Health Gorilla Coverage Retrieval

arazzo: 1.0.1
info:
  title: Health Gorilla Coverage Retrieval
  summary: Locate a patient, search their insurance Coverage resources, then read a single Coverage for full plan detail.
  description: >-
    An insurance-coverage flow against the Health Gorilla FHIR R4 clinical and
    lab network API. The patient is located by demographics, their Coverage
    resources are searched within the patient compartment, and a single Coverage
    is read by id for complete plan and payer detail. This mirrors the US Core
    Coverage retrieval pattern over the /fhir/R4 server base. Every step inlines
    its request so the flow is self-contained.
  version: 1.0.0
  x-realizes-capability-ids:
  - BC-2800.30
  - BC-2900.60
  x-capability-derivation:
    method: 'deterministic join: sourceDescriptions -> per-tag OpenAPI -> tag/capability edge. No classification at this step.'
    min_confidence: 0.7
    sources:
    - capability_id: BC-2800.30
      capability_name: Eligibility & Benefits Verification
      spec: health-gorilla-coverage-api-openapi.yml
      confidence: 0.75
    - capability_id: BC-2900.60
      capability_name: Healthcare Interoperability Operations
      spec: health-gorilla-patient-api-openapi.yml
      confidence: 0.7
    model: Turbo EA Capabilities by Vincent Verdet — Turbo EA, https://github.com/vincentmakes/turbo-ea-capabilities, CC BY 4.0
sourceDescriptions:
- name: coverageApi
  url: ../openapi/health-gorilla-coverage-api-openapi.yml
  type: openapi
- name: patientApi
  url: ../openapi/health-gorilla-patient-api-openapi.yml
  type: openapi
workflows:
- workflowId: coverage-retrieval
  summary: Retrieve insurance Coverage resources and full plan detail for a matched patient.
  description: >-
    Finds the patient by date of birth, searches their Coverage resources, and
    reads a single Coverage by id for full plan and payer detail.
  inputs:
    type: object
    required:
    - birthdate
    properties:
      birthdate:
        type: string
        description: Patient date of birth (YYYY-MM-DD) to locate the coverage subject.
  steps:
  - stepId: findPatient
    description: Locate the patient by date of birth.
    operationId: searchPatients
    parameters:
    - name: birthdate
      in: query
      value: $inputs.birthdate
    successCriteria:
    - condition: $statusCode == 200
    outputs:
      patientId: $response.body#/entry/0/resource/id
  - stepId: getCoverage
    description: Search the patient's insurance Coverage resources.
    operationId: searchCoverage
    parameters:
    - name: patient
      in: query
      value: $steps.findPatient.outputs.patientId
    successCriteria:
    - condition: $statusCode == 200
    outputs:
      coverage: $response.body
      coverageId: $response.body#/entry/0/resource/id
  - stepId: readCoverage
    description: Read a single Coverage resource by id for full plan detail.
    operationId: readCoverage
    parameters:
    - name: id
      in: path
      value: $steps.getCoverage.outputs.coverageId
    successCriteria:
    - condition: $statusCode == 200
    outputs:
      coverageDetail: $response.body
  outputs:
    patientId: $steps.findPatient.outputs.patientId
    coverage: $steps.getCoverage.outputs.coverage
    coverageDetail: $steps.readCoverage.outputs.coverageDetail