Get Coverages API

[Bharti Tijare]

Hi Team,

We are using FHIR Coverage API to get patient insurance details through patient id.

Reference: https://fhir.cerner.com/millennium/r4/financial/support/coverage/#search 

Currently we are able to get Plan and Group Ids related to patient's insurance.

We have questions on carrier id and member id. 

1. How to get carrier id from this API? 
2. Is there any property in Coverage API which defines carrier id?
3. Is there any specific FHIR API to get Carrier details?
4. As per FHIR doc, we will get Member Id in Coverage.Identifier property (as shown in below screenshot).               
   1. Coverage.identifier can be any one of the below highlighted property (see screenshot). 
   2. How to identify if it is Member Id?
   3. Is there any way to identify if this property contains member id?

Thanks & Regards,

Bharti Tijare

[Nishanth Namana (Cerner)]

Hello Bharti Tijare,

I'm currently checking with my team regarding carrier id and member id information. I'll post my response once I have an update from our team.

Thank you,

Nishanth Namana.

[Nishanth Namana (Cerner)]

Hello Bharti Tijare,

I got a response from my team and here they are

• For Public Coverages, we don't have support for carrier organization id or the member id.
• For Private Coverages, Carrier is an Organization. We can find the Carrier information from Coverage.payor field. And to get additional information about the Carrier, you can use FHIR Organization resource.
• For Member Id's in Private Coverages, we got two different member id's.
  • Subscriber's Member Id: This information can be extracted from Coverage.SubscriberId field
  • Patient's Member Id: This can be extracted from Coverage.dependent field.

Hope this answers your question. Please let us know if you have any other questions.

Thank you,

Nishanth Namana.