CARIN Digital Insurance Card
2.0.0-ballot - STU 2 Ballot

CARIN Digital Insurance Card - Downloaded Version 2.0.0-ballot See the Directory of published versions

## CapabilityStatement: C4DIC CapabilityStatement

Official URL: http://hl7.org/fhir/us/insurance-card/CapabilityStatement/c4dic | Version: 2.0.0-ballot
Standards status: Trial-use | Maturity Level: 2 | Computable Name: InsuranceCardCapabilityStatement
Other Identifiers: OID:2.16.840.1.113883.4.642.40.9.13.1

This Section describes the expected capabilities of the C4DIC Server actor which is responsible for providing responses to the queries submitted by the C4DIC Requestors.

Raw OpenAPI-Swagger Definition file | Download

## C4DIC CapabilityStatement

- Official URL:`http://hl7.org/fhir/us/insurance-card/CapabilityStatement/c4dic`
- Implementation Guide Version: 0.1.0
- FHIR Version: 4.0.1
- Intended Use: Requirements
- Supported Formats: shall support JSON, should support XML
- Supported Patch Formats: APPLICATION/JSON-PATCH+JSON
- Published: 2022-04-20
- Published by: HL7 Payer/Provider Information Exchange Working Group (PIE WG)
- Status: Active

This Section describes the expected capabilities of the C4DIC Server actor which is responsible for providing responses to the queries submitted by the C4DIC Requestors.

### Support the Following Implementation Guides:

- http://hl7.org/fhir/us/insurance-card/ImplementationGuide/hl7.fhir.us.insurance-card

### FHIR Server RESTful Capabilities

The C4DIC Server SHALL:

1. Support all profiles defined in this Implementation Guide.
2. Implement the RESTful behavior according to the FHIR specification.
3. For all the supported search interactions in this guide, support the GET based search.
4. Return the following response classes: • (Status 400): invalid parameter • (Status 401/4xx): unauthorized request • (Status 403): insufficient scopes • (Status 404): unknown resource • (Status 410): deleted resource
5. Support json source formats for all profiles C4DIC interactions.
6. Identify the C4DIC profiles supported as part of the FHIR meta.profile attribute for each instance.
7. Support the searchParameters on each profile individually and in combination.

The C4DIC Server SHOULD:

1. Support xml source formats for all C4DIC interactions.

Security:

1. See the General Security Considerations section for requirements and recommendations.
2. A server SHALL reject any unauthorized requests by returning an `HTTP 401` unauthorized response code.

### RESTful Capabilities by Resource/Profile:

Summary

Resource Type | Supported Interactions | Supported Profiles | Supported Searches | Supported `_includes` | Supported `_revincludes` | Supported Operations
--- | --- | --- | --- | --- | --- | ---
Coverage | search-type, read, vread | C4DIC-Coverage | _id, _profile, _lastUpdated, beneficiary, subscriber, patient, identifier, period, status | Coverage:beneficiary, Coverage:payor |  |
Organization | search-type, read, vread | C4DIC-Organization | _id |  |  |
Patient | search-type, read, vread | C4DIC-Patient | _id, _lastUpdated, identifier, name |  |  |

#### Coverage

Conformance Expectation: SHALL

Resource Specific Documentation:

Example query to search for Coverages which contain insurance card information: {baseurl}/Coverage?_profile=http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage

Supported Profiles:

- C4DIC-Coverage

Reference Policy: `resolves`

Profile Interaction Summary:

- SHALL support `search-type`, `read`.
- SHOULD support `vread`.

Fetch and Search Criteria:

- A Server SHALL be capable of returning a Coverage resource using: `GET [base]/Coverage/[id]`
- A Server SHOULD be capable of returning a Coverage resource using: `GET [base]/Coverage/[id]/_history/vid`
- A Server SHALL be capable of returning resources matching a search query using: `GET [base]/Coverage/[id]{?[parameters]{&_format=[mime-type]}}`
- A Server (conformance expectation undefined) be capable of supporting the following _includes:
  - Coverage:beneficiary - `GET [base]/Coverage?[parameter=value]&_include=Coverage:beneficiary`
  - Coverage:payor - `GET [base]/Coverage?[parameter=value]&_include=Coverage:payor`

Search Parameter Summary:

Conformance | Parameter | Type | Example
--- | --- | --- | ---
SHALL | _id | token | `GET [base]/Coverage?_id=[id]`
SHALL | _profile | token | `GET [base]/Coverage?_profile=http://hl7.org/fhir/us/insurance-card/StructureDefinition/C4DIC-Coverage`
SHALL | _lastUpdated | reference | `GET [base]/Coverage?_lastUpdated=[dateTime]`
SHALL | beneficiary | date | `GET [base]/Coverage?beneficiary=[beneficiary]`
SHALL | subscriber | token | `GET [base]/Coverage?subscriber=[system]|[code]`
SHALL | patient | token | `GET [base]/Coverage?patient=[system]|[code]`
SHALL | identifier | date | `GET [base]/Coverage?identifier=[identifier]`
SHALL | period | date | `GET [base]/Coverage?period=[period]`
SHALL | status | token | `GET [base]/Coverage?status=[system]|[code]`

#### Organization

Conformance Expectation: SHALL

Supported Profiles:

- C4DIC-Organization

Reference Policy: `resolves`

Profile Interaction Summary:

- SHALL support `search-type`, `read`.
- SHOULD support `vread`.

Fetch and Search Criteria:

- A Server SHALL be capable of returning an Organization resource using: `GET [base]/Organization/[id]`
- A Server SHOULD be capable of returning an Organization resource using: `GET [base]/Organization/[id]/_history/vid`
- A Server SHALL be capable of returning resources matching a search query using: `GET [base]/Organization/[id]{?[parameters]{&_format=[mime-type]}}`

Search Parameter Summary:

Conformance | Parameter | Type | Example
--- | --- | --- | ---
SHALL | _id | reference | `GET [base]/Organization?_id=[id]`

#### Patient

Conformance Expectation: SHALL

Supported Profiles:

- C4DIC-Patient

Reference Policy: `resolves`

Profile Interaction Summary:

- SHALL support `search-type`, `read`.
- SHOULD support `vread`.

Fetch and Search Criteria:

- A Server SHALL be capable of returning a Patient resource using: `GET [base]/Patient/[id]`
- A Server SHOULD be capable of returning a Patient resource using: `GET [base]/Patient/[id]/_history/vid`
- A Server SHALL be capable of returning resources matching a search query using: `GET [base]/Patient/[id]{?[parameters]{&_format=[mime-type]}}`

Search Parameter Summary:

Conformance | Parameter | Type | Example
--- | --- | --- | ---
SHALL | _id | reference | `GET [base]/Patient?_id=[id]`
SHALL | _lastUpdated | reference | `GET [base]/Patient?_lastUpdated=[dateTime]`
SHALL | identifier | reference | `GET [base]/Patient?identifier=[type]/[id]`
SHALL | name | reference | `GET [base]/Patient?name=[type]/[id]`