Understand how SAFHIR uses the CPCDS layouts to create ExplanationOfBenefit FHIR profiles from a Payer's claim data.

I don’t see ExplanationOfBenefit (EOB) profiles in the Data Ingestion Guides. How do we generate EOBs in the FHIR API?

The Claims Data Ingestion Guide captures the necessary information. EOBs are logically a customer representation of a Claim, Claim Response and Eligibility. All of the necessary data required by the CARIN Blue Button Implementation Guide (CARIN BB IG) is defined by the Common Payer Consumer Data Set (CPCDS) specification in the IG. The Claims Data Ingestion Guide provides the flat file specifications for Member, Coverage and Claims that enable EOBs to be generated in FHIR format.

Tags: safhir faq fhir