Blue KC

Blue KC Provider Directory API Guide

INTEROPERABILITY
PATIENT ACCESS
PROVIDER DIRECTORY
PAYER TO PAYER

Overview

The provider directory is an open access API that does not require a user authentication to use.

This documentation presumes that the developer is familiar with the implementation guide for provider directory works as the process for extracting useful information is not intuitive.

In the insurance world providers sign contracts to participate in certain networks. These networks are then assigned to insurance policies that are sold to customers. To find the providers that will accept a given insurance policy requires traversing multiple FHIR elements.

The insurance plan to provider relations is as follows: Insurance Plan -> Network (represented by FHIR Organization resource) -> PractionerRole -> Practioner

Security

The provider directory API has not authentication on it, but usage is tracked and logged per IP address and normal rate limits and other protections to BlueKC systems applies. Application access to the Patient Access API may be terminated for violations of the Terms of Service of the Provider Directory API.

Endpoint Examples

Additional Examples, Search Parameters, and Information

Swagger documentation for specific parameters and search capabilities and for pagination of search results is available

Swagger Documentation

The capabilities statment can be found here as well.

Capabilities Statement