CRD (Coverage Requirements Discovery) FHIR API Specification

Service Overview

InterSystems® Payer Services CRD (Coverage Requirements Discovery) APIs are designed in compliance with the CMS-0057-F regulationsOpens in a new tab. CRD gives providers a means to discover, in real time, specific payer requirements which may affect whether the provision of a service or device to a patient is covered by the responsible payer.

Refer to the Getting Started section for information on connectivity, authentication and how to get help. To use these APIs, you will need to know the base URL of the payer server that you will be connecting to. You can also retrieve the capability statement for the service.

Available APIs

InterSystems Payer Services CRD provides the following APIs:

• Discovery, which allows the provider to find out what information is required to query the CRD service.

• Service, which responds to the provider’s CRD query.

Implementation Guides

InterSystems Payer Services CRD conforms to the following implementation guide(s):

• Da Vinci Documentation Coverage Requirements DiscoveryOpens in a new tab implementation guide, version 2.0.1.

• CDS HooksOpens in a new tab implementation guide, version 2.0.