ExplanationOfBenefit

FHIR resource from the Financial Management module, the benefit statement.

Definition

The EOB synthesises the reimbursement request and its adjudication into a patient-friendly format, excluding proprietary payer information. Where Claim carries the provider's request for reimbursement, the EOB serves benefit transparency and data exchange for analytics and regulatory reporting (e.g. CARIN Blue Button profiles).

Origin

Defined in the HL7 FHIR specification (R4/R5), Financial Management module, maturity FMM level 2 (Trial Use), published by HL7 International.

Example in context

<ExplanationOfBenefit><status value="active"/><patient><reference value="Patient/123"/></patient><claim><reference value="Claim/c1"/></claim></ExplanationOfBenefit>

Related terms

• FHIR Coverage — referenced financial coverage.