CARIN Digital Insurance Card
1.1.0 - STU 1.1 United States of America flag

CARIN Digital Insurance Card, published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 1.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-digital-insurance-card/ and changes regularly. See the Directory of published versions

CapabilityStatement: C4DIC CapabilityStatement

Official URL: http://hl7.org/fhir/us/insurance-card/CapabilityStatement/c4dic Version: 1.1.0
Active as of 2022-04-20 Computable Name: InsuranceCardCapabilityStatement

This Section describes the expected capabilities of the C4DIC Server actor which is responsible for providing responses to the queries submitted by the C4DIC Requestors.

Raw OpenAPI-Swagger Definition file | Download

C4DIC CapabilityStatement

  • Official URL:http://hl7.org/fhir/us/insurance-card/CapabilityStatement/c4dic
  • Implementation Guide Version: 0.1.0
  • FHIR Version: 4.0.1
  • Intended Use: Requirements
  • Supported Formats: SHALL support JSON, SHOULD support XML
  • Supported Patch Formats: APPLICATION/JSON-PATCH+JSON
  • Published: 2022-04-20
  • Published by: HL7 Payer/Provider Information Exchange Working Group (PIE WG)
  • Status: Active

This Section describes the expected capabilities of the C4DIC Server actor which is responsible for providing responses to the queries submitted by the C4DIC Requestors.

Support the Following Implementation Guides:

FHIR Server RESTful Capabilities

The C4DIC Server SHALL:

  1. Support all profiles defined in this Implementation Guide.
  2. Implement the RESTful behavior according to the FHIR specification.
  3. For all the supported search interactions in this guide, support the GET based search.
  4. Return the following response classes: • (Status 400): invalid parameter • (Status 401/4xx): unauthorized request • (Status 403): insufficient scopes • (Status 404): unknown resource • (Status 410): deleted resource
  5. Support json source formats for all profiles C4DIC interactions.
  6. Identify the C4DIC profiles supported as part of the FHIR meta.profile attribute for each instance.
  7. Support the searchParameters on each profile individually and in combination.

The C4DIC Server SHOULD:

  1. Support xml source formats for all C4DIC interactions.

Security:

  1. See the General Security Considerations section for requirements and recommendations.
  2. A server SHALL reject any unauthorized requests by returning an HTTP 401 unauthorized response code.

RESTful Capabilities by Resource/Profile:

Summary

Resource TypeSupported InteractionsSupported ProfilesSupported SearchesSupported _includesSupported _revincludesSupported Operations
Coverage search-type, read, vread C4DIC-Coverage _id, _profile, _lastUpdated, beneficiary, subscriber, patient, identifier, period, status Coverage:beneficiary, Coverage:payor
Organization search-type, read, vread C4DIC-Organization _id
Patient search-type, read, vread C4DIC-Patient _id, _lastUpdated, identifier, name

Coverage

Conformance Expectation: SHALL

Resource Specific Documentation:

Example query to search for Coverages which contain insurance card information: {baseurl}/Coverage?_profile=http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage

Supported Profiles:

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a Coverage resource using: GET [base]/Coverage/[id]
  • A Server SHOULD be capable of returning a Coverage resource using: GET [base]/Coverage/[id]/_history/vid
  • A Server SHALL be capable of returning resources matching a search query using: GET [base]/Coverage/[id]{?[parameters]{&_format=[mime-type]}}
  • A Server (conformance expectation undefined) be capable of supporting the following _includes:
    • Coverage:beneficiary - GET [base]/Coverage?[parameter=value]&_include=Coverage:beneficiary
    • Coverage:payor - GET [base]/Coverage?[parameter=value]&_include=Coverage:payor

Search Parameter Summary:

ConformanceParameterTypeExample
SHALL _id token GET [base]/Coverage?_id=[id]
SHALL _profile token GET [base]/Coverage?_profile=http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage
SHALL _lastUpdated reference GET [base]/Coverage?_lastUpdated=[dateTime]
SHALL beneficiary date GET [base]/Coverage?beneficiary=[beneficiary]
SHALL subscriber token GET [base]/Coverage?subscriber=[system]|[code]
SHALL patient token GET [base]/Coverage?patient=[system]|[code]
SHALL identifier date GET [base]/Coverage?identifier=[identifier]
SHALL period date GET [base]/Coverage?period=[period]
SHALL status token GET [base]/Coverage?status=[system]|[code]

Organization

Conformance Expectation: SHALL

Supported Profiles:

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning an Organization resource using: GET [base]/Organization/[id]
  • A Server SHOULD be capable of returning an Organization resource using: GET [base]/Organization/[id]/_history/vid
  • A Server SHALL be capable of returning resources matching a search query using: GET [base]/Organization/[id]{?[parameters]{&_format=[mime-type]}}

Search Parameter Summary:

ConformanceParameterTypeExample
SHALL _id reference GET [base]/Organization?_id=[id]

Patient

Conformance Expectation: SHALL

Supported Profiles:

Reference Policy: resolves

Profile Interaction Summary:

  • SHALL support search-type, read.
  • SHOULD support vread.

Fetch and Search Criteria:

  • A Server SHALL be capable of returning a Patient resource using: GET [base]/Patient/[id]
  • A Server SHOULD be capable of returning a Patient resource using: GET [base]/Patient/[id]/_history/vid
  • A Server SHALL be capable of returning resources matching a search query using: GET [base]/Patient/[id]{?[parameters]{&_format=[mime-type]}}

Search Parameter Summary:

ConformanceParameterTypeExample
SHALL _id reference GET [base]/Patient?_id=[id]
SHALL _lastUpdated reference GET [base]/Patient?_lastUpdated=[dateTime]
SHALL identifier reference GET [base]/Patient?identifier=[type]/[id]
SHALL name reference GET [base]/Patient?name=[type]/[id]