Interoperability Patient Access API Clinical v1

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As part of the CMS Interoperability and Patient Access final rule (CMS-9115-F), members must have access to any clinical data that a payer has readily available. These APIs are required to retrieve that information on behalf of a member.

There are twenty-six (26) clinical resources that conform to the HL7 FHIR standards. These resources provide the USCDI data elements stored by the payer.

Prior to calling this, you must have the proper authentication tokens. Also, the Who Am I API will be necessary to retrieve profile information on the logged in user and their dependents as well as the patient search criteria for the other APIs.

More details on this API can be found in the Capability Statement API as well as in the swagger document.

APIs in this category follow the US Core Implementation Guide v3.1.1 found at