WellCare FHIR Patient Access API — Explanation of Benefits

naftiko: 1.0.0-alpha2
info:
  label: WellCare FHIR Patient Access API — Explanation of Benefits
  description: 'WellCare FHIR Patient Access API — Explanation of Benefits. 1 operations. Lead operation: List Explanation
    of Benefit. Self-contained Naftiko capability covering one Wellcare Health Plans business surface.'
  tags:
  - Wellcare Health Plans
  - Explanation of Benefits
  created: '2026-05-19'
  modified: '2026-05-19'
binds:
- namespace: env
  keys:
    WELLCARE_HEALTH_PLANS_API_KEY: WELLCARE_HEALTH_PLANS_API_KEY
capability:
  consumes:
  - type: http
    namespace: wellcare-fhir-patient-access-explanation-of-benefits
    baseUri: https://partners.centene.com
    description: WellCare FHIR Patient Access API — Explanation of Benefits business capability. Self-contained, no shared
      references.
    resources:
    - name: fhir-r4-ExplanationOfBenefit
      path: /fhir/r4/ExplanationOfBenefit
      operations:
      - name: listexplanationofbenefit
        method: GET
        description: List Explanation of Benefit
        outputRawFormat: json
        outputParameters:
        - name: result
          type: object
          value: $.
        inputParameters:
        - name: patient
          in: query
          type: string
          description: The FHIR Patient ID to retrieve EOBs for.
          required: true
        - name: service-date
          in: query
          type: string
          description: Filter by service date range (format YYYY-MM-DD or YYYY-MM-DD,YYYY-MM-DD).
        - name: type
          in: query
          type: string
          description: Filter by claim type (e.g., pharmacy, oral, vision, institutional, professional).
        - name: _count
          in: query
          type: integer
          description: Number of results per page.
    authentication:
      type: bearer
      token: '{{env.WELLCARE_HEALTH_PLANS_API_KEY}}'
  exposes:
  - type: rest
    namespace: wellcare-fhir-patient-access-explanation-of-benefits-rest
    port: 8080
    description: REST adapter for WellCare FHIR Patient Access API — Explanation of Benefits. One Spectral-compliant resource
      per consumed operation, prefixed with /v1.
    resources:
    - path: /v1/fhir/r4/explanationofbenefit
      name: fhir-r4-explanationofbenefit
      description: REST surface for fhir-r4-ExplanationOfBenefit.
      operations:
      - method: GET
        name: listexplanationofbenefit
        description: List Explanation of Benefit
        call: wellcare-fhir-patient-access-explanation-of-benefits.listexplanationofbenefit
        with:
          patient: rest.patient
          service-date: rest.service-date
          type: rest.type
          _count: rest._count
        outputParameters:
        - type: object
          mapping: $.
  - type: mcp
    namespace: wellcare-fhir-patient-access-explanation-of-benefits-mcp
    port: 9090
    transport: http
    description: MCP adapter for WellCare FHIR Patient Access API — Explanation of Benefits. One tool per consumed operation,
      routed inline through this capability's consumes block.
    tools:
    - name: list-explanation-benefit
      description: List Explanation of Benefit
      hints:
        readOnly: true
        destructive: false
        idempotent: true
      call: wellcare-fhir-patient-access-explanation-of-benefits.listexplanationofbenefit
      with:
        patient: tools.patient
        service-date: tools.service-date
        type: tools.type
        _count: tools._count
      outputParameters:
      - type: object
        mapping: $.