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Explanation of Benefit - search

Updated on October 19, 2021

Explanation of benefit search API takes ID (Patient ID), Claim ID and Created as the parameter to provide policy details.

Pega Foundation for Healthcare

Below are key rules:

URL format



Key rules

Rule NameRule TypeUsage

Class: Int-Fhir401-ExplanationOfBenefitAPI

explanationofbenefitf74ff796469fe6c8d5e36 76e4411d79cService REST
GetExplanationOfBenefitReadActivityMethod in REST service to get details related to explanation of benefit.
MapFromExplanationOfBenefitData TransformMap results from PFHC Policy to API Integration object
Pre_MapFromEOB_EXTData TransformPre mapping data transform
Post_MapFromEOB_EXTData TransformPost mapping data transform

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