CARIN Digital Insurance Card
1.1.0 - STU 1.1
CARIN Digital Insurance Card
1.1.0 - STU 1.1
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
| Active as of 2022-04-20 |
<CapabilityStatement xmlns="http://hl7.org/fhir">
<id value="c4dic"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><h2 id="title">C4DIC CapabilityStatement</h2><ul><li><b>Official URL:</b><code>http://hl7.org/fhir/us/insurance-card/CapabilityStatement/c4dic</code></li><li><b>Implementation Guide Version:</b> 0.1.0</li><li><b>FHIR Version:</b> 4.0.1</li><li><b>Intended Use:</b> Requirements</li><li><b>Supported Formats:</b>
<b>SHALL</b> support JSON, <b>SHOULD</b> support XML
</li><li><b>Supported Patch Formats:</b>
APPLICATION/JSON-PATCH+JSON
</li><li><b>Published:</b> 2022-04-20</li><li><b>Published by:</b> HL7 Payer/Provider Information Exchange Working Group (PIE WG)</li><li><b>Status:</b> Active</li></ul><p>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.</p> <!-- No support expectation extension --><h3 id="igs" class="no_toc">Support the Following Implementation Guides:</h3><ul><li><a href="http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card">http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card</a></li></ul> <!-- REST Behavior --><h3 id="behavior">FHIR Server RESTful Capabilities</h3><p>The C4DIC Server <strong>SHALL</strong>:</p><ol><li>Support all profiles defined in this Implementation Guide.</li><li>Implement the RESTful behavior according to the FHIR specification.</li><li>For all the supported search interactions in this guide, support the GET based search.</li><li>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</li><li>Support json source formats for all profiles C4DIC interactions.</li><li>Identify the C4DIC profiles supported as part of the FHIR meta.profile attribute for each instance.</li><li>Support the searchParameters on each profile individually and in combination.</li></ol><p>The C4DIC Server <strong>SHOULD</strong>:</p><ol><li>Support xml source formats for all C4DIC interactions.</li></ol><p id="security"><strong>Security:</strong></p><ol><li>See the <a href="Authorization_Authentication_and_Registration.html">General Security Considerations</a> section for requirements and recommendations.</li><li>A server <strong>SHALL</strong> reject any unauthorized requests by returning an <code>HTTP 401</code> unauthorized response code.</li></ol><h3 id="resource--details" class="no_toc">RESTful Capabilities by Resource/Profile:</h3><p><strong>Summary</strong></p><table class="grid"><thead><tr><th>Resource Type</th><th>Supported Interactions</th><th>Supported Profiles</th><th>Supported Searches</th><th>Supported <code>_includes</code></th><th>Supported <code>_revincludes</code></th><th>Supported Operations</th></tr></thead><tbody><tr><td><a href="#coverage">Coverage</a></td><td>
search-type,
read,
vread
</td> <!-- Supported Profiles --><td><a href="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage">C4DIC-Coverage</a></td> <!-- Supported Searches --><td>
_id, _profile, _lastUpdated, beneficiary, subscriber, patient, identifier, period, status
</td> <!-- Supported _includes --><td>
Coverage:beneficiary, Coverage:payor
</td> <!-- Supported _revincludes --><td>
</td> <!-- Supported Operations --><td>
</td></tr><tr><td><a href="#organization">Organization</a></td><td>
search-type,
read,
vread
</td> <!-- Supported Profiles --><td><a href="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Organization">C4DIC-Organization</a></td> <!-- Supported Searches --><td>
_id
</td> <!-- Supported _includes --><td>
</td> <!-- Supported _revincludes --><td>
</td> <!-- Supported Operations --><td>
</td></tr><tr><td><a href="#patient">Patient</a></td><td>
search-type,
read,
vread
</td> <!-- Supported Profiles --><td><a href="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Patient">C4DIC-Patient</a></td> <!-- Supported Searches --><td>
_id, _lastUpdated, identifier, name
</td> <!-- Supported _includes --><td>
</td> <!-- Supported _revincludes --><td>
</td> <!-- Supported Operations --><td>
</td></tr></tbody></table> <!-- Resource Details --><h4 id="coverage" class="no_toc">Coverage</h4><p>Conformance Expectation: <strong>SHALL</strong></p><p>Resource Specific Documentation:</p><p>Example query to search for Coverages which contain insurance card information: {baseurl}/Coverage?_profile=http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage</p><p>Supported Profiles:</p><ul><li><a href="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage">C4DIC-Coverage</a></li></ul><p>Reference Policy: <code>resolves</code></p><p>Profile Interaction Summary:</p><ul><li><strong>SHALL</strong> support
<code>search-type</code>,
<code>read</code>.</li><li><strong>SHOULD</strong> support
<code>vread</code>.</li></ul><p>Fetch and Search Criteria:</p><ul><li>
A Server <strong>SHALL</strong> be capable of returning a Coverage resource using:
<code class="highlighter-rouge">GET [base]/Coverage/[id]</code>
</li><li>
A Server <strong>SHOULD</strong> be capable of returning a Coverage resource using:
<code class="highlighter-rouge">GET [base]/Coverage/[id]/_history/vid</code>
</li><li>
A Server <strong>SHALL</strong> be capable of returning resources matching a search query using:
<code class="highlighter-rouge">GET [base]/Coverage/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li><li>
A Server <strong>(conformance expectation undefined)</strong> be capable of supporting the following _includes:
<ul><li>Coverage:beneficiary - <code class="highlighter-rouge">GET [base]/Coverage?[parameter=value]&_include=Coverage:beneficiary</code></li><li>Coverage:payor - <code class="highlighter-rouge">GET [base]/Coverage?[parameter=value]&_include=Coverage:payor</code></li></ul>
</li></ul> <!-- Only included search parameters that are not MAY or there is no conformance requirement included --><p>Search Parameter Summary:</p><table class="grid"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Example</th></tr></thead><tbody><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/search.html#id">
_id</a></td><td>
token
</td><td><code class="highlighter-rouge">GET [base]/Coverage?_id=[id]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/search.html#id">
_profile</a></td><td>
token
</td><td><code class="highlighter-rouge">GET [base]/Coverage?_profile=http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/search.html#lastUpdated">
_lastUpdated</a></td><td>
reference
</td><td><code class="highlighter-rouge">GET [base]/Coverage?_lastUpdated=[dateTime]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/coverage.html#search">
beneficiary</a></td><td>
date
</td><td><code class="highlighter-rouge">GET [base]/Coverage?beneficiary=[beneficiary]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/coverage.html#search">
subscriber</a></td><td>
token
</td><td><code class="highlighter-rouge">GET [base]/Coverage?subscriber=[system]|[code]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/coverage.html#search">
patient</a></td><td>
token
</td><td><code class="highlighter-rouge">GET [base]/Coverage?patient=[system]|[code]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/coverage.html#search">
identifier</a></td><td>
date
</td><td><code class="highlighter-rouge">GET [base]/Coverage?identifier=[identifier]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/coverage.html#search">
period</a></td><td>
date
</td><td><code class="highlighter-rouge">GET [base]/Coverage?period=[period]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/coverage.html#search">
status</a></td><td>
token
</td><td><code class="highlighter-rouge">GET [base]/Coverage?status=[system]|[code]</code></td></tr></tbody></table><h4 id="organization" class="no_toc">Organization</h4><p>Conformance Expectation: <strong>SHALL</strong></p><p>Supported Profiles:</p><ul><li><a href="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Organization">C4DIC-Organization</a></li></ul><p>Reference Policy: <code>resolves</code></p><p>Profile Interaction Summary:</p><ul><li><strong>SHALL</strong> support
<code>search-type</code>,
<code>read</code>.</li><li><strong>SHOULD</strong> support
<code>vread</code>.</li></ul><p>Fetch and Search Criteria:</p><ul><li>
A Server <strong>SHALL</strong> be capable of returning an Organization resource using:
<code class="highlighter-rouge">GET [base]/Organization/[id]</code>
</li><li>
A Server <strong>SHOULD</strong> be capable of returning an Organization resource using:
<code class="highlighter-rouge">GET [base]/Organization/[id]/_history/vid</code>
</li><li>
A Server <strong>SHALL</strong> be capable of returning resources matching a search query using:
<code class="highlighter-rouge">GET [base]/Organization/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li></ul> <!-- Only included search parameters that are not MAY or there is no conformance requirement included --><p>Search Parameter Summary:</p><table class="grid"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Example</th></tr></thead><tbody><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/search.html#id">
_id</a></td><td>
reference
</td><td><code class="highlighter-rouge">GET [base]/Organization?_id=[id]</code></td></tr></tbody></table><h4 id="patient" class="no_toc">Patient</h4><p>Conformance Expectation: <strong>SHALL</strong></p><p>Supported Profiles:</p><ul><li><a href="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Patient">C4DIC-Patient</a></li></ul><p>Reference Policy: <code>resolves</code></p><p>Profile Interaction Summary:</p><ul><li><strong>SHALL</strong> support
<code>search-type</code>,
<code>read</code>.</li><li><strong>SHOULD</strong> support
<code>vread</code>.</li></ul><p>Fetch and Search Criteria:</p><ul><li>
A Server <strong>SHALL</strong> be capable of returning a Patient resource using:
<code class="highlighter-rouge">GET [base]/Patient/[id]</code>
</li><li>
A Server <strong>SHOULD</strong> be capable of returning a Patient resource using:
<code class="highlighter-rouge">GET [base]/Patient/[id]/_history/vid</code>
</li><li>
A Server <strong>SHALL</strong> be capable of returning resources matching a search query using:
<code class="highlighter-rouge">GET [base]/Patient/[id]{?[parameters]{&_format=[mime-type]}}</code>
</li></ul> <!-- Only included search parameters that are not MAY or there is no conformance requirement included --><p>Search Parameter Summary:</p><table class="grid"><thead><tr><th>Conformance</th><th>Parameter</th><th>Type</th><th>Example</th></tr></thead><tbody><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/search.html#id">
_id</a></td><td>
reference
</td><td><code class="highlighter-rouge">GET [base]/Patient?_id=[id]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/search.html#lastUpdated">
_lastUpdated</a></td><td>
reference
</td><td><code class="highlighter-rouge">GET [base]/Patient?_lastUpdated=[dateTime]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/patient.html#search">
identifier</a></td><td>
reference
</td><td><code class="highlighter-rouge">GET [base]/Patient?identifier=[type]/[id]</code></td></tr><tr><td><strong>SHALL</strong></td><td><a href="http://hl7.org/fhir/R4/patient.html#search">
name</a></td><td>
reference
</td><td><code class="highlighter-rouge">GET [base]/Patient?name=[type]/[id]</code></td></tr></tbody></table></div>
</text>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
<valueCode value="claims"/>
</extension>
<url
value="http://hl7.org/fhir/us/insurance-card/CapabilityStatement/c4dic"/>
<version value="1.1.0"/>
<name value="InsuranceCardCapabilityStatement"/>
<title value="C4DIC CapabilityStatement"/>
<status value="active"/>
<experimental value="false"/>
<date value="2022-04-20"/>
<publisher
value="HL7 International / Payer/Provider Information Exchange Work Group"/>
<contact>
<name
value="HL7 International / Payer/Provider Information Exchange Work Group"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/claims"/>
</telecom>
<telecom>
<system value="email"/>
<value value="pie@lists.HL7.org"/>
</telecom>
</contact>
<description
value="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."/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<kind value="requirements"/>
<fhirVersion value="4.0.1"/>
<format value="json">
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
</format>
<format value="xml">
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
</format>
<patchFormat value="application/json-patch+json"/>
<implementationGuide
value="http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card"/>
<rest>
<mode value="server"/>
<documentation
value="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>
<description
value="1. See the [General Security Considerations](Authorization_Authentication_and_Registration.html) section for requirements and recommendations.
1. A server **SHALL** reject any unauthorized requests by returning an `HTTP 401` unauthorized response code."/>
</security>
<resource>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<type value="Coverage"/>
<supportedProfile
value="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage"/>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
<code value="vread"/>
</interaction>
<referencePolicy value="resolves"/>
<searchInclude value="Coverage:beneficiary"/>
<searchInclude value="Coverage:payor"/>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_id"/>
<type value="token"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_profile"/>
<type value="token"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_lastUpdated"/>
<type value="reference"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="beneficiary"/>
<type value="date"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="subscriber"/>
<type value="token"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="patient"/>
<type value="token"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="identifier"/>
<type value="date"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="period"/>
<type value="date"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="status"/>
<type value="token"/>
</searchParam>
</resource>
<resource>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<type value="Organization"/>
<supportedProfile
value="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Organization"/>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
<code value="vread"/>
</interaction>
<referencePolicy value="resolves"/>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_id"/>
<type value="reference"/>
</searchParam>
</resource>
<resource>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<type value="Patient"/>
<supportedProfile
value="http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Patient"/>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="search-type"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<code value="read"/>
</interaction>
<interaction>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHOULD"/>
</extension>
<code value="vread"/>
</interaction>
<referencePolicy value="resolves"/>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_id"/>
<type value="reference"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="_lastUpdated"/>
<type value="reference"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="identifier"/>
<type value="reference"/>
</searchParam>
<searchParam>
<extension
url="http://hl7.org/fhir/StructureDefinition/capabilitystatement-expectation">
<valueCode value="SHALL"/>
</extension>
<name value="name"/>
<type value="reference"/>
</searchParam>
</resource>
</rest>
</CapabilityStatement>
IG © 2022+ HL7 International / Payer/Provider Information Exchange Work Group. Package hl7.fhir.us.insurance-card#1.1.0 based on FHIR 4.0.1. Generated 2024-04-16
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