Explanation of Benefit - search
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
https://[hostname:port]/prweb/api/fhirapi/v1/ExplanationOfBenefit
Parameters
Key rules
| Rule Name | Rule Type | Usage |
Class: Int-Fhir401-ExplanationOfBenefitAPI | ||
| explanationofbenefitf74ff796469fe6c8d5e36 76e4411d79c | Service REST | |
| GetExplanationOfBenefitRead | Activity | Method in REST service to get details related to explanation of benefit. |
| MapFromExplanationOfBenefit | Data Transform | Map results from PFHC Policy to API Integration object |
| Pre_MapFromEOB_EXT | Data Transform | Pre mapping data transform |
| Post_MapFromEOB_EXT | Data Transform | Post mapping data transform |
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