National Directory of Healthcare Providers & Services (NDH) Implementation Guide
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This page is part of the National Directory of Healthcare Providers and Services (NDH) Implementation Guide (v1.0.0-ballot: STU1 Ballot 1) based on FHIR R4. . For a full list of available versions, 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.

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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-update

Reference policy: literal, local

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, CareTeam:careteam-endpoint, HealthcareService:endpoint, InsurancePlan:endpoint, Location:endpoint, Organization:endpoint, OrganizationAffiliation:endpoint, Practitioner:practitioner-endpoint, PractitionerRole:endpoint

Supported Reverse-Includes: HealthcareService:endpoint, Location:endpoint, Organization:endpoint, OrganizationAffiliation:endpoint, Practitioner:practitioner-endpoint, PractitionerRole:endpoint

Parameter Name Definition Conformance Type Description
endpoint-usecase-type EndpointUsecaseTypeSearchParameter SHALL token

Endpoint usecase type
endpoint-nonfhir-usecase-type EndpointNonfhirUsecaseTypeSearchParameter SHALL token

Endpoint nonfhir usecase type
endpoint-trust-framework-type EndpointTrustFrameworkTypeSearchParameter SHALL token

Endpoint trust framework type
endpoint-dynamic-registration-trust-profile EndpointDynamicRegistrationTrustProfileSearchParameter SHALL token

Endpoint dynamic registration trust profile
endpoint-access-control-mechanism EndpointAccessControlMechanismSearchParameter SHALL token

Endpoint access control mechanism
endpoint-connection-type-version EndpointConnectionTypeVersionSearchParameter SHALL token

Endpoint connection type version
endpoint-ihe-connection-type EndpointIheConnectionTypeSearchParameter SHALL token

Endpoint ihe connection type
endpoint-verification-status EndpointVerificationStatusSearchParameter SHALL token

Endpoint verification status
connection-type http://hl7.org/fhir/SearchParameter/Endpoint-connection-type SHALL token

Connection type
identifier http://hl7.org/fhir/SearchParameter/Endpoint-identifier SHALL token

Endpoint identifier
organization http://hl7.org/fhir/SearchParameter/Endpoint-organization SHALL reference

Organization that manages the Endpoint
status http://hl7.org/fhir/SearchParameter/Endpoint-status SHALL token

Endpoint status
_id http://hl7.org/fhir/SearchParameter/Resource-id SHALL token

Logical id allows to retrive more than one in a single call
_lastUpdated http://hl7.org/fhir/SearchParameter/Resource-lastUpdated SHALL date

Allows filtering for only records that have changed since last query.


HealthcareService

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal, local

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:healthcareservice-new-patient-from-network, HealthcareService:organization

Supported Reverse-Includes: CareTeam:careteam-service, OrganizationAffiliation:service, PractitionerRole:service

Parameter Name Definition Conformance Type Description
healthcareservice-new-patient-from-network HealthcareServiceNewPatientFromNetworkSearchParameter SHALL reference

New patient from network
healthcareservice-eligibility HealthcareServiceEligibilitySearchParameter SHALL token

Eligibility
healthcareservice-new-patient HealthcareServiceNewPatientSearchParameter SHALL token

New patient
healthcareservice-verification-status HealthcareServiceVerificationStatusSearchParameter SHALL token

Verification status
active http://hl7.org/fhir/SearchParameter/HealthcareService-active SHALL token

Whether this HealthcareService record is in active use
coverage-area http://hl7.org/fhir/SearchParameter/HealthcareService-coverage-area SHALL reference

Location service is inteded for/available to
endpoint http://hl7.org/fhir/SearchParameter/HealthcareService-endpoint SHALL reference

Technical endpoints providing access to services operated for the location
identifier http://hl7.org/fhir/SearchParameter/HealthcareService-identifier SHALL token

External identifiers for this item
location http://hl7.org/fhir/SearchParameter/HealthcareService-location SHALL reference

The location of the Healthcare Service
name http://hl7.org/fhir/SearchParameter/HealthcareService-name SHALL string

A portion of the Healthcare service name
organization http://hl7.org/fhir/SearchParameter/HealthcareService-organization SHALL reference

The organization that provides this Healthcare Service
program http://hl7.org/fhir/SearchParameter/HealthcareService-program SHALL token

One of the Program Names that categorize the service
service-category http://hl7.org/fhir/SearchParameter/HealthcareService-service-category SHALL token

Service Category of the Healthcare Service
service-type http://hl7.org/fhir/SearchParameter/HealthcareService-service-type SHALL token

The type of service provided by this healthcare service
specialty http://hl7.org/fhir/SearchParameter/HealthcareService-specialty SHALL token

Specialties handled by the HealthcareService
_id http://hl7.org/fhir/SearchParameter/Resource-id SHALL token

Logical id allows to retrive more than one in a single call
_lastUpdated http://hl7.org/fhir/SearchParameter/Resource-lastUpdated SHALL date

Allows filtering for only records that have changed since last query.


InsurancePlan

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal, local

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:insuranceplan-coverage-area, InsurancePlan:insuranceplan-coverage-network, InsurancePlan:insuranceplan-plan-network, InsurancePlan:insuranceplan-network

Parameter Name Definition Conformance Type Description
insuranceplan-coverage-area InsuranceCoverageAreaSearchParameter SHALL reference

InsurancePlan coverage area
insuranceplan-coverage-benefit-type InsuranceplanCoverageBenefitTypeSearchParameter SHALL token

InsurancePlan coverage benefit type
insuranceplan-coverage-type InsuranceplanCoverageTypeSearchParameter SHALL token

InsurancePlan coverage type
insuranceplan-coverage-network InsuranceplanCoverageNetworkSearchParameter SHALL reference

InsurancePlan coverage network
insuranceplan-network InsuranceplanPlanNetworkSearchParameter SHALL reference

InsurancePlan network
insuranceplan-plan-network InsuranceplanPlanNetworkSearchParameter SHALL reference

InsurancePlan plan network
insuranceplan-plan-type InsuranceplanPlanTypeSearchParameter SHALL token

InsurancePlan plan type
insuranceplan-verification-status InsuranceplanVerificationStatusSearchParameter SHALL token

Verification status
address http://hl7.org/fhir/SearchParameter/InsurancePlan-address SHALL string

InsurancePlan contact address
address-city http://hl7.org/fhir/SearchParameter/InsurancePlan-address-city SHALL string

InsurancePlan contact address-city
address-country http://hl7.org/fhir/SearchParameter/InsurancePlan-address-country SHALL string

InsurancePlan contact address-country
address-postalcode http://hl7.org/fhir/SearchParameter/InsurancePlan-address-postalcode SHALL string

InsurancePlan contact address-postalcode
address-state http://hl7.org/fhir/SearchParameter/InsurancePlan-address-state SHALL string

InsurancePlan contact address-state
administered-by http://hl7.org/fhir/SearchParameter/InsurancePlan-administered-by SHALL reference

InsurancePlan administered by
endpoint http://hl7.org/fhir/SearchParameter/InsurancePlan-endpoint SHALL reference

InsurancePlan endpoint
identifier http://hl7.org/fhir/SearchParameter/InsurancePlan-identifier SHALL token

InsurancePlan identifier
name http://hl7.org/fhir/SearchParameter/InsurancePlan-name SHALL string

InsurancePlan name
owned-by http://hl7.org/fhir/SearchParameter/InsurancePlan-owned-by SHALL reference

InsurancePlan owned by
status http://hl7.org/fhir/SearchParameter/InsurancePlan-status SHALL token

InsurancePlan status
type http://hl7.org/fhir/SearchParameter/InsurancePlan-type SHALL token

InsurancePlan type
_id http://hl7.org/fhir/SearchParameter/Resource-id SHALL token

Logical id allows to retrive more than one in a single call
_lastUpdated http://hl7.org/fhir/SearchParameter/Resource-lastUpdated SHALL date

Allows filtering for only records that have changed since last query.


Location

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal, local

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:location-new-patient-from-network, Location:organization, Location:partof

Supported Reverse-Includes: CareTeam:careteam-location, HealthcareService:coverage-area, HealthcareService:location, InsurancePlan:insuranceplan-coverage-area, Location:partof, OrganizationAffiliation:location, PractitionerRole:location

Parameter Name Definition Conformance Type Description
location-accessibility LocationAccessibilitySearchParameter SHALL token

Location accessibility
location-contains LocationContainsSearchParameter SHALL special

Location contains
location-new-patient-from-network LocationNewPatientFromNetworkSearchParameter SHALL reference

Location new patient from network
location-new-patient LocationNewPatientSearchParameter SHALL token

Location new patient
address http://hl7.org/fhir/SearchParameter/Location-address SHALL string

Location address
address-city http://hl7.org/fhir/SearchParameter/Location-address-city SHALL string

Location address-city
address-country http://hl7.org/fhir/SearchParameter/Location-address-country SHALL string

Location address-country
address-postalcode http://hl7.org/fhir/SearchParameter/Location-address-postalcode SHALL string

Location address-postalcode
address-state http://hl7.org/fhir/SearchParameter/Location-address-state SHALL string

Location address-state
address-use http://hl7.org/fhir/SearchParameter/Location-address-use SHALL token

Location address-use
organization http://hl7.org/fhir/SearchParameter/Location-organization SHALL reference

Location organization
type http://hl7.org/fhir/SearchParameter/Location-type SHALL token

Location type
_id http://hl7.org/fhir/SearchParameter/Resource-id SHALL token

Logical id allows to retrive more than one in a single call
_lastUpdated http://hl7.org/fhir/SearchParameter/Resource-lastUpdated SHALL date

Allows filtering for only records that have changed since last query.


Organization

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal, local

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:organization-identifier-assigner, Organization:partof, Organization:organization-via-intermediary

Supported Reverse-Includes: CareTeam:careteam-organization, Endpoint:organization, Endpoint:endpoint-identifier-assigner, HealthcareService:organization, HealthcareService:healthcareservice-new-patient-from-network, HealthcareService:healthcareservice-via-intermediary, InsurancePlan:administered-by, InsurancePlan:owned-by, InsurancePlan:insuranceplan-coverage-network, InsurancePlan:insuranceplan-plan-network, InsurancePlan:insuranceplan-network, Location:organization, Location:location-via-intermediary, Location:location-new-patient-from-network, Organization:organization-identifier-assigner, Organization:organization-via-intermediary, Organization:partof, OrganizationAffiliation:network, OrganizationAffiliation:participating-organization, OrganizationAffiliation:primary-organization, OrganizationAffiliation:organizationaffiliation-via-intermediary, Practitioner:practitioner-identifier-assigner, Practitioner:practitioner-qualification-issuer, Practitioner:practitioner-via-intermediary, PractitionerRole:organization, PractitionerRole:practitionerrole-network, PractitionerRole:practitionerrole-new-patient-from-network, VerificationResult:verificationresult-validator-organization, VerificationResult:verificationresult-attestation-who

Parameter Name Definition Conformance Type Description
network-coverage-area NetworkCoverageAreaSearchParameter SHALL reference

Network coverage area
active http://hl7.org/fhir/SearchParameter/Organization-active SHALL token

Organization active
address http://hl7.org/fhir/SearchParameter/Organization-address SHALL string

Organization address
address-city http://hl7.org/fhir/SearchParameter/Organization-address-city SHALL string

Organization address-city
address-country http://hl7.org/fhir/SearchParameter/Organization-address-country SHALL string

Organization address-country
address-postalcode http://hl7.org/fhir/SearchParameter/Organization-address-postalcode SHALL string

Organization address-postalcode
address-state http://hl7.org/fhir/SearchParameter/Organization-address-state SHALL string

Organization address-state
address-use http://hl7.org/fhir/SearchParameter/Organization-address-use SHALL token

Organization address-use
endpoint http://hl7.org/fhir/SearchParameter/Organization-endpoint SHALL reference

Organization endpoint
identifier http://hl7.org/fhir/SearchParameter/Organization-identifier SHALL token

Organization identifier
name http://hl7.org/fhir/SearchParameter/Organization-name SHALL string

Organization name
partof http://hl7.org/fhir/SearchParameter/Organization-partof SHALL reference

Organization partof
type http://hl7.org/fhir/SearchParameter/Organization-type SHALL token

Organization type
_id http://hl7.org/fhir/SearchParameter/Resource-id SHALL token

Logical id allows to retrive more than one in a single call
_lastUpdated http://hl7.org/fhir/SearchParameter/Resource-lastUpdated SHALL date

Allows filtering for only records that have changed since last query.


OrganizationAffiliation

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal, local

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, OrganizationAffiliation:organizationaffiliation-via-intermediary

Supported Reverse-Includes: Endpoint:endpoint-via-intermediary, HealthcareService:healthcareservice-via-intermediary, Location:location-via-intermediary, Organization:network-via-intermediary, Organization:organization-via-intermediary, OrganizationAffiliation:organizationaffiliation-via-intermediary, Practitioner:practitioner-via-intermediary, PractitionerRole:practitionerrole-via-intermediary

Parameter Name Definition Conformance Type Description
organizationaffiliation-via-intermediary OrganizationAffiliationViaIntermediarySearchParameter SHALL reference

OrganizationAffiliation via intermediary
endpoint http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-endpoint SHALL reference

OrganizationAffiliation endpoint
identifier http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-identifier SHALL token

OrganizationAffiliation identifier
location http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-location SHALL reference

OrganizationAffiliation location
network http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-network SHALL reference

OrganizationAffiliation network
participating-organization http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-participating-organization SHALL reference

OrganizationAffiliation participating-organization
primary-organization http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-primary-organization SHALL reference

OrganizationAffiliation primary-organization
role http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-role SHALL token

OrganizationAffiliation role
service http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-service SHALL reference

OrganizationAffiliation service
specialty http://hl7.org/fhir/SearchParameter/OrganizationAffiliation-specialty SHALL token

OrganizationAffiliation specialty
_id http://hl7.org/fhir/SearchParameter/Resource-id SHALL token

Logical id allows to retrive more than one in a single call
_lastUpdated http://hl7.org/fhir/SearchParameter/Resource-lastUpdated SHALL date

Allows filtering for only records that have changed since last query.


Practitioner

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal, local

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:practitioner-endpoint, Practitioner:practitioner-identifier-assigner, Practitioner:practitioner-qualification-issuer, Practitioner:practitione-via-intermediary, Practitioner:verification-attestation-who

Supported Reverse-Includes: PractitionerRole:practitioner

Parameter Name Definition Conformance Type Description
practitioner-qualification-issuer PractitionerQualificationIssuerSearchParameter SHALL reference

Practitioner qualification issuer
practitioner-qualification-code PractitionerQualificationCodeSearchParameter SHALL token

Practitioner qualification code
active http://hl7.org/fhir/SearchParameter/Practitioner-active SHALL token

Whether this practitioner's record is in active use
name http://hl7.org/fhir/SearchParameter/Practitioner-name SHALL string

A portion of either family or given name of the practitioner
identifier http://hl7.org/fhir/SearchParameter/Practitioner-identifier SHALL token

A practitioner's Identifier
_id http://hl7.org/fhir/SearchParameter/Resource-id SHALL token

Logical id allows to retrive more than one in a single call
_lastUpdated http://hl7.org/fhir/SearchParameter/Resource-lastUpdated SHALL date

Allows filtering for only records that have changed since last query.


PractitionerRole

Supported Profile(s):

Behavior

Versioning support: versioned-update

Reference policy: literal, local

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:practitionerrole-network, PractitionerRole:practitionerrole-new-patient-from-network, PractitionerRole:organization, PractitionerRole:practitioner, PractitionerRole:service, PractitionerRole:practitionerrole-via-intermediary

Supported Reverse-Includes: Endpoint:endpoint-via-intermediary, HealthcareService:healthcareservice-via-intermediary, Location:location-via-intermediary, Organization:organization-via-intermediary, OrganizationAffiliation:organizationaffiliation-via-intermediary, Practitioner:practitioner-via-intermediary, PractitionerRole:practitionerrole-via-intermediary

Parameter Name Definition Conformance Type Description
practitionerrole-network PractitionerroleNetworkSearchParameter SHALL reference

PractitionerRole network
practitionerrole-new-patient PractitionerroleNewPatientSearchParameter SHALL token

PractitionerRole new-patient
practitionerrole-new-patient-from-network PractitionerroleNewPatientFromNetworkSearchParameter SHALL reference

PractitionerRole new-patient from network
active http://hl7.org/fhir/SearchParameter/PractitionerRole-active SHALL token

Whether this practitioner's record is in active use
endpoint http://hl7.org/fhir/SearchParameter/PractitionerRole-endpoint SHALL reference

Technical endpoints providing access to services operated for the practitioner with this role
identifier http://hl7.org/fhir/SearchParameter/PractitionerRole-identifier SHALL token

A practitioner's Identifier
location http://hl7.org/fhir/SearchParameter/PractitionerRole-location SHALL reference

One of the locations at which this practitioner provides care
organization http://hl7.org/fhir/SearchParameter/PractitionerRole-organization SHALL reference

The identity of the organization the practitioner represents / acts on behalf of
practitioner http://hl7.org/fhir/SearchParameter/PractitionerRole-practitioner SHALL reference

Practitioner that is able to provide the defined services for the organization
role http://hl7.org/fhir/SearchParameter/PractitionerRole-role SHALL token

The practitioner can perform this role at for the organization
service http://hl7.org/fhir/SearchParameter/PractitionerRole-service SHALL reference

The list of healthcare services that this worker provides for this role's Organization/Location
specialty http://hl7.org/fhir/SearchParameter/PractitionerRole-specialty SHALL token

The practitioner has this specialty at an organization
_id http://hl7.org/fhir/SearchParameter/Resource-id SHALL token

Logical id allows to retrive more than one in a single call
_lastUpdated http://hl7.org/fhir/SearchParameter/Resource-lastUpdated SHALL date

Allows filtering for only records that have changed since last query.