Plan-Net CapabilityStatement Implementation Guide Version: 1.0.0 FHIR Version: 4.0.1 Supported formats: xml, json Published: 2022-03-18 Published by: HL7 Financial Management Working Group (FM WG) This Section describes the expected capabilities of the Plan-Net Server actor which is responsible for providing responses to the queries submitted by the Plan-Net Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Plan-Net Servers are defined. Systems implementing this capability statement should meet the CMS FInal Rule requirement for provider directory access. Plan-Net Clients can use the required capabilities to access necessary data based on their local use cases and other contextual requirements. FHIR RESTful Capabilities The Plan-Net Server SHALL: Support all profiles defined in this Implementation Guide.. Implement the RESTful behavior according to the FHIR specification. Return the following response classes: (Status 400): invalid parameter (Status 401/4xx): unauthorized request (Status 403): insufficient scope (Status 404): unknown resource (Status 410): deleted resource. Support json source formats for all Plan-Net interactions. Support the searchParameters on each profile individually and in combination. 1.Support forward and reverse chaining on all search parameters that specify the 'chain' property The Plan-Net Server SHOULD: Support xml source formats for all Plan-Net interactions. Security: See the General Security Considerations section for requirements and recommendations. A server SHALL reject any unauthorized requests by returning an HTTP 401 unauthorized response code. RESTful Capabilities by Resource/Profile: Summary of Search Criteria Resource Type Supported Profiles Supported Searches Supported _includes Supported _revincludes Supported Operations Endpoint Plan-Net Endpoint organization, _id, _lastUpdated Endpoint:organization HealthcareService Plan-Net HealthcareService location, coverage-area, organization, endpoint, name, service-category, service-type, specialty, _id, _lastUpdated HealthcareService:location, HealthcareService:coverage-area, HealthcareService:organization, HealthcareService:endpoint PractitionerRole:service, OrganizationAffiliation:service InsurancePlan Plan-Net InsurancePlan administered-by, owned-by, coverage-area, name, plan-type, identifier, _id, _lastUpdated, type InsurancePlan:administered-by, InsurancePlan:owned-by, InsurancePlan:coverage-area Location Plan-Net Location partof, organization, endpoint, address-city, address-state, address-postalcode, address, type, _id, _lastUpdated Location:endpoint, Location:organization, Location:partof HealthcareService:location, InsurancePlan:coverage-area, OrganizationAffiliation:location, PractitionerRole:location Organization Plan-Net Network, Plan-Net Organization partof, endpoint, address, name, _id, _lastUpdated, type, coverage-area Organization:partof, Organization:endpoint, Organization:coverage-area Endpoint:organization, HealthcareService:organization, InsurancePlan:administered-by, InsurancePlan:owned-by, OrganizationAffiliation:primary-organization, PractitionerRole:organization, PractitionerRole:network, OrganizationAffiliation:participating-organization OrganizationAffiliation Plan-Net OrganizationAffiliation primary-organization, participating-organization, location, service, network, endpoint, role, specialty, _id, _lastUpdated OrganizationAffiliation:primary-organization, OrganizationAffiliation:participating-organization, OrganizationAffiliation:location, OrganizationAffiliation:service, OrganizationAffiliation:endpoint, OrganizationAffiliation:network Practitioner Plan-Net Practitioner name, _id, _lastUpdated, family, given PractitionerRole:practitioner PractitionerRole Plan-Net PractitionerRole practitioner, organization, location, service, network, endpoint, role, specialty, _id, _lastUpdated PractitionerRole:practitioner, PractitionerRole:organization, PractitionerRole:location, PractitionerRole:service, PractitionerRole:network, PractitionerRole:endpoint Endpoint Conformance Expectation: SHALL Supported Profiles: Plan-Net Endpoint 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 Endpoint resource using: GET [base]/Endpoint/[id] A Server SHOULD be capable of returning a Endpoint resource using: GET [base]/Endpoint/[id]/_history/vid A Server SHALL be capable of supporting the following _includes: Endpoint:organization - GET [base]/Endpoint?[parameter=value]&_include=Endpoint:organization Search Parameter Summary: Conformance Parameter Type Example SHALL organization reference GET [base]/Endpoint?organization=[organization] SHALL _id token GET [base]/Endpoint?_id=[id] SHALL _lastUpdated date GET [base]/Endpoint?_lastUpdated=[_lastUpdated] HealthcareService Conformance Expectation: SHALL Supported Profiles: Plan-Net HealthcareService 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 HealthcareService resource using: GET [base]/HealthcareService/[id] A Server SHOULD be capable of returning a HealthcareService resource using: GET [base]/HealthcareService/[id]/_history/vid A Server SHALL be capable of supporting the following _includes: HealthcareService:location - GET [base]/HealthcareService?[parameter=value]&_include=HealthcareService:location HealthcareService:coverage-area - GET [base]/HealthcareService?[parameter=value]&_include=HealthcareService:coverage-area HealthcareService:organization - GET [base]/HealthcareService?[parameter=value]&_include=HealthcareService:organization HealthcareService:endpoint - GET [base]/HealthcareService?[parameter=value]&_include=HealthcareService:endpoint A Server SHALL be capable of supporting the following _revincludes: PractitionerRole:service - GET [base]/HealthcareService?[parameter=value]&_revinclude=PractitionerRole:service OrganizationAffiliation:service - GET [base]/HealthcareService?[parameter=value]&_revinclude=OrganizationAffiliation:service Search Parameter Summary: Conformance Parameter Type Example SHALL location reference GET [base]/HealthcareService?location=[location] SHALL coverage-area reference GET [base]/HealthcareService?coverage-area=[coverage-area] SHALL organization reference GET [base]/HealthcareService?organization=[organization] SHALL endpoint reference GET [base]/HealthcareService?endpoint=[endpoint] SHALL name string GET [base]/HealthcareService?name=[name] SHALL service-category token GET [base]/HealthcareService?service-category=[system]|[code] SHALL service-type token GET [base]/HealthcareService?service-type=[system]|[code] SHALL specialty token GET [base]/HealthcareService?specialty=[system]|[code] SHALL _id token GET [base]/HealthcareService?_id=[id] SHALL _lastUpdated date GET [base]/HealthcareService?_lastUpdated=[_lastUpdated] InsurancePlan Conformance Expectation: SHALL Supported Profiles: Plan-Net InsurancePlan 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 InsurancePlan resource using: GET [base]/InsurancePlan/[id] A Server SHOULD be capable of returning a InsurancePlan resource using: GET [base]/InsurancePlan/[id]/_history/vid A Server SHALL be capable of supporting the following _includes: InsurancePlan:administered-by - GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:administered-by InsurancePlan:owned-by - GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:owned-by InsurancePlan:coverage-area - GET [base]/InsurancePlan?[parameter=value]&_include=InsurancePlan:coverage-area Search Parameter Summary: Conformance Parameter Type Example SHALL administered-by reference GET [base]/InsurancePlan?administered-by=[administered-by] SHALL owned-by reference GET [base]/InsurancePlan?owned-by=[owned-by] SHALL coverage-area reference GET [base]/InsurancePlan?coverage-area=[coverage-area] SHALL name string GET [base]/InsurancePlan?name=[name] SHALL plan-type token GET [base]/InsurancePlan?plan-type=[system]|[code] SHALL identifier token GET [base]/InsurancePlan?identifier=[system]|[code] SHALL _id token GET [base]/InsurancePlan?_id=[id] SHALL _lastUpdated date GET [base]/InsurancePlan?_lastUpdated=[_lastUpdated] SHALL type token GET [base]/InsurancePlan?type=[system]|[code] Location Conformance Expectation: SHALL Supported Profiles: Plan-Net Location 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 Location resource using: GET [base]/Location/[id] A Server SHOULD be capable of returning a Location resource using: GET [base]/Location/[id]/_history/vid A Server SHALL be capable of supporting the following _includes: Location:endpoint - GET [base]/Location?[parameter=value]&_include=Location:endpoint Location:organization - GET [base]/Location?[parameter=value]&_include=Location:organization Location:partof - GET [base]/Location?[parameter=value]&_include=Location:partof A Server SHALL be capable of supporting the following _revincludes: HealthcareService:location - GET [base]/Location?[parameter=value]&_revinclude=HealthcareService:location InsurancePlan:coverage-area - GET [base]/Location?[parameter=value]&_revinclude=InsurancePlan:coverage-area OrganizationAffiliation:location - GET [base]/Location?[parameter=value]&_revinclude=OrganizationAffiliation:location PractitionerRole:location - GET [base]/Location?[parameter=value]&_revinclude=PractitionerRole:location Search Parameter Summary: Conformance Parameter Type Example SHALL partof reference GET [base]/Location?partof=[partof] SHALL organization reference GET [base]/Location?organization=[organization] SHALL endpoint reference GET [base]/Location?endpoint=[endpoint] SHALL address-city string GET [base]/Location?address-city=[address-city] SHALL address-state string GET [base]/Location?address-state=[address-state] SHALL address-postalcode string GET [base]/Location?address-postalcode=[address-postalcode] SHALL address string GET [base]/Location?address=[address] SHALL type token GET [base]/Location?type=[system]|[code] SHALL _id token GET [base]/Location?_id=[id] SHALL _lastUpdated date GET [base]/Location?_lastUpdated=[_lastUpdated] Organization Conformance Expectation: SHALL Supported Profiles: Plan-Net Network, Plan-Net Organization 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 Organization resource using: GET [base]/Organization/[id] A Server SHOULD be capable of returning a Organization resource using: GET [base]/Organization/[id]/_history/vid A Server SHALL be capable of supporting the following _includes: Organization:partof - GET [base]/Organization?[parameter=value]&_include=Organization:partof Organization:endpoint - GET [base]/Organization?[parameter=value]&_include=Organization:endpoint Organization:coverage-area - GET [base]/Organization?[parameter=value]&_include=Organization:coverage-area A Server SHALL be capable of supporting the following _revincludes: Endpoint:organization - GET [base]/Organization?[parameter=value]&_revinclude=Endpoint:organization HealthcareService:organization - GET [base]/Organization?[parameter=value]&_revinclude=HealthcareService:organization InsurancePlan:administered-by - GET [base]/Organization?[parameter=value]&_revinclude=InsurancePlan:administered-by InsurancePlan:owned-by - GET [base]/Organization?[parameter=value]&_revinclude=InsurancePlan:owned-by OrganizationAffiliation:primary-organization - GET [base]/Organization?[parameter=value]&_revinclude=OrganizationAffiliation:primary-organization PractitionerRole:organization - GET [base]/Organization?[parameter=value]&_revinclude=PractitionerRole:organization PractitionerRole:network - GET [base]/Organization?[parameter=value]&_revinclude=PractitionerRole:network OrganizationAffiliation:participating-organization - GET [base]/Organization?[parameter=value]&_revinclude=OrganizationAffiliation:participating-organization Search Parameter Summary: Conformance Parameter Type Example SHALL partof reference GET [base]/Organization?partof=[partof] SHALL endpoint reference GET [base]/Organization?endpoint=[endpoint] SHALL address string GET [base]/Organization?address=[address] SHALL name string GET [base]/Organization?name=[name] SHALL _id token GET [base]/Organization?_id=[id] SHALL _lastUpdated date GET [base]/Organization?_lastUpdated=[_lastUpdated] SHALL type token GET [base]/Organization?type=[system]|[code] SHALL coverage-area reference GET [base]/Organization?coverage-area=[coverage-area] OrganizationAffiliation Conformance Expectation: SHALL Supported Profiles: Plan-Net OrganizationAffiliation 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 OrganizationAffiliation resource using: GET [base]/OrganizationAffiliation/[id] A Server SHOULD be capable of returning a OrganizationAffiliation resource using: GET [base]/OrganizationAffiliation/[id]/_history/vid A Server SHALL be capable of supporting the following _includes: OrganizationAffiliation:primary-organization - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:primary-organization OrganizationAffiliation:participating-organization - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:participating-organization OrganizationAffiliation:location - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:location OrganizationAffiliation:service - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:service OrganizationAffiliation:endpoint - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:endpoint OrganizationAffiliation:network - GET [base]/OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:network Search Parameter Summary: Conformance Parameter Type Example SHALL primary-organization reference GET [base]/OrganizationAffiliation?primary-organization=[primary-organization] SHALL participating-organization reference GET [base]/OrganizationAffiliation?participating-organization=[participating-organization] SHALL location reference GET [base]/OrganizationAffiliation?location=[location] SHALL service reference GET [base]/OrganizationAffiliation?service=[service] SHALL network reference GET [base]/OrganizationAffiliation?network=[network] SHALL endpoint reference GET [base]/OrganizationAffiliation?endpoint=[endpoint] SHALL role token GET [base]/OrganizationAffiliation?role=[system]|[code] SHALL specialty token GET [base]/OrganizationAffiliation?specialty=[system]|[code] SHALL _id token GET [base]/OrganizationAffiliation?_id=[id] SHALL _lastUpdated date GET [base]/OrganizationAffiliation?_lastUpdated=[_lastUpdated] Practitioner Conformance Expectation: SHALL Supported Profiles: Plan-Net Practitioner 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 Practitioner resource using: GET [base]/Practitioner/[id] A Server SHOULD be capable of returning a Practitioner resource using: GET [base]/Practitioner/[id]/_history/vid A Server SHALL be capable of supporting the following _revincludes: PractitionerRole:practitioner - GET [base]/Practitioner?[parameter=value]&_revinclude=PractitionerRole:practitioner Search Parameter Summary: Conformance Parameter Type Example SHALL name string GET [base]/Practitioner?name=[name] SHALL _id token GET [base]/Practitioner?_id=[id] SHALL _lastUpdated date GET [base]/Practitioner?_lastUpdated=[_lastUpdated] SHALL family string GET [base]/Practitioner?family=[family] SHALL given string GET [base]/Practitioner?given=[given] PractitionerRole Conformance Expectation: SHALL Supported Profiles: Plan-Net PractitionerRole 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 PractitionerRole resource using: GET [base]/PractitionerRole/[id] A Server SHOULD be capable of returning a PractitionerRole resource using: GET [base]/PractitionerRole/[id]/_history/vid A Server SHALL be capable of supporting the following _includes: PractitionerRole:practitioner - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:practitioner PractitionerRole:organization - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:organization PractitionerRole:location - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:location PractitionerRole:service - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:service PractitionerRole:network - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:network PractitionerRole:endpoint - GET [base]/PractitionerRole?[parameter=value]&_include=PractitionerRole:endpoint Search Parameter Summary: Conformance Parameter Type Example SHALL practitioner reference GET [base]/PractitionerRole?practitioner=[practitioner] SHALL organization reference GET [base]/PractitionerRole?organization=[organization] SHALL location reference GET [base]/PractitionerRole?location=[location] SHALL service reference GET [base]/PractitionerRole?service=[service] SHALL network reference GET [base]/PractitionerRole?network=[network] SHALL endpoint reference GET [base]/PractitionerRole?endpoint=[endpoint] SHALL role token GET [base]/PractitionerRole?role=[system]|[code] SHALL specialty token GET [base]/PractitionerRole?specialty=[system]|[code] SHALL _id token GET [base]/PractitionerRole?_id=[id] SHALL _lastUpdated date GET [base]/PractitionerRole?_lastUpdated=[_lastUpdated]
HL7 International / Financial Management
This Section describes the expected capabilities of the Plan-Net Server actor which is responsible for providing responses to the queries submitted by the Plan-Net Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Plan-Net Servers are defined. Systems implementing this capability statement should meet the CMS FInal Rule requirement for provider directory access. Plan-Net Clients can use the required capabilities to access necessary data based on their local use cases and other contextual requirements.
The Plan-Net Server **SHALL**: 1. Support all profiles defined in this Implementation Guide.. 1. Implement the RESTful behavior according to the FHIR specification. 1. Return the following response classes: - (Status 400): invalid parameter - (Status 401/4xx): unauthorized request - (Status 403): insufficient scope - (Status 404): unknown resource - (Status 410): deleted resource. 1. Support json source formats for all Plan-Net interactions. 1. Identify the Plan-Net profiles supported as part of the FHIR `meta.profile` attribute for each instance. 1. Support the searchParameters on each profile individually and in combination. 1.Support forward and reverse chaining on all search parameters that specify the 'chain' property The Plan-Net Server **SHOULD**: 1. Support xml source formats for all Plan-Net interactions.
1. See the [General Security Considerations](implementation.html#general-security-considerations) section for requirements and recommendations. 1. A server **SHALL** reject any unauthorized requests by returning an `HTTP 401` unauthorized response code.