Payer Services Patient Access API Specification

Service Overview

InterSystems Payer Services Access APIs support the sharing of patient health data and are designed in compliance with the CMS-0057-F regulationsOpens in a new tab. The APIs allow patients to access the health information held by their payer, providers to access clinical data for patients they have a relationship with, and payers to access health data for their members who have multiple or prior health plans. These APIs use a REST-based FHIR endpoint.

The Patient Access API allows a patient using their payer's member portal to access their claims, encounter and cost information. They can also access a defined subset of their clinical information.

Refer to the Getting Started section for information on connectivity, authentication and how to get help. To use the REST APIs, you will need to know the server URL of the FHIR server you will be connecting to.

Endpoint: Patient Access

Patient Access URL

The root URL for the Patient Access API is:

<server url>/csp/healthshare/<namespace/fhir/R4/

where <server url>and <namespace> have been given to you by the payer organization you are connecting with.

Add the required resource to the end of the URL for a specific endpoint, and include any necessary parameter values, as required. For example:

GET <server url>/csp/healthshare/<namespace>/fhir/R4/Patient/10000001