Flexpa

Flexpa Claims Data API

The Claims Data API from Flexpa — 5 operation(s) for claims data.

GitHub OpenAPI
Business capability
Healthcare Interoperability Operations BC-2900.60

Operations 5

Each operation below carries the questions people ask an LLM about it and the instructions they give an agent to run it. Generated by API Evangelist overlay

GET /fhir/Patient/{id}/$everything Get every record for a patient · Return all resources in the patient compartment #
Ask an LLM
“Can I pull every resource in a patient's compartment in a single call instead of searching each type?”
“What's the fastest way to fetch all claims, coverage and clinical data Flexpa holds for one patient?”
Tell an agent
Fetch everything in the patient compartment for patient {id}.
Pull all available records for patient {id} in one bundle.
GET /fhir/Patient/{id}/$summary Generate an International Patient Summary · Generate an International Patient Summary (IPS) document #
Ask an LLM
“Can I generate an International Patient Summary (IPS) document for a connected patient?”
“Is there a way to get a condensed IPS summary of a patient's health record rather than every resource?”
Tell an agent
Generate an International Patient Summary for patient {id}.
Build the IPS document for patient {id}.
GET /fhir/Patient/{id}/$pdf Export a patient's health data as a PDF · Export comprehensive patient health data as a PDF #
Ask an LLM
“Can I export a patient's health data as a printable PDF?”
“Is there a PDF version of a patient's comprehensive health record I can hand to a clinician?”
Tell an agent
Export patient {id}'s health data as a PDF.
Download a PDF report of patient {id}'s full health record.
GET /fhir/ExplanationOfBenefit Search a patient's insurance claims · Search ExplanationOfBenefit (claims) resources #
Ask an LLM
“How do I list a patient's health insurance claims as ExplanationOfBenefit resources?”
“Can I filter claims by the date they were created, the treating provider, or their status?”
Tell an agent
List insurance claims for patient {patient}.
Find claims for patient {patient} created {created} with status {status}.
GET /fhir/ExplanationOfBenefit/{id} Get one insurance claim · Read a single ExplanationOfBenefit resource #
Ask an LLM
“Can I open a single ExplanationOfBenefit by its resource ID to see the full claim detail?”
“What does one specific claim look like once I already have its FHIR ID?”
Tell an agent
Read ExplanationOfBenefit {id}.
Show me the full detail of claim resource {id}.

Documentation

📖
Documentation
https://www.flexpa.com/docs/tools/link
📖
APIReference
https://www.flexpa.com/docs/consent
📖
Documentation
https://www.flexpa.com/docs/consent
📖
Documentation
https://www.flexpa.com/blog/introducing-application-access-tokens-server-to-server-authentication-for-the-flexpa-fhir-api
📖
Documentation
https://www.flexpa.com/docs/records
📖
Documentation
https://www.flexpa.com/docs/fhir/explanation-of-benefit

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/flexpa/refs/heads/main/openapi/flexpa-claims-data-api-openapi.yml

Schemas & Data

📊
JSONSchema
https://raw.githubusercontent.com/api-evangelist/flexpa/refs/heads/main/json-schema/flexpa-bundle-schema.json

Other Resources

🔗
Overlay
https://raw.githubusercontent.com/api-evangelist/flexpa/refs/heads/main/overlays/flexpa-claims-data-api-overlay.yaml

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OpenAPI Specification

flexpa-claims-data-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: Flexpa Claims Data API
  description: Flexpa lets applications connect a patient to their health insurance plan and retrieve claims and clinical data as normalized FHIR R4 resources. Patients authorize access through Flexpa Link using OAuth 2.0 with PKCE, producing a Patient Access Token. Server-to-server Application Access Tokens are minted with the client_credentials grant using publishable and secret keys. The FHIR API is served under https://api.flexpa.com/fhir.
  termsOfService: https://www.flexpa.com/legal/terms
  contact:
    name: Flexpa Support
    url: https://www.flexpa.com/docs
  version: '1.0'
servers:
- url: https://api.flexpa.com
tags:
- name: Claims Data
paths:
  /fhir/Patient/{id}/$everything:
    get:
      operationId: patientEverything
      tags:
      - Claims Data
      summary: Return all resources in the patient compartment
      security:
      - bearerAuth: []
      parameters:
      - $ref: '#/components/parameters/resourceId'
      responses:
        '200':
          description: A FHIR Bundle of all patient compartment resources.
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
  /fhir/Patient/{id}/$summary:
    get:
      operationId: patientSummary
      tags:
      - Claims Data
      summary: Generate an International Patient Summary (IPS) document
      security:
      - bearerAuth: []
      parameters:
      - $ref: '#/components/parameters/resourceId'
      responses:
        '200':
          description: A FHIR IPS Bundle.
  /fhir/Patient/{id}/$pdf:
    get:
      operationId: patientPdf
      tags:
      - Claims Data
      summary: Export comprehensive patient health data as a PDF
      security:
      - bearerAuth: []
      parameters:
      - $ref: '#/components/parameters/resourceId'
      responses:
        '200':
          description: A PDF document.
          content:
            application/pdf:
              schema:
                type: string
                format: binary
  /fhir/ExplanationOfBenefit:
    get:
      operationId: searchExplanationOfBenefit
      tags:
      - Claims Data
      summary: Search ExplanationOfBenefit (claims) resources
      description: Returns health-insurance claims as FHIR ExplanationOfBenefit resources. Supports FHIR R4 search parameters including patient, created, provider, coverage, status, and identifier.
      security:
      - bearerAuth: []
      parameters:
      - $ref: '#/components/parameters/patient'
      - name: created
        in: query
        schema:
          type: string
      - name: provider
        in: query
        schema:
          type: string
      - name: coverage
        in: query
        schema:
          type: string
      - $ref: '#/components/parameters/status'
      - $ref: '#/components/parameters/identifier'
      responses:
        '200':
          description: A FHIR Bundle of ExplanationOfBenefit resources.
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/Bundle'
        '429':
          $ref: '#/components/responses/Syncing'
        '422':
          $ref: '#/components/responses/SyncFailed'
  /fhir/ExplanationOfBenefit/{id}:
    get:
      operationId: readExplanationOfBenefit
      tags:
      - Claims Data
      summary: Read a single ExplanationOfBenefit resource
      security:
      - bearerAuth: []
      parameters:
      - $ref: '#/components/parameters/resourceId'
      responses:
        '200':
          description: A FHIR ExplanationOfBenefit resource.
components:
  schemas:
    Bundle:
      type: object
      description: A FHIR R4 Bundle of resources.
      properties:
        resourceType:
          type: string
          example: Bundle
        type:
          type: string
          example: searchset
        total:
          type: integer
        entry:
          type: array
          items:
            type: object
  parameters:
    identifier:
      name: identifier
      in: query
      schema:
        type: string
    resourceId:
      name: id
      in: path
      required: true
      schema:
        type: string
    status:
      name: status
      in: query
      schema:
        type: string
    patient:
      name: patient
      in: query
      schema:
        type: string
  responses:
    Syncing:
      description: The patient's data is still being synchronized from the payer (typically under one minute). Retry after a short delay.
    SyncFailed:
      description: Synchronization with the payer failed.
  securitySchemes:
    bearerAuth:
      type: http
      scheme: bearer
      bearerFormat: JWT
      description: 'A Patient Access Token (from the authorization_code flow) or an Application Access Token (from the client_credentials flow), sent as Authorization: Bearer {access_token}.'