantity) Count of products or services
- ExplanationOfBenefit.addItem.unitPrice [0..1]: Money Fee, charge or cost per item
- ExplanationOfBenefit.addItem.factor [0..1]: decimal Price scaling factor
- ExplanationOfBenefit.addItem.tax [0..1]: Money Total tax
- ExplanationOfBenefit.addItem.net [0..1]: Money Total item cost
- ExplanationOfBenefit.addItem.bodySite [0..*]: BackboneElement Anatomical location
- ExplanationOfBenefit.addItem.bodySite.site [1..*]: CodeableReference example:tooth Location
- ExplanationOfBenefit.addItem.bodySite.subSite [0..*]: CodeableConcept example:surface Sub-location
- ExplanationOfBenefit.addItem.noteNumber [0..*]: positiveInt Applicable note numbers
- ExplanationOfBenefit.addItem.reviewOutcome [0..1]: - Additem level adjudication results
- ExplanationOfBenefit.addItem.adjudication [0..*]: - Added items adjudication
- ExplanationOfBenefit.addItem.detail [0..*]: BackboneElement Insurer added line items
- ExplanationOfBenefit.addItem.detail.traceNumber [0..*]: Identifier Number for tracking
- ExplanationOfBenefit.addItem.detail.revenue [0..1]: CodeableConcept example:ex-revenue-center Revenue or cost center code
- ExplanationOfBenefit.addItem.detail.productOrService [0..1]: CodeableConcept example:service-uscls Billing, service, product, or drug code
- ExplanationOfBenefit.addItem.detail.productOrServiceEnd [0..1]: CodeableConcept example:service-uscls End of a range of codes
- ExplanationOfBenefit.addItem.detail.modifier [0..*]: CodeableConcept example:claim-modifiers Service/Product billing modifiers
- ExplanationOfBenefit.addItem.detail.patientPaid [0..1]: Money Paid by the patient
- ExplanationOfBenefit.addItem.detail.quantity [0..1]: Quantity(SimpleQuantity) Count of products or services
- ExplanationOfBenefit.addItem.detail.unitPrice [0..1]: Money Fee, charge or cost per item
- ExplanationOfBenefit.addItem.detail.factor [0..1]: decimal Price scaling factor
- ExplanationOfBenefit.addItem.detail.tax [0..1]: Money Total tax
- ExplanationOfBenefit.addItem.detail.net [0..1]: Money Total item cost
- ExplanationOfBenefit.addItem.detail.noteNumber [0..*]: positiveInt Applicable note numbers
- ExplanationOfBenefit.addItem.detail.reviewOutcome [0..1]: - Additem detail level adjudication results
- ExplanationOfBenefit.addItem.detail.adjudication [0..*]: - Added items adjudication
- ExplanationOfBenefit.addItem.detail.subDetail [0..*]: BackboneElement Insurer added line items
- ExplanationOfBenefit.addItem.detail.subDetail.traceNumber [0..*]: Identifier Number for tracking
- ExplanationOfBenefit.addItem.detail.subDetail.revenue [0..1]: CodeableConcept example:ex-revenue-center Revenue or cost center code
- ExplanationOfBenefit.addItem.detail.subDetail.productOrService [0..1]: CodeableConcept example:service-uscls Billing, service, product, or drug code
- ExplanationOfBenefit.addItem.detail.subDetail.productOrServiceEnd [0..1]: CodeableConcept example:service-uscls End of a range of codes
- ExplanationOfBenefit.addItem.detail.subDetail.modifier [0..*]: CodeableConcept example:claim-modifiers Service/Product billing modifiers
- ExplanationOfBenefit.addItem.detail.subDetail.patientPaid [0..1]: Money Paid by the patient
- ExplanationOfBenefit.addItem.detail.subDetail.quantity [0..1]: Quantity(SimpleQuantity) Count of products or services
- ExplanationOfBenefit.addItem.detail.subDetail.unitPrice [0..1]: Money Fee, charge or cost per item
- ExplanationOfBenefit.addItem.detail.subDetail.factor [0..1]: decimal Price scaling factor
- ExplanationOfBenefit.addItem.detail.subDetail.tax [0..1]: Money Total tax
- ExplanationOfBenefit.addItem.detail.subDetail.net [0..1]: Money Total item cost
- ExplanationOfBenefit.addItem.detail.subDetail.noteNumber [0..*]: positiveInt Applicable note numbers
- ExplanationOfBenefit.addItem.detail.subDetail.reviewOutcome [0..1]: - Additem subdetail level adjudication results
- ExplanationOfBenefit.addItem.detail.subDetail.adjudication [0..*]: - Added items adjudication
- ExplanationOfBenefit.adjudication [0..*]: - Header-level adjudication
- ExplanationOfBenefit.total [0..*]: BackboneElement Adjudication totals
- ExplanationOfBenefit.total.category [1..1]: CodeableConcept example:adjudication Type of adjudication information
- ExplanationOfBenefit.total.amount [1..1]: Money Financial total for the category
- ExplanationOfBenefit.payment [0..1]: BackboneElement Payment Details
- ExplanationOfBenefit.payment.type [0..1]: CodeableConcept preferred:ex-paymenttype Partial or complete payment
- ExplanationOfBenefit.payment.adjustment [0..1]: Money Payment adjustment for non-claim issues
- ExplanationOfBenefit.payment.adjustmentReason [0..1]: CodeableConcept preferred:payment-adjustment-reason Explanation for the variance
- ExplanationOfBenefit.payment.date [0..1]: date Expected date of payment
- ExplanationOfBenefit.payment.amount [0..1]: Money Payable amount after adjustment
- ExplanationOfBenefit.payment.identifier [0..1]: Identifier Business identifier for the payment
- ExplanationOfBenefit.formCode [0..1]: CodeableConcept example:forms Printed form identifier
- ExplanationOfBenefit.form [0..1]: Attachment Printed reference or actual form
- ExplanationOfBenefit.processNote [0..*]: BackboneElement Note concerning adjudication
- ExplanationOfBenefit.processNote.class [0..1]: CodeableConcept Business kind of note
- ExplanationOfBenefit.processNote.number [0..1]: positiveInt Note instance identifier
- ExplanationOfBenefit.processNote.type [0..1]: CodeableConcept extensible:note-type Note purpose
- ExplanationOfBenefit.processNote.text [0..1]: markdown Note explanatory text
- ExplanationOfBenefit.processNote.language [0..1]: CodeableConcept required:all-languages Language of the text
- ExplanationOfBenefit.benefitPeriod [0..1]: Period When the benefits are applicable
- ExplanationOfBenefit.benefitBalance [0..*]: BackboneElement Balance by Benefit Category
- ExplanationOfBenefit.benefitBalance.category [1..1]: CodeableConcept example:ex-benefitcategory Benefit classification
- ExplanationOfBenefit.benefitBalance.excluded [0..1]: boolean Excluded from the plan
- ExplanationOfBenefit.benefitBalance.name [0..1]: string Short name for the benefit
- ExplanationOfBenefit.benefitBalance.description [0..1]: string Description of the benefit or services covered
- ExplanationOfBenefit.benefitBalance.network [0..1]: CodeableConcept example:benefit-network In or out of network
- ExplanationOfBenefit.benefitBalance.unit [0..1]: CodeableConcept example:benefit-unit Individual or family
- ExplanationOfBenefit.benefitBalance.term [0..1]: CodeableConcept example:benefit-term Annual or lifetime
- ExplanationOfBenefit.benefitBalance.financial [0..*]: BackboneElement Benefit Summary
- ExplanationOfBenefit.benefitBalance.financial.type [1..1]: CodeableConcept example:benefit-type Benefit classification
- ExplanationOfBenefit.benefitBalance.financial.allowed[x] [0..1]: unsignedInt, string, Money Benefits allowed
- ExplanationOfBenefit.benefitBalance.financial.used[x] [0..1]: unsignedInt, Money Benefits used
- ClaimResponse.error [0..*]: BackboneElement Processing errors
- ClaimResponse.error.itemSequence [0..1]: positiveInt Item sequence number
- ClaimResponse.error.detailSequence [0..1]: positiveInt Detail sequence number
- ClaimResponse.error.subDetailSequence [0..1]: positiveInt Subdetail sequence number
- ClaimResponse.error.code [1..1]: CodeableConcept example:adjudication-error Error code detailing processing issues
- ExplanationOfBenefit.error.expression [0..*]: string FHIRPath of element(s) related to issue
Mappings
- ExplanationOfBenefit Mappings — 32 mapping entries
Resource Packs
list-ExplanationOfBenefit-packs.xml
<?xml version="1.0" encoding="UTF-8"?>
<List xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../publish/List.xsd">
<id value="ExplanationOfBenefit-packs"/>
<status value="current"/>
<mode value="working"/>
</List>
Search Parameters
- care-team — reference — Member of the CareTeam —
ExplanationOfBenefit.careTeam.provider - claim — reference — The reference to the claim —
ExplanationOfBenefit.claim - coverage — reference — The plan under which the claim was adjudicated —
ExplanationOfBenefit.insurance.coverage - created — date — The creation date for the EOB —
ExplanationOfBenefit.created - detail-udi — reference — UDI associated with a line item detail product or service —
ExplanationOfBenefit.item.detail.udi - disposition — string — The contents of the disposition message —
ExplanationOfBenefit.disposition - encounter — reference — Encounters associated with a billed line item —
ExplanationOfBenefit.item.encounter - enterer — reference — The party responsible for the entry of the Claim —
ExplanationOfBenefit.enterer - facility — reference — Facility responsible for the goods and services —
ExplanationOfBenefit.facility - group — reference — The reference to the group —
ExplanationOfBenefit.subject.where(resolve() is Group) | ExplanationOfBenefit.item.subject.where(resolve() is Group) | ExplanationOfBenefit.addItem.subject.where(resolve() is Group) - identifier — token — The business identifier of the Explanation of Benefit —
ExplanationOfBenefit.identifier - item-udi — reference — UDI associated with a line item product or service —
ExplanationOfBenefit.item.udi - patient — reference — The reference to the patient —
ExplanationOfBenefit.subject.where(resolve() is Patient) | ExplanationOfBenefit.item.subject.where(resolve() is Patient) | ExplanationOfBenefit.addItem.subject.where(resolve() is Patient) - payee — reference — The party receiving any payment for the Claim —
ExplanationOfBenefit.payee.party - subject — reference — Subject receiving the products or services —
ExplanationOfBenefit.subject | ExplanationOfBenefit.item.subject | ExplanationOfBenefit.addItem.subject - procedure-udi — reference — UDI associated with a procedure —
ExplanationOfBenefit.procedure.udi - provider — reference — The reference to the provider —
ExplanationOfBenefit.provider - status — token — Status of the instance —
ExplanationOfBenefit.status - subdetail-udi — reference — UDI associated with a line item detail subdetail product or service —
ExplanationOfBenefit.item.detail.subDetail.udi
Examples
- EB3500 — explanationofbenefit-example — General Person Primary Coverage EOB Example
- EB3501 — explanationofbenefit-example-2 — EOB for an Claim that had errors
- explanationofbenefit-example — explanationofbenefit-example
- explanationofbenefit-example-2 — explanationofbenefit-example-2
- explanationofbenefit-examples-header — explanationofbenefit-examples-header
Mapping Exceptions
explanationofbenefit-event-mapping-exceptions.xml
Divergent Elements
- Event.identifier → ExplanationOfBenefit.identifier
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Business identifier for explanation of benefit | resource=Business Identifier for the resource
- definitionUnmatched | reason=Unknown | pattern=Business identifiers assigned to this explanation of benefit by the performer and/or other systems. These identifiers remain constant as the resource is updated and propagates from server to server. | resource=A unique identifier assigned to this explanation of benefit.
- commentsUnmatched | reason=Unknown | pattern=Note: This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.
- requirementsUnmatched | reason=Unknown | pattern=Allows identification of the explanation of benefit as it is known by various participating systems and in a way that remains consistent across servers. | resource=Allows EOBs to be distinguished and referenced.
- Event.status → ExplanationOfBenefit.status
- shortUnmatched | reason=Unknown | pattern=preparation | in-progress | not-done | suspended | aborted | completed | entered-in-error | unknown | resource=active | cancelled | draft | entered-in-error
- definitionUnmatched | reason=Unknown | pattern=The current state of the explanation of benefit. | resource=The status of the resource instance.
- commentsUnmatched | reason=Unknown | pattern=A nominal state-transition diagram can be found in the (Event pattern documentation
Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. | resource=This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
- Event.code → ExplanationOfBenefit.type
- bindingStrength | reason=Unknown | pattern=example
- shortUnmatched | reason=Unknown | pattern=What service was done | resource=Category or discipline
- definitionUnmatched | reason=Unknown | pattern=A code that identifies the specific service or action that was or is being performed. | resource=The category of claim, e.g. oral, pharmacy, vision, institutional, professional.
- Event.subject → ExplanationOfBenefit.subject
- shortUnmatched | reason=Unknown | pattern=Individual service was done for/to | resource=The recipient(s) of the products and services
- definitionUnmatched | reason=Unknown | pattern=The individual or set of individuals the action is being or was performed on. | resource=The party/group to whom the professional services and/or products have been supplied or are being considered and for whom actual for forecast reimbursement is sought.
- requirementsUnmatched | reason=Unknown | pattern=Links the explanation of benefit to the Patient context. May also affect access control. | resource=The patient must be supplied to the insurer so that confirmation of coverage and service history may be considered as part of the authorization and/or adjudiction.
- Event.occurrence[x] → ExplanationOfBenefit.created
- missingTypes | reason=Unknown | pattern=Period, Timing
- shortUnmatched | reason=Unknown | pattern=When explanation of benefit occurred/is occurring | resource=Response creation date
- definitionUnmatched | reason=Unknown | pattern=The date, period or timing when the explanation of benefit did occur or is occurring. | resource=The date this resource was created.
- commentsUnmatched | reason=Unknown | pattern=This indicates when the activity actually occurred or is occurring, not when it was asked/requested/ordered to occur. For the latter, look at the occurence element of the Request this {{event}} is "basedOn". The status code allows differentiation of whether the timing reflects a historic event or an ongoing event. Ongoing events should not include an upper bound in the Period or Timing.bounds. .
Unmapped Elements
- Event.partOf — Unknown
- Event.reported — Unknown
- Event.reason — Unknown
- Event.relevantHistory — Unknown
- Event.location — Unknown
- Event.statusReason — Unknown
- Event.performer.actor — Unknown
- Event.performer.function — Unknown
- Event.note — Unknown
- Event.category — Unknown
- Event.encounter — Unknown
- Event.recorded — Unknown
- Event.product — Unknown
- Event.performer — Unknown
- Event.researchStudy — Unknown
explanationofbenefit-fivews-mapping-exceptions.xml
Unmapped Elements
- FiveWs.what — Unknown
- FiveWs.version — Unknown
- FiveWs.witness — Unknown
- FiveWs.context — Unknown
- FiveWs.init — Unknown
- FiveWs.who — Unknown
- FiveWs.grade — Unknown
- FiveWs.planned — Unknown