Cigna

Cigna ExplanationOfBenefit API

The ExplanationOfBenefit API from Cigna — 1 operation(s) for explanationofbenefit.

GitHub OpenAPI

Operations 1

GET /ExplanationOfBenefit Retrieve EOB claims data for the authenticated member #

Documentation

📖
Documentation
https://developer.cigna.com/docs/service-apis/patient-access/implementation-guide
📖
Documentation
https://developer.cigna.com/docs/service-apis/provider-directory/implementation-guide
📖
Documentation
https://developer.cigna.com/docs/service-apis

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/cigna/refs/heads/main/openapi/cigna-explanationofbenefit-api-openapi.yml

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OpenAPI Specification

cigna-explanationofbenefit-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: Cigna Patient Access Explanation Of Benefit API
  description: FHIR R4 API exposing Cigna member health information including coverage, claims, encounters, observations, conditions, medications, and immunizations for authorized third-party applications acting on behalf of a member. Implements the HL7 Da Vinci PDex implementation guide and the CMS Interoperability and Patient Access final rule (CMS-9115-F).
  version: '1.0'
  contact:
    name: Cigna Developer Support
    url: https://developer.cigna.com/support
servers:
- url: https://fhir.cigna.com/PatientAccess/v1
  description: Cigna Patient Access Production
- url: https://fhir.cigna.com/PatientAccess/v1-devportal
  description: Developer Sandbox
security:
- smartOnFhir: []
tags:
- name: ExplanationOfBenefit
paths:
  /ExplanationOfBenefit:
    get:
      operationId: searchExplanationOfBenefit
      summary: Retrieve EOB claims data for the authenticated member
      tags:
      - ExplanationOfBenefit
      parameters:
      - name: patient
        in: query
        schema:
          type: string
      responses:
        '200':
          description: FHIR Bundle of ExplanationOfBenefit resources
components:
  securitySchemes:
    smartOnFhir:
      type: oauth2
      description: SMART on FHIR authorization with patient-context launch
      flows:
        authorizationCode:
          authorizationUrl: https://r-hi2.cigna.com/mga/sps/oauth/oauth20/authorize
          tokenUrl: https://r-hi2.cigna.com/mga/sps/oauth/oauth20/token
          scopes:
            patient/*.read: Read all patient-context FHIR resources
            launch/patient: Launch in patient context
            offline_access: Receive a refresh token
            openid: Receive an OpenID Connect identity token
            fhirUser: Receive the user resource identifier
externalDocs:
  description: Patient Access Implementation Guide
  url: https://developer.cigna.com/docs/service-apis/patient-access/implementation-guide