This statement defines the expected capabilities of payer systems supporting Electronic Prior Authorization (EPA), including CDS Hooks order-sign service, DTR questionnaire operations (questionnaire-package and next-question), ValueSet expansion, PAS claim submission and inquiry, and subscription-based prior authorization notifications.

This Section describes the expected capabilities of the DaVinci ATR Consumer, which is responsible for retrieving and using the Member Attribution List.

This Section describes the expected capabilities of the C4BB Server actor which is responsible for providing responses to the queries submitted by the C4BB Requestors. The EOB Resource is the focal Consumer-Directed Payer Data Exchange (CDPDE) Resource. Several Reference Resources are defined directly/indirectly from the EOB: Coverage, Patient, Organization (Payer ID), Practioner, and Organizati...

This Payer Data Exchange (PDex) Capability Statement describes the clinical data available to registered Consumer applications that have received approval from a health plan member to receive their data. The Capability Statement embraces all of the US Core 3.1.1 profiles and adds additional profiles to support Health Plan needs.

This Section describes the expected capabilities of the PDex with US Core 6.1 Support Server actor which is responsible for providing responses to the queries submitted by the PDex Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by PDex and US Core Servers are defined. Systems implementing this capability statement should meet the ONC 2015 Common...

The Capability Statement describes the capabilities of this Plan-Net Server which provides responses to queries submitted by Consumer Applications. The complete list of FHIR profiles, RESTful operations, and search parameters supported by the Server are defined. This capability statement should meet the CMS Interoperability and Patient Access Final Rule requirement for provider directory access. ...

This Capability Statement describes the features of the US Core Server which is responsible for providing responses to the queries submitted by the US Core Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by this server are defined. Systems implementing this capability statement should meet the ONC 2015 Common Clinical Data Set (CCDS) access requi...

This Section describes the expected capabilities of the US Drug Formulary Server actor which is responsible for providing responses to the queries submitted by the US Drug Formulary Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by US Drug Formulary Server are defined.