ExplanationOfBenefit

Explanation of Benefit resource.

This resource provides: the claim details; adjudication details from the processing of a Claim; and optionally account balance information, for informing the subscriber of the benefits provided.

Details of an accident.

Insurer added line items.

Balance by Benefit Category.

Period for charge submission.

Care Team members.

Claim reference.

Claim response reference.

Creation date.

List of Diagnosis.

Disposition Message.

Period unable to work.

Author.

Servicing Facility.

Printed Form Identifier.

Period in hospital.

Business Identifier.

Exceptions, special considerations, the condition, situation, prior or concurrent issues.

Insurance or medical plan.

Insurer responsible for the EOB.

Goods and Services.

Responsible organization for the claim.

Original prescription if superceded by fulfiller.

complete | error | partial.

The subject of the Products and Services.

Party to be paid any benefits payable.

Payment (if paid).

Precedence (primary, secondary, etc.).

Prescription authorizing services or products.

Procedures performed.

Processing notes.

Responsible provider for the claim.

Treatment Referral.

Related Claims which may be revelant to processing this claim.

The status of the resource instance.

Finer grained claim type information.

Total benefit payable for the Claim.

Total Cost of service from the Claim.

Type or discipline.

Unallocated deductable.

Unallocated deductable.

Undocumented