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FHIR Resources supported for “Health Plans”

Administrative Health Plan Data (such as eligibility, enrollment, adjudicated claims, providers, and organizations)

FHIR Resources supported for “Health Plans” under the CARIN Consumer Directed Payer Data Exchange (CARIN IG for Blue Button®) implementation guide (IG version 1.2.0, FHIR 4.0.1). For the CARIN BB implementation, the following resources are supported:
1) C4BB Patient (based on Patient R4)
2) C4BB Coverage (based on Coverage R4)
3) C4BB ExplanationOfBenefit (based on Claim R4 and ClaimResponse R4)
4) C4BB Practitioner (based on Coverage R4)
5) C4BB Organization (based on Coverage R4)

Supplemental Clinical Data from Healthcare Providers maintained by Health Plans

In addition, for Health Plans that also maintain supplemental clinical data from Healthcare Providers that meet the criteria of U.S. Core Data for Interoperability (USCDI) v1 the following FHIR resources are supported under the US Core Implementation Guide (v4.0.0: STU4) based on FHIR R4:
  1. 1.
    ​US Core AllergyIntolerance Profile​
  2. 2.
    ​US Core BMI Profile​
  3. 3.
    ​US Core Blood Pressure Profile​
  4. 4.
    ​US Core Body Height Profile​
  5. 5.
    ​US Core Body Temperature Profile​
  6. 6.
    ​US Core Body Weight Profile​
  7. 7.
    ​US Core CarePlan Profile​
  8. 8.
    ​US Core CareTeam Profile​
  9. 9.
    ​US Core Condition Profile​
  10. 10.
    ​US Core DiagnosticReport Profile for Laboratory Results Reporting​
  11. 11.
    ​US Core DiagnosticReport Profile for Report and Note exchange​
  12. 12.
    ​US Core DocumentReference Profile​
  13. 13.
    ​US Core Encounter Profile​
  14. 14.
    ​US Core Goal Profile​
  15. 15.
    ​US Core Head Circumference Profile​
  16. 16.
    ​US Core Heart Rate Profile​
  17. 17.
    ​US Core Immunization Profile​
  18. 18.
    ​US Core Implantable Device Profile​
  19. 19.
    ​US Core Laboratory Result Observation Profile​
  20. 20.
    ​US Core Location Profile​
  21. 21.
    ​US Core Medication Profile​
  22. 22.
    ​US Core MedicationRequest Profile​
  23. 23.
    ​US Core Organization Profile​
  24. 24.
    ​US Core Patient Profile​
  25. 25.
    ​US Core Pediatric BMI for Age Observation Profile​
  26. 26.
    ​US Core Pediatric Head Occipital-frontal Circumference Percentile Profile​
  27. 27.
    ​US Core Pediatric Weight for Height Observation Profile​
  28. 28.
    ​US Core Practitioner Profile​
  29. 29.
    ​US Core PractitionerRole Profile​
  30. 30.
    ​US Core Procedure Profile​
  31. 31.
    ​US Core Provenance Profile​
  32. 32.
    ​US Core Pulse Oximetry Profile​
  33. 33.
    ​US Core Respiratory Rate Profile​
  34. 34.
    ​US Core Smoking Status Observation Profile​
  35. 35.
    ​US Core Vital Signs Profile​
Note that clinical data maintained by payers can vary, and only data that meets the criteria of USCDI is required.
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Last modified 1yr ago