National Directory of Healthcare Providers & Services (NDH) Implementation Guide
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National Directory of Healthcare Providers & Services (NDH) Implementation Guide, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-ndh/ and changes regularly. See the Directory of published versions

CapabilityStatement: Workflow Directory Server Payer Provider Network Query Capability Statement

Official URL: http://hl7.org/fhir/us/ndh/CapabilityStatement/wds-payer-provider-network-query-server Version: 1.0.0-ballot
Active as of 2022-11-01 Computable Name: WdsPayerProviderNetworkQueryCapabilityStatement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

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General

Supported FHIR Version: 4.0.1
Supported exchange formats: xml, json

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REST Server behavior

Workflow Directory Payer Provider Network Query Server


Resource summary



Endpoint

Supported Profile(s):

Behavior

Versioning support: Versioned

Reference policy: Literal References, Local References Only

Interactions

Name Conformance Description
  search-type SHOULD

Search all resources of the specified type based on some filter criteria.

  read SHALL

Read the current state of the resource

  vread SHALL

Read the state of a specific version of the resource

  history-instance SHALL

Retrieve the history of the resource

  history-type SHALL

Retrieve the history of the resource type

Search

Supported Includes: Endpoint:organization

Supported Reverse-Includes: HealthcareService:endpoint, Location:endpoint, Organization:endpoint, OrganizationAffiliation:endpoint, Practitioner:practitioner-endpoint, PractitionerRole:endpoint

Parameter Name Definition Conformance Type Description
usecase-type EndpointUsecaseTypeSearchParameter SHALL Token

Endpoint usecase type

nonfhir-usecase-type EndpointNonfhirUsecaseTypeSearchParameter SHALL Token

Endpoint nonfhir usecase type

trust-framework-type EndpointTrustFrameworkTypeSearchParameter SHALL Token

Endpoint trust framework type

dynamic-registration-trust-profile EndpointDynamicRegistrationTrustProfileSearchParameter SHALL Token

Endpoint dynamic registration trust profile

access-control-mechanism EndpointAccessControlMechanismSearchParameter SHALL Token

Endpoint access control mechanism

connection-type-version EndpointConnectionTypeVersionSearchParameter SHALL Token

Endpoint connection type version

ihe-connection-type EndpointIheConnectionTypeSearchParameter SHALL Token

Endpoint ihe connection type

verification-status EndpointVerificationStatusSearchParameter SHALL Token

Endpoint verification status

connection-type connection-type SHALL Token

Connection type

identifier identifier SHALL Token

Endpoint identifier

organization organization SHALL Reference

Organization that manages the Endpoint

status status SHALL Token

Endpoint status

_id _id SHALL Token

Logical id allows to retrive more than one in a single call

_lastUpdated _lastUpdated SHALL Date/DateTime

Allows filtering for only records that have changed since last query.



HealthcareService

Supported Profile(s):

Behavior

Versioning support: Versioned

Reference policy: Literal References, Local References Only

Interactions

Name Conformance Description
  search-type SHALL

Search all resources of the specified type based on some filter criteria.

  read SHALL

Read the current state of the resource

  vread SHALL

Read the state of a specific version of the resource

  history-instance SHALL

Retrieve the history of the resource

  history-type SHALL

Retrieve the history of the resource type

Search

Supported Includes: HealthcareService:coverage-area, HealthcareService:endpoint, HealthcareService:location, HealthcareService:new-patient-from-network, HealthcareService:organization

Supported Reverse-Includes: CareTeam:service, OrganizationAffiliation:service, PractitionerRole:service

Parameter Name Definition Conformance Type Description
new-patient-from-network HealthcareServiceNewPatientFromNetworkSearchParameter SHALL Reference

New patient from network

eligibility HealthcareServiceEligibilitySearchParameter SHALL Token

Eligibility

new-patient HealthcareServiceNewPatientSearchParameter SHALL Token

New patient

verification-status HealthcareServiceVerificationStatusSearchParameter SHALL Token

Verification status

location HealthcareServiceLocationSearchParameter SHALL Reference

The location of the Healthcare Service

organization HealthcareServiceOrganizationSearchParameter SHALL Reference

The organization that provides this Healthcare Service

active active SHALL Token

Whether this HealthcareService record is in active use

coverage-area coverage-area SHALL Reference

Location service is inteded for/available to

endpoint endpoint SHALL Reference

Technical endpoints providing access to services operated for the location

identifier identifier SHALL Token

External identifiers for this item

name name SHALL String

A portion of the Healthcare service name

program program SHALL Token

One of the Program Names that categorize the service

service-category service-category SHALL Token

Service Category of the Healthcare Service

service-type service-type SHALL Token

The type of service provided by this healthcare service

specialty specialty SHALL Token

Specialties handled by the HealthcareService

_id _id SHALL Token

Logical id allows to retrive more than one in a single call

_lastUpdated _lastUpdated SHALL Date/DateTime

Allows filtering for only records that have changed since last query.



InsurancePlan

Supported Profile(s):

Behavior

Versioning support: Versioned

Reference policy: Literal References, Local References Only

Interactions

Name Conformance Description
  search-type SHALL

Search all resources of the specified type based on some filter criteria.

  read SHALL

Read the current state of the resource

  vread SHALL

Read the state of a specific version of the resource

  history-instance SHALL

Retrieve the history of the resource

  history-type SHALL

Retrieve the history of the resource type

Search

Supported Includes: InsurancePlan:administered-by, InsurancePlan:endpoint, InsurancePlan:owned-by, InsurancePlan:coverage-area, InsurancePlan:coverage-network, InsurancePlan:plan-network, InsurancePlan:network

Parameter Name Definition Conformance Type Description
coverage-area InsuranceCoverageAreaSearchParameter SHALL Reference

InsurancePlan coverage area

coverage-benefit-type InsuranceplanCoverageBenefitTypeSearchParameter SHALL Token

InsurancePlan coverage benefit type

coverage-type InsuranceplanCoverageTypeSearchParameter SHALL Token

InsurancePlan coverage type

coverage-network InsuranceplanCoverageNetworkSearchParameter SHALL Reference

InsurancePlan coverage network

network InsuranceplanPlanNetworkSearchParameter SHALL Reference

InsurancePlan network

plan-network InsuranceplanPlanNetworkSearchParameter SHALL Reference

InsurancePlan plan network

plan-type InsuranceplanPlanTypeSearchParameter SHALL Token

InsurancePlan plan type

verification-status InsuranceplanVerificationStatusSearchParameter SHALL Token

Verification status

address address SHALL String

InsurancePlan contact address

address-city address-city SHALL String

InsurancePlan contact address-city

address-country address-country SHALL String

InsurancePlan contact address-country

address-postalcode address-postalcode SHALL String

InsurancePlan contact address-postalcode

address-state address-state SHALL String

InsurancePlan contact address-state

administered-by administered-by SHALL Reference

InsurancePlan administered by

endpoint endpoint SHALL Reference

InsurancePlan endpoint

identifier identifier SHALL Token

InsurancePlan identifier

name name SHALL String

InsurancePlan name

owned-by owned-by SHALL Reference

InsurancePlan owned by

status status SHALL Token

InsurancePlan status

type type SHALL Token

InsurancePlan type

_id _id SHALL Token

Logical id allows to retrive more than one in a single call

_lastUpdated _lastUpdated SHALL Date/DateTime

Allows filtering for only records that have changed since last query.



Location

Supported Profile(s):

Behavior

Versioning support: Versioned

Reference policy: Literal References, Local References Only

Interactions

Name Conformance Description
  search-type SHALL

Search all resources of the specified type based on some filter criteria.

  read SHALL

Read the current state of the resource

  vread SHALL

Read the state of a specific version of the resource

  history-instance SHALL

Retrieve the history of the resource

  history-type SHALL

Retrieve the history of the resource type

Search

Supported Includes: Location:endpoint, Location:new-patient-from-network, Location:organization, Location:partof

Supported Reverse-Includes: CareTeam:location, HealthcareService:coverage-area, HealthcareService:location, InsurancePlan:coverage-area, Location:partof, OrganizationAffiliation:location, PractitionerRole:location

Parameter Name Definition Conformance Type Description
accessibility LocationAccessibilitySearchParameter SHALL Token

Location accessibility

contains LocationContainsSearchParameter SHALL Special

Location contains

new-patient-from-network LocationNewPatientFromNetworkSearchParameter SHALL Reference

Location new patient from network

new-patient LocationNewPatientSearchParameter SHALL Token

Location new patient

verification-status LocationVerificationStatusSearchParameter SHALL Token

Verification status

address address SHALL String

Location address

address-city address-city SHALL String

Location address-city

address-country address-country SHALL String

Location address-country

address-postalcode address-postalcode SHALL String

Location address-postalcode

address-state address-state SHALL String

Location address-state

address-use address-use SHALL Token

Location address-use

endpoint endpoint SHALL Reference

Location endpoint

identifier identifier SHALL Token

Location identifier

name name SHALL String

Location name

near near SHALL Special

Location position

partof partof SHALL Reference

Location partof

organization organization SHALL Reference

Location organization

type type SHALL Token

Location type

_id _id SHALL Token

Logical id allows to retrive more than one in a single call

_lastUpdated _lastUpdated SHALL Date/DateTime

Allows filtering for only records that have changed since last query.



Organization

Supported Profile(s):

Behavior

Versioning support: Versioned

Reference policy: Literal References, Local References Only

Interactions

Name Conformance Description
  search-type SHALL

Search all resources of the specified type based on some filter criteria.

  read SHALL

Read the current state of the resource

  vread SHALL

Read the state of a specific version of the resource

  history-instance SHALL

Retrieve the history of the resource

  history-type SHALL

Retrieve the history of the resource type

Search

Supported Includes: Organization:endpoint, Organization:partof

Supported Reverse-Includes: CareTeam:organization, Endpoint:organization, HealthcareService:organization, HealthcareService:new-patient-from-network, InsurancePlan:administered-by, InsurancePlan:owned-by, InsurancePlan:coverage-network, InsurancePlan:plan-network, InsurancePlan:network, Location:organization, Location:new-patient-from-network, Organization:partof, OrganizationAffiliation:network, OrganizationAffiliation:participating-organization, OrganizationAffiliation:primary-organization, Practitioner:qualification-issuer, PractitionerRole:organization, PractitionerRole:network, PractitionerRole:new-patient-from-network, VerificationResult:validator-organization, VerificationResult:attestation-who

Parameter Name Definition Conformance Type Description
coverage-area NetworkCoverageAreaSearchParameter SHALL Reference

network organization type is needed for searching network coverage area

verification-status OrganizationVerificationStatusSearchParameter SHALL Token

Verification status

active active SHALL Token

Organization active

address address SHALL String

Organization address

address-city address-city SHALL String

Organization address-city

address-country address-country SHALL String

Organization address-country

address-postalcode address-postalcode SHALL String

Organization address-postalcode

address-state address-state SHALL String

Organization address-state

address-use address-use SHALL Token

Organization address-use

endpoint endpoint SHALL Reference

Organization endpoint

identifier identifier SHALL Token

Organization identifier

name name SHALL String

Organization name

partof partof SHALL Reference

Organization partof

type type SHALL Token

Organization type

_id _id SHALL Token

Logical id allows to retrive more than one in a single call

_lastUpdated _lastUpdated SHALL Date/DateTime

Allows filtering for only records that have changed since last query.



OrganizationAffiliation

Supported Profile(s):

Behavior

Versioning support: Versioned

Reference policy: Literal References, Local References Only

Interactions

Name Conformance Description
  history-instance SHALL

Retrieve the history of the resource

  history-type SHALL

Retrieve the history of the resource type

  read SHALL

Read the current state of the resource

  search-type SHALL

Search all resources of the specified type based on some filter criteria.

  vread SHALL

Read the state of specific version of the resource

Search

Supported Includes: OrganizationAffiliation:network, OrganizationAffiliation:participating-organization, OrganizationAffiliation:primary-organization

Parameter Name Definition Conformance Type Description
location OrganizationAffiliationLocationSearchParameter SHALL Reference

OrganizationAffiliation location

participating-organization OrganizationAffiliationParticipatingOrganizationSearchParameter SHALL Reference

OrganizationAffiliation participating-organization

primary-organization OrganizationAffiliationPrimaryOrganizationSearchParameter SHALL Reference

OrganizationAffiliation primary-organization

verification-status OrganizationAffiliationVerificationStatusSearchParameter SHALL Token

Verification status

endpoint endpoint SHALL Reference

OrganizationAffiliation endpoint

identifier identifier SHALL Token

OrganizationAffiliation identifier

network network SHALL Reference

OrganizationAffiliation network

role role SHALL Token

OrganizationAffiliation role

service service SHALL Reference

OrganizationAffiliation service

specialty specialty SHALL Token

OrganizationAffiliation specialty

_id _id SHALL Token

Logical id allows to retrive more than one in a single call

_lastUpdated _lastUpdated SHALL Date/DateTime

Allows filtering for only records that have changed since last query.



Practitioner

Supported Profile(s):

Behavior

Versioning support: Versioned

Reference policy: Literal References, Local References Only

Interactions

Name Conformance Description
  read SHALL

Read the current state of the resource

  search-type SHALL

Search all resources of the specified type based on some filter criteria.

  vread SHALL

Read the state of specific version of the resource

  history-instance SHALL

Retrieve the history of the resource

  history-type SHALL

Retrieve the history of the resource type

Search

Supported Includes: Practitioner:endpoint, Practitioner:qualification-issuer

Supported Reverse-Includes: PractitionerRole:practitioner

Parameter Name Definition Conformance Type Description
endpoint PractitionerEndpointSearchParameter SHALL Reference

Practitioner endpoint

qualification-issuer PractitionerQualificationIssuerSearchParameter SHALL Reference

Practitioner qualification issuer

qualification-code PractitionerQualificationCodeSearchParameter SHALL Token

Practitioner qualification code

verification-status PractitionerVerificationStatusSearchParameter SHALL Token

Verification status

active active SHALL Token

Whether this practitioner's record is in active use

name name SHALL String

A portion of either family or given name of the practitioner

identifier identifier SHALL Token

A practitioner's Identifier

_id _id SHALL Token

Logical id allows to retrive more than one in a single call

_lastUpdated _lastUpdated SHALL Date/DateTime

Allows filtering for only records that have changed since last query.



PractitionerRole

Supported Profile(s):

Behavior

Versioning support: Versioned

Reference policy: Literal References, Local References Only

Interactions

Name Conformance Description
  read SHALL

Read the current state of the resource

  search-type SHALL

Search all resources of the specified type based on some filter criteria.

  vread SHALL

Read the state of specific version of the resource

  history-instance SHALL

Retrieve the history of the resource

  history-type SHALL

Retrieve the history of the resource type

Search

Supported Includes: PractitionerRole:endpoint, PractitionerRole:location, PractitionerRole:network, PractitionerRole:new-patient-from-network, PractitionerRole:organization, PractitionerRole:practitioner, PractitionerRole:service

Parameter Name Definition Conformance Type Description
network PractitionerroleNetworkSearchParameter SHALL Reference

PractitionerRole network

new-patient PractitionerroleNewPatientSearchParameter SHALL Token

PractitionerRole new-patient

new-patient-from-network PractitionerroleNewPatientFromNetworkSearchParameter SHALL Reference

PractitionerRole new-patient from network

location PractitionerroleLocationSearchParameter SHALL Reference

One of the locations at which this practitioner provides care

organization PractitionerroleOrganizationSearchParameter SHALL Reference

The identity of the organization the practitioner represents / acts on behalf of

verification-status PractitionerroleVerificationStatusSearchParameter SHALL Token

Verification status

active active SHALL Token

Whether this practitioner's record is in active use

endpoint endpoint SHALL Reference

Technical endpoints providing access to services operated for the practitioner with this role

identifier identifier SHALL Token

A practitioner's Identifier

practitioner practitioner SHALL Reference

Practitioner that is able to provide the defined services for the organization

role role SHALL Token

The practitioner can perform this role at for the organization

service service SHALL Reference

The list of healthcare services that this worker provides for this role's Organization/Location

specialty specialty SHALL Token

The practitioner has this specialty at an organization

_id _id SHALL Token

Logical id allows to retrive more than one in a single call

_lastUpdated _lastUpdated SHALL Date/DateTime

Allows filtering for only records that have changed since last query.