Coverage
GET https://api.flexpa.com/fhir/Coverage
Coverage is a financial FHIR Resource that describes the financial terms of a specific health insurance plan for a specific person.
Accessing a patient's coverage can aid in workflows such as:
- Recommending services based on costs, co-pays, or features of a specific health plan
- Validating that a patient has an active health plan
- Retrieving information commonly found on an health insurance card such as Member ID and Group ID
As a core financial resource, almost all payers make this available. However, this resource typically does not provide a more detailed view of a patient's eligibility or accumulators.
Search parameters
The full list of search parameters can be found here. Some of the most important are:
Parameters
- patient
- string
The ID of the patient for whom the coverage is or was active. We recommend using this search parameter along with the $PATIENT_ID wildcard
Sample request
While some servers may support a resource-level search without any parameters, not all do. We recommend using the format below with the patient ID via the $PATIENT_ID wildcard as a search parameter.
This is a sample request using curl
ACCESS_TOKEN=flexpa-link-access-token
curl "https://api.flexpa.com/fhir/Coverage?patient=$PATIENT_ID" \
-H "Authorization: Bearer $ACCESS_TOKEN"
Sample response
This is a sample response from Humana using Flexpa API in test mode
Notable fields
A Coverage response contains many fields. You can get an exhaustive list and explanation of each field here.
Some notable fields:
entry - A collection of Coverages (see response type on best practice of checking resourceType)entry[i].status - A string representing the status of the Coverage, can have a value of "active", "cancelled", "draft", "entered-in-error"entry[i].type - An object describing the Coverage category (e.g., drug policy, dental policy, automobile injury policy)entry[i].period - A period datatype describing the Coverage's start and end dateentry[i].identifier - (optional) The primary identifier of the insured and the Coverage. May contain the insured's member ID, group ID, etc.