Review the CARIN BB IG to understand how Coverage is referenced from EOB: EOB.insurance.coverage must reference a CARIN BB Coverage resource, and EOB.patient must reference a CARIN BB Patient resource.
Ensure Coverage resources include the plan, group, and member class slices defined in the CARIN BB Coverage profile, and that Coverage.beneficiary references the CARIN BB Patient.
Search for Coverage resources for a member: GET [base]/Coverage?patient=[id] and verify that all active and historical coverage periods are returned with correct plan identifiers.
From a Coverage resource, construct the link to related EOBs: GET [base]/ExplanationOfBenefit?patient=[id]&insurance-coverage=[Coverage-id] to retrieve EOBs associated with a specific coverage.
Use the Patient $everything operation: GET [base]/Patient/[id]/$everything to retrieve all resources in the patient's record including Patient, Coverage, EOB, and referenced Practitioner and Organization resources in a single Bundle.
Handle $everything pagination: large member records may result in paginated $everything responses using Bundle next links — implement pagination logic to retrieve the complete result set before processing.
Known gotchas
The $everything operation may not be scoped the same way as individual resource searches — some servers limit $everything to resources within a defined time period; check the server's CapabilityStatement for the $everything operation definition and supported parameters.
EOB.insurance is an array supporting multiple coverage references (primary and secondary); CARIN BB profiles may include specific slicing on this array — ensure both primary and secondary coverage references are populated if the member has COB (coordination of benefits) situations.
Coverage.status must be 'active' for current coverage, but historical (inactive) Coverage resources should be retained and linkable from historical EOBs — payers that purge inactive Coverage records break the historical traceability required by CARIN BB.
Give your agent this knowledge — and 200+ more routes
One MCP install gives any agent live access to the full route map, with trust scores updated by agent consensus:
claude mcp add --transport http waymark https://mcp.waymark.network/mcp