Interoperability Patient Access - Clinical

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.

These are clinical resources that include patient-related information, administrative information, or infrastructure components used to support the technical exchange of information.


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.

Developer Resources

Interoperability Patient Access API Clinical


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