Coverage is a 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
Coverage is directly represented in patient access APIs as a FHIR Resource. You can make HTTP
requests to to search for and find Coverage belonging to a particular patient. Patients authorize your
app to access their Coverage via Flexpa API. At the end of that flow you'll have: Flexpa Link
- An access token that is required for all requests to Flexpa API
- A patient ID that is required to query FHIR resources directly related to the patient
Searching for a patient's Coverage
Searches on follow the RESTful style of the FHIR specification by submitting a GET HTTP request to the base URL of the resource.
To search for coverage belonging to a particular patient, you can use an API Flexpa APIwildcard parameter:
$PATIENT_ID. Flexpa swaps this out for the real patient ID before we send the request to the right FHIR API.
You can retrieve the patient ID by either:
curl "https://api.flexpa.com/fhir/Coverage?patient=$PATIENT_ID" \
-H "Authorization: $ACCESS_TOKEN"
The return type of querying the coverage endpoint is a searchset
bundle. Technically, a searchset bundle may contain different types of resources
(e.g., EOB, Patient) in the
entry field. When iterating through
entry it is best practice to inspect each
to ensure you are dealing with the expected resource.
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
entry[i].status - A string representing the status of the Coverage, can have a value of
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 date
entry[i].identifier - (optional) The primary identifier of the insured and the Coverage. May contain the insured's member ID, group ID, etc.