Clever Care Health Plan

Clever Care Health Plan Patient Access API

Secured (OpenID Connect / OAuth 2.0) member data resources

GitHub OpenAPI

Operations 6

GET /Patient Search Patient #
GET /Patient/{id} Read Patient by id #
GET /ExplanationOfBenefit Search ExplanationOfBenefit (CARIN Blue Button) #
GET /ExplanationOfBenefit/{id} Read ExplanationOfBenefit by id #
GET /Coverage Search Coverage #
GET /Coverage/{id} Read Coverage by id #

Documentation

📖
Documentation
https://fhir-portal.clevercarehealthplan.com/api-docs/
📖
APIReference
https://fhir-portal.clevercarehealthplan.com/api-docs/

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/clevercarehealthplan/refs/heads/main/openapi/clevercarehealthplan-patient-access-api-openapi.yml

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OpenAPI Specification

clevercarehealthplan-patient-access-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: Clever Care Health Plan FHIR R4 Patient Access API
  version: 4.0.1
  description: HL7 FHIR R4 (4.0.1) API for Clever Care Health Plan, implementing the CMS Interoperability and Patient Access final rule (CMS-9115-F).
  x-generated-by: api-evangelist-enrichment-pipeline
  x-source: https://fhir.clevercarehealthplan.com/r4/metadata
  x-fhir-version: 4.0.1
  contact:
    name: Clever Care Health Plan
    url: https://clevercarehealthplan.com/fhir-api-developer-resources/
servers:
- url: https://fhir.clevercarehealthplan.com/r4
  description: FHIR R4 production base URL
tags:
- name: Patient Access
  description: Secured (OpenID Connect / OAuth 2.0) member data resources
paths:
  /Patient:
    get:
      operationId: searchPatient
      summary: Search Patient
      tags:
      - Patient Access
      security:
      - smartOnFhir:
        - patient/*.cruds
        - user/*.cruds
      parameters:
      - $ref: '#/components/parameters/id'
      - $ref: '#/components/parameters/lastUpdated'
      - $ref: '#/components/parameters/profile'
      responses:
        '200':
          $ref: '#/components/responses/Bundle'
        '401':
          $ref: '#/components/responses/OperationOutcome'
        '403':
          $ref: '#/components/responses/OperationOutcome'
  /Patient/{id}:
    get:
      operationId: readPatient
      summary: Read Patient by id
      tags:
      - Patient Access
      security:
      - smartOnFhir:
        - patient/*.cruds
        - user/*.cruds
      parameters:
      - $ref: '#/components/parameters/resourceId'
      responses:
        '200':
          $ref: '#/components/responses/Resource'
        '401':
          $ref: '#/components/responses/OperationOutcome'
        '404':
          $ref: '#/components/responses/OperationOutcome'
  /ExplanationOfBenefit:
    get:
      operationId: searchExplanationOfBenefit
      summary: Search ExplanationOfBenefit (CARIN Blue Button)
      tags:
      - Patient Access
      security:
      - smartOnFhir:
        - patient/*.cruds
        - user/*.cruds
      parameters:
      - name: patient
        in: query
        required: true
        description: Patient reference (required).
        schema:
          type: string
      - $ref: '#/components/parameters/id'
      - $ref: '#/components/parameters/lastUpdated'
      - $ref: '#/components/parameters/profile'
      - name: identifier
        in: query
        required: false
        schema:
          type: string
      - name: service-date
        in: query
        required: false
        schema:
          type: string
      - name: type
        in: query
        required: false
        schema:
          type: string
      responses:
        '200':
          $ref: '#/components/responses/Bundle'
        '401':
          $ref: '#/components/responses/OperationOutcome'
        '403':
          $ref: '#/components/responses/OperationOutcome'
  /ExplanationOfBenefit/{id}:
    get:
      operationId: readExplanationOfBenefit
      summary: Read ExplanationOfBenefit by id
      tags:
      - Patient Access
      security:
      - smartOnFhir:
        - patient/*.cruds
        - user/*.cruds
      parameters:
      - $ref: '#/components/parameters/resourceId'
      responses:
        '200':
          $ref: '#/components/responses/Resource'
        '401':
          $ref: '#/components/responses/OperationOutcome'
        '404':
          $ref: '#/components/responses/OperationOutcome'
  /Coverage:
    get:
      operationId: searchCoverage
      summary: Search Coverage
      tags:
      - Patient Access
      security:
      - smartOnFhir:
        - patient/*.cruds
        - user/*.cruds
      parameters:
      - $ref: '#/components/parameters/id'
      - $ref: '#/components/parameters/lastUpdated'
      - $ref: '#/components/parameters/profile'
      responses:
        '200':
          $ref: '#/components/responses/Bundle'
        '401':
          $ref: '#/components/responses/OperationOutcome'
        '403':
          $ref: '#/components/responses/OperationOutcome'
  /Coverage/{id}:
    get:
      operationId: readCoverage
      summary: Read Coverage by id
      tags:
      - Patient Access
      security:
      - smartOnFhir:
        - patient/*.cruds
        - user/*.cruds
      parameters:
      - $ref: '#/components/parameters/resourceId'
      responses:
        '200':
          $ref: '#/components/responses/Resource'
        '401':
          $ref: '#/components/responses/OperationOutcome'
        '404':
          $ref: '#/components/responses/OperationOutcome'
components:
  responses:
    Resource:
      description: A single FHIR resource.
      content:
        application/fhir+json:
          schema:
            type: object
    OperationOutcome:
      description: A FHIR OperationOutcome describing an error.
      content:
        application/fhir+json:
          schema:
            $ref: '#/components/schemas/OperationOutcome'
    Bundle:
      description: A FHIR searchset Bundle of matching resources.
      content:
        application/fhir+json:
          schema:
            $ref: '#/components/schemas/Bundle'
  parameters:
    profile:
      name: _profile
      in: query
      description: Filter by conformance to a named HL7 profile.
      required: false
      schema:
        type: string
    lastUpdated:
      name: _lastUpdated
      in: query
      description: Filter by last modification date (prefixes eq,ne,gt,lt,ge,le).
      required: false
      schema:
        type: string
    resourceId:
      name: id
      in: path
      description: Logical id of the resource.
      required: true
      schema:
        type: string
    id:
      name: _id
      in: query
      description: Filter by logical id of the resource.
      required: false
      schema:
        type: string
  schemas:
    OperationOutcome:
      type: object
      description: FHIR R4 OperationOutcome error envelope.
      properties:
        resourceType:
          type: string
          enum:
          - OperationOutcome
        issue:
          type: array
          items:
            type: object
            properties:
              severity:
                type: string
                enum:
                - fatal
                - error
                - warning
                - information
              code:
                type: string
              diagnostics:
                type: string
    Bundle:
      type: object
      description: FHIR R4 Bundle (type searchset).
      properties:
        resourceType:
          type: string
          enum:
          - Bundle
        type:
          type: string
        total:
          type: integer
        link:
          type: array
          items:
            type: object
            properties:
              relation:
                type: string
              url:
                type: string
        entry:
          type: array
          items:
            type: object
            properties:
              fullUrl:
                type: string
              resource:
                type: object
  securitySchemes:
    smartOnFhir:
      type: oauth2
      description: SMART-on-FHIR OAuth 2.0 (PKCE S256), OpenID Connect enabled.
      flows:
        authorizationCode:
          authorizationUrl: https://fhir-portal.clevercarehealthplan.com/oauth2/authorize
          tokenUrl: https://fhir-portal.clevercarehealthplan.com/oauth2/token
          refreshUrl: https://fhir-portal.clevercarehealthplan.com/oauth2/token
          scopes:
            openid: OpenID Connect authentication
            launch/patient: Launch in patient context
            patient/*.cruds: Patient-scoped access to permitted resources
            user/*.cruds: User-scoped access to permitted resources
        clientCredentials:
          tokenUrl: https://fhir-portal.clevercarehealthplan.com/oauth2/token
          scopes:
            openid: OpenID Connect authentication
            user/*.cruds: User-scoped access to permitted resources