Provider Directory API Specification
Provider Directory API Overview
Welcome to our Provider Directory API, designed in compliance with the CMS 9115-F regulations. This API facilitates secure and efficient access to a health insurer’s plan and network data, utilizing the HL7® FHIR® R4 standard, a globally recognized framework for health care information exchange.
What is an API?
API stands for “Application Programming Interface” and is a way for an application to interact with a server on the internet. The Provider Directory API allows an application to access a health insurer's plans, associated networks, and the organizations and providers participating in these networks.
Capability Statement
The FHIR Capability Statement documents the behaviors of the FHIR server for a particular version of the FHIR standard. For more information, consult the official specificationOpens in a new tab.
Connecting Your Application
To connect your application to the Provider Directory API, you will need to ensure that your application supports the following standard:
Implementation Guides
The Provider Directory API FHIR endpoint is configured using the following implementation guides:
-
US CoreOpens in a new tab implementation guide version 3.1.1
-
PDEX Payer NetworkOpens in a new tab (Plan Net) implementation guide version 1.0.0
Authentication
Use of the Provider Directory API does not require authentication as stipulated by the Plan Net implementation guide.
Profiles and Resources
The following list describes the resources currently supported:
Compliance and Security
Our APIs are built with a focus on security and compliance, adhering to CMS 9115-F regulations and implementing state-of-the-art security measures to ensure compliance with relevant privacy laws.
Support and Contact Information
Our dedicated Worldwide Response Center (WRC) team is available to assist you with any API-related queries. Contact us at support@intersystems.com.