National Directory of Healthcare Providers & Services (NDH) Implementation Guide
1.0.0-ballot - ballot United States of America flag

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.

Raw OpenAPI-Swagger Definition file | Download


General

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

Jump to:


REST Server behavior

Workflow Directory Payer Provider Network Query Server


Resource summary

Resource Search Read Read Version Instance History Resource History Create Update Delete Operations
Endpoint SHOULD SHALL SHALL SHALL SHALL
HealthcareService SHALL SHALL SHALL SHALL SHALL
InsurancePlan SHALL SHALL SHALL SHALL SHALL
Location SHALL SHALL SHALL SHALL SHALL
Organization SHALL SHALL SHALL SHALL SHALL
OrganizationAffiliation SHALL SHALL SHALL SHALL SHALL
Practitioner SHALL SHALL SHALL SHALL SHALL
PractitionerRole SHALL SHALL SHALL SHALL SHALL


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.