Independence Blue Cross (IBX) is the Blue Cross Blue Shield Association licensee for southeastern Pennsylvania (Bucks, Chester, Delaware, Montgomery, and Philadelphia counties) and a subsidiary of Independence Health Group, Inc., the parent holding company that consolidated IBX, AmeriHealth (commercial, including AmeriHealth New Jersey and the AmeriHealth Administrators TPA business), and the AmeriHealth Caritas family of Medicaid managed care plans in 2013. The company has called Philadelphia home for more than 85 years, serves nearly three million members directly, and — through Independence Health Group — supports roughly nine million covered lives across commercial, Medicare Advantage, Medicaid, CHIP, dental, vision, and behavioral health lines of business. Independence Health Group reported consolidated revenue of $36.3 billion for 2025. To satisfy the CMS Interoperability and Patient Access final rule (CMS-9115-F), IBX publishes three HL7 FHIR R4 (4.0.1) APIs from its `eapics.ibx.com` gateway and developer portal at `devportal.ibx.com`: a SMART-on-FHIR / OAuth 2.0 secured Patient Access API for Medicare Advantage and Keystone HMO CHIP members, a public Da Vinci PDex Plan-Net Provider Directory API, and a public Da Vinci US Drug Formulary (USDF) API. The provider also publishes monthly Transparency in Coverage machine-readable files (in-network rates, allowed amounts, prescription drugs) for three carrier brands — Keystone Health Plan East, QCC Insurance Company, and Independence Assurance Co, Inc.
Independence Blue Cross publishes 3 APIs on the APIs.io network: Formulary API, Patient Access API, and Provider Directory API. Tagged areas include Healthcare, Health Insurance, Blue Cross Blue Shield, Managed Care, and Medicare.
The Independence Blue Cross catalog on APIs.io includes 1 JSON-LD context and 2 Spectral governance rulesets.
Independence Blue Cross’ developer surface includes authentication, developer portal, documentation, YouTube channel, engineering blog, and 34 more developer resources.
Monthly machine-readable JSON files published under 45 CFR Part §147.211 / the Transparency in Coverage rule for three carrier brands operated by Independence Blue Cross: Keyst...
CARIN Blue Button / Da Vinci / US Core Conformance
Patient Access aligns with CARIN BB, CPCDS, US Core 3.1.1, and Da Vinci PDex. Provider Directory implements Da Vinci PDex Plan-Net. Drug Formulary implements Da Vinci USDF.
Developer Portal Self-Service
devportal.ibx.com provides documentation, registration (`/cmssignin/`), sandbox services, and per-app credentials. App onboarding support is at AppOnboardingSupport@ibx.com.
Transparency In Coverage Machine-Readable Files
Monthly published in-network rate, allowed amount, and prescription drug JSON files for Keystone Health Plan East, QCC Insurance Company, and Independence Assurance Co, Inc. at ...
No Public GitHub Organization
Independence Blue Cross does not maintain a public api-evangelist-discoverable GitHub organization for its FHIR developer surface; SDKs, sample code, and documentation are distr...
Consumer health apps allow Independence Medicare Advantage and Keystone HMO CHIP members to consent to share their clinical, claims, encounter, medication, and immunization hist...
Provider Directory Lookups
Member-facing tools, broker apps, and care navigation tools query the public Da Vinci Plan-Net Provider Directory FHIR API to find in-network Practitioners, PractitionerRoles, O...
Drug Formulary Browsing
Members, prescribers, and pharmacy apps query the public USDF Drug Formulary FHIR API to confirm whether a medication is covered, the tier, and any prior authorization requireme...
Payer-To-Payer Data Sharing
When a member switches plans, the Patient Access surface can inform payer-to-payer exchange workflows aligned with Da Vinci PDex to migrate clinical history.
Price Comparison & Cost Transparency
Researchers, employers, and consumer cost-transparency tools ingest the monthly Transparency in Coverage machine-readable files for Keystone Health Plan East, QCC, and IAC to co...
Clinical & Quality Reporting
Population health partners ingest member-authorized FHIR data to support HEDIS measure capture, risk adjustment, care-gap closure, and SDOH reporting.
Pre-built integrations with other platforms and tools.
Independence Health Group
Independence Blue Cross is a subsidiary of Independence Health Group, Inc., the 2013 holding company that also owns AmeriHealth (commercial) and majority-owns AmeriHealth Carita...
AmeriHealth Caritas
Majority-owned (61.3%) by Independence with Blue Cross Blue Shield of Michigan as a 38.7% co-owner; runs Medicaid managed care, CHIP, D-SNP, LTSS, and Marketplace plans across t...
AmeriHealth New Jersey
Independence operates AmeriHealth Insurance Company of New Jersey, a commercial payer serving roughly 209,000 New Jersey members.
AmeriHealth Administrators
National third-party administrator (TPA) serving self-funded health plans, carriers, and administrators with business process outsourcing.
Tandigm Health
Independence-affiliated value-based primary care enablement company supporting coordinated, proactive care for primary care physicians.
Blue Cross Blue Shield Association
Independence Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving Bucks, Chester, Delaware, Montgomery, and Philadelphia counties in PA.
CMS Interoperability Framework
APIs exist to satisfy the CMS-9115-F Interoperability and Patient Access final rule for Medicare Advantage and Children's Health Insurance Program (CHIP) populations.
HL7 FHIR R4
All three APIs implement HL7 FHIR 4.0.1 with SMART App Launch 1.0.0 security, CARIN BB, Da Vinci PDex / Plan-Net, and Da Vinci USDF guidance.
SMART on FHIR / OAuth 2.0 / OIDC / PKCE
Standard SMART App Launch authorization code flow and PKCE flow back the Patient Access security model. SMART configuration is published at the well-known endpoint on eapics.ibx...
Carrier Brands
Underwriting carriers include Keystone Health Plan East, QCC Insurance Company, Independence Assurance Co, Inc., and Keystone Health Plan East HMO products. Each publishes its o...
Group commercial coverage for individuals, families, small and mid-sized businesses, large employers, municipalities, unions, and education boards in southeastern Pennsylvania.
Medicare Advantage
Keystone 65 HMO, Personal Choice 65 PPO, and related Medicare Advantage products including PA and re-entered NJ MA markets in 2024. Patient Access FHIR API is required for this ...
Children's Health Insurance Program (CHIP)
Keystone HMO CHIP covers eligible children in southeastern Pennsylvania under the Pennsylvania CHIP program; CHIP members are in scope for the Patient Access API.
Medicaid (Through AmeriHealth Caritas)
Medicaid managed care delivered through the AmeriHealth Caritas subsidiary family (Keystone First, AmeriHealth Caritas Pennsylvania, AmeriHealth Caritas DC, AmeriHealth Caritas ...
Dental
IBX Dental coverage offered through Keystone and United Concordia networks for commercial, Medicare, and individual buyers.
Vision
Vision coverage and provider network delivered through partner vision networks for commercial and Medicare buyers.
Behavioral Health
Behavioral health benefits embedded in commercial, Medicare Advantage, and Medicaid lines; PerformCare (operated by AmeriHealth Caritas) supports PA behavioral health.
Pharmacy Benefits
Pharmacy benefits administration including the covered drug list (formulary) surfaced via the Drug Formulary FHIR API.
aid: independence-blue-cross
name: Independence Blue Cross
description: 'Independence Blue Cross (IBX) is the Blue Cross Blue Shield Association licensee for southeastern Pennsylvania
(Bucks, Chester, Delaware, Montgomery, and Philadelphia counties) and a subsidiary of Independence Health Group, Inc., the
parent holding company that consolidated IBX, AmeriHealth (commercial, including AmeriHealth New Jersey and the AmeriHealth
Administrators TPA business), and the AmeriHealth Caritas family of Medicaid managed care plans in 2013. The company has
called Philadelphia home for more than 85 years, serves nearly three million members directly, and — through Independence
Health Group — supports roughly nine million covered lives across commercial, Medicare Advantage, Medicaid, CHIP, dental,
vision, and behavioral health lines of business. Independence Health Group reported consolidated revenue of $36.3 billion
for 2025. To satisfy the CMS Interoperability and Patient Access final rule (CMS-9115-F), IBX publishes three HL7 FHIR R4
(4.0.1) APIs from its `eapics.ibx.com` gateway and developer portal at `devportal.ibx.com`: a SMART-on-FHIR / OAuth 2.0
secured Patient Access API for Medicare Advantage and Keystone HMO CHIP members, a public Da Vinci PDex Plan-Net Provider
Directory API, and a public Da Vinci US Drug Formulary (USDF) API. The provider also publishes monthly Transparency in Coverage
machine-readable files (in-network rates, allowed amounts, prescription drugs) for three carrier brands — Keystone Health
Plan East, QCC Insurance Company, and Independence Assurance Co, Inc.'
url: https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/apis.yml
type: Index
accessModel:
pricing: freemium
onboarding: self-serve
trial: false
try_now: true
public: false
label: Freemium · Self-serve signup
confidence: high
source:
- plans
- authentication
generated: '2026-07-22'
method: derived
image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/icons/independence-blue-cross.png
tags:
- Healthcare
- Health Insurance
- Blue Cross Blue Shield
- Managed Care
- Medicare
- Medicare Advantage
- Medicaid
- CHIP
- Commercial
- Dental
- Vision
- Behavioral Health
- Pharmacy Benefits
- Interoperability
- FHIR
- SMART On FHIR
- CMS
- Patient Access
- Provider Directory
- Drug Formulary
- Transparency In Coverage
created: '2024-01-01'
modified: '2026-07-25'
specificationVersion: '0.19'
apis:
- aid: independence-blue-cross:transparency-in-coverage
name: Independence Blue Cross Transparency In Coverage Data
description: 'Monthly machine-readable JSON files published under 45 CFR Part §147.211 / the Transparency in Coverage rule
for three carrier brands operated by Independence Blue Cross: Keystone Health Plan East, QCC Insurance Company, and Independence
Assurance Co, Inc. Files cover in-network negotiated rates, out-of-network allowed amounts, and prescription drug pricing
across medical, dental, vision, pharmacy, and plan domains.'
humanURL: https://www.ibx.com/resources/for-members/transparency-in-coverage.html
baseURL: https://www.ibx.com/cmstic/
tags:
- Transparency In Coverage
- Machine Readable Files
- Pricing
- Regulatory
properties:
- type: Index
url: https://www.ibx.com/cmstic/?brand=khpe
- type: Index
url: https://www.ibx.com/cmstic/?brand=qcc
- type: Index
url: https://www.ibx.com/cmstic/?brand=iac
- type: Regulation
url: https://www.cms.gov/healthplan-price-transparency
- aid: independence-blue-cross:independence-blue-cross-formulary-api
name: Independence Blue Cross Formulary API
description: Public Da Vinci USDF FHIR R4 drug formulary resources.
humanURL: https://devportal.ibx.com/documentation/
baseURL: https://eapics.ibx.com/patient/v1/fhir
tags:
- Formulary
properties:
- type: OpenAPI
url: openapi/independence-blue-cross-formulary-api-openapi.yml
- type: Portal
url: https://devportal.ibx.com/
- type: Documentation
url: https://devportal.ibx.com/documentation/
- type: Swagger
url: https://www.ibx.com/scripts/custom/swagger/cmsSwagger.json
- type: CapabilityStatement
url: https://eapics.ibx.com/patient/v1/fhir/metadata
- type: SmartConfiguration
url: https://eapics.ibx.com/patient/v1/fhir/.well-known/smart-configuration
- type: AuthorizeURL
url: https://member.ibx.com/patientaccesssvc/oauth2/v1/authorize
- type: TokenURL
url: https://eapics.ibx.com/oauth2/v2/token
- type: Registration
url: https://devportal.ibx.com/cmssignin/
- type: TermsOfService
url: https://www.ibx.com/htdocs/custom/tnc/Developer%20Portal%20TandC.pdf
- type: ContactEmail
url: mailto:AppOnboardingSupport@ibx.com
- type: SpectralRules
url: rules/independence-blue-cross-rules.yml
- type: JSONSchema
url: json-schema/independence-blue-cross-patient-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-coverage-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-explanation-of-benefit-schema.json
- type: CapabilityStatement
url: https://eapics.ibx.com/provider/v1/fhir/metadata
- type: ImplementationGuide
url: http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net
- type: JSONSchema
url: json-schema/independence-blue-cross-practitioner-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-organization-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-location-schema.json
- type: CapabilityStatement
url: https://eapics.ibx.com/formulary/v1/fhir/metadata
- type: ImplementationGuide
url: http://hl7.org/fhir/us/davinci-drug-formulary/ImplementationGuide/hl7.fhir.us.davinci-drug-formulary
- aid: independence-blue-cross:independence-blue-cross-patient-access-api
name: Independence Blue Cross Patient Access API
description: FHIR R4 Patient Access resources for member-authorized access.
humanURL: https://devportal.ibx.com/documentation/
baseURL: https://eapics.ibx.com/patient/v1/fhir
tags:
- Patient Access
properties:
- type: OpenAPI
url: openapi/independence-blue-cross-patient-access-api-openapi.yml
- type: Portal
url: https://devportal.ibx.com/
- type: Documentation
url: https://devportal.ibx.com/documentation/
- type: Swagger
url: https://www.ibx.com/scripts/custom/swagger/cmsSwagger.json
- type: CapabilityStatement
url: https://eapics.ibx.com/patient/v1/fhir/metadata
- type: SmartConfiguration
url: https://eapics.ibx.com/patient/v1/fhir/.well-known/smart-configuration
- type: AuthorizeURL
url: https://member.ibx.com/patientaccesssvc/oauth2/v1/authorize
- type: TokenURL
url: https://eapics.ibx.com/oauth2/v2/token
- type: Registration
url: https://devportal.ibx.com/cmssignin/
- type: TermsOfService
url: https://www.ibx.com/htdocs/custom/tnc/Developer%20Portal%20TandC.pdf
- type: ContactEmail
url: mailto:AppOnboardingSupport@ibx.com
- type: SpectralRules
url: rules/independence-blue-cross-rules.yml
- type: JSONSchema
url: json-schema/independence-blue-cross-patient-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-coverage-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-explanation-of-benefit-schema.json
- type: CapabilityStatement
url: https://eapics.ibx.com/provider/v1/fhir/metadata
- type: ImplementationGuide
url: http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net
- type: JSONSchema
url: json-schema/independence-blue-cross-practitioner-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-organization-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-location-schema.json
- type: CapabilityStatement
url: https://eapics.ibx.com/formulary/v1/fhir/metadata
- type: ImplementationGuide
url: http://hl7.org/fhir/us/davinci-drug-formulary/ImplementationGuide/hl7.fhir.us.davinci-drug-formulary
- aid: independence-blue-cross:independence-blue-cross-provider-directory-api
name: Independence Blue Cross Provider Directory API
description: Public Da Vinci Plan-Net FHIR R4 provider directory resources.
humanURL: https://devportal.ibx.com/documentation/
baseURL: https://eapics.ibx.com/patient/v1/fhir
tags:
- Provider Directory
properties:
- type: OpenAPI
url: openapi/independence-blue-cross-provider-directory-api-openapi.yml
- type: Portal
url: https://devportal.ibx.com/
- type: Documentation
url: https://devportal.ibx.com/documentation/
- type: Swagger
url: https://www.ibx.com/scripts/custom/swagger/cmsSwagger.json
- type: CapabilityStatement
url: https://eapics.ibx.com/patient/v1/fhir/metadata
- type: SmartConfiguration
url: https://eapics.ibx.com/patient/v1/fhir/.well-known/smart-configuration
- type: AuthorizeURL
url: https://member.ibx.com/patientaccesssvc/oauth2/v1/authorize
- type: TokenURL
url: https://eapics.ibx.com/oauth2/v2/token
- type: Registration
url: https://devportal.ibx.com/cmssignin/
- type: TermsOfService
url: https://www.ibx.com/htdocs/custom/tnc/Developer%20Portal%20TandC.pdf
- type: ContactEmail
url: mailto:AppOnboardingSupport@ibx.com
- type: SpectralRules
url: rules/independence-blue-cross-rules.yml
- type: JSONSchema
url: json-schema/independence-blue-cross-patient-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-coverage-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-explanation-of-benefit-schema.json
- type: CapabilityStatement
url: https://eapics.ibx.com/provider/v1/fhir/metadata
- type: ImplementationGuide
url: http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net
- type: JSONSchema
url: json-schema/independence-blue-cross-practitioner-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-organization-schema.json
- type: JSONSchema
url: json-schema/independence-blue-cross-location-schema.json
- type: CapabilityStatement
url: https://eapics.ibx.com/formulary/v1/fhir/metadata
- type: ImplementationGuide
url: http://hl7.org/fhir/us/davinci-drug-formulary/ImplementationGuide/hl7.fhir.us.davinci-drug-formulary
common:
- type: PostmanWorkspace
url: https://www.postman.com/kinlaneapi/independence-blue-cross/overview
- type: AgenticAccess
url: agentic-access/independence-blue-cross-agentic-access.yml
- type: DomainSecurity
url: security/independence-blue-cross-domain-security.yml
- type: Authentication
url: authentication/independence-blue-cross-authentication.yml
- type: OAuthScopes
url: scopes/independence-blue-cross-scopes.yml
- type: Portal
url: https://devportal.ibx.com/
- type: Website
url: https://www.ibx.com
- type: Documentation
url: https://devportal.ibx.com/documentation/
- type: Swagger
url: https://www.ibx.com/scripts/custom/swagger/cmsSwagger.json
- type: Authentication
url: https://eapics.ibx.com/patient/v1/fhir/.well-known/smart-configuration
- type: Registration
url: https://devportal.ibx.com/cmssignin/
- type: TermsOfService
url: https://www.ibx.com/htdocs/custom/tnc/Developer%20Portal%20TandC.pdf
- type: PrivacyPolicy
url: https://www.ibx.com/privacy-policy
- type: Login
url: https://www.ibx.com/login
- type: CMSFinalRule
url: https://www.cms.gov/priorities/key-initiatives/burden-reduction/interoperability
- type: CARINBlueButton
url: https://hl7.org/fhir/us/carin-bb/history.html
- type: DaVinciPDex
url: https://hl7.org/fhir/us/davinci-pdex/history.html
- type: DaVinciPlanNet
url: http://hl7.org/fhir/us/davinci-pdex-plan-net/ImplementationGuide/hl7.fhir.us.davinci-pdex-plan-net
- type: DaVinciUSDF
url: http://hl7.org/fhir/us/davinci-drug-formulary/ImplementationGuide/hl7.fhir.us.davinci-drug-formulary
- type: USCore
url: https://hl7.org/fhir/us/core/STU3.1.1/
- type: SMARTAppLaunch
url: https://hl7.org/fhir/smart-app-launch/1.0.0/
- type: Affiliates
url: https://www.ibx.com/about-us/affiliates
- type: ContactUs
url: mailto:AppOnboardingSupport@ibx.com
- type: ContactSupport
url: https://www.ibx.com/contact-us
- type: NewsBlog
url: https://news.ibx.com/
- type: TransparencyInCoverage
url: https://www.ibx.com/resources/for-members/transparency-in-coverage.html
- type: Facebook
url: https://www.facebook.com/ibx
- type: Twitter
url: https://www.twitter.com/ibx
- type: YouTube
url: https://www.youtube.com/ibxphilly
- type: Instagram
url: https://www.instagram.com/ibxfearless/
- type: Pinterest
url: https://pinterest.com/IBXBlueCross/
- type: AntiFraud
url: https://www.ibx.com/anti-fraud
- type: Plans
url: plans/independence-blue-cross-plans-pricing.yml
- type: RateLimits
url: rate-limits/independence-blue-cross-rate-limits.yml
- type: FinOps
url: finops/independence-blue-cross-finops.yml
- type: Vocabulary
url: vocabulary/independence-blue-cross-vocabulary.yml
- type: JSONLDContext
url: json-ld/independence-blue-cross-context.jsonld
- type: JSONStructure
url: json-structure/independence-blue-cross-health-plan-structure.json
- type: Features
data:
- name: HL7 FHIR R4 Patient Access API
description: SMART on FHIR / OAuth 2.0 secured member access (Medicare Advantage and Keystone HMO CHIP populations) to
AllergyIntolerance, CarePlan, Condition, Coverage, DiagnosticReport, Encounter, ExplanationOfBenefit, Goal, Immunization,
Location, Medication, MedicationDispense, MedicationRequest, Observation, Organization, Patient, Practitioner, PractitionerRole,
and Procedure FHIR R4 resources.
- name: HL7 FHIR R4 Provider Directory API
description: Public, unauthenticated Da Vinci PDex Plan-Net FHIR Provider Directory exposing Practitioner, PractitionerRole,
Organization, OrganizationAffiliation, Location, HealthcareService, InsurancePlan, and Endpoint resources for the Independence
Blue Cross network.
- name: HL7 FHIR R4 Drug Formulary API
description: Public Da Vinci USDF Drug Formulary surface exposing MedicationKnowledge and List resources for the Independence
Blue Cross covered drug list.
- name: SMART App Launch 1.0.0 OAuth 2.0 with PKCE
description: SMART configuration advertises `client-public`, `sso-openid-connect`, `launch-standalone`, `client-confidential-symmetric`,
`context-standalone-patient`, `permission-offline`, and `permission-patient` capabilities. Authorize at `member.ibx.com/patientaccesssvc/oauth2/v1/authorize`,
exchange at `eapics.ibx.com/oauth2/v2/token`.
- name: CARIN Blue Button / Da Vinci / US Core Conformance
description: Patient Access aligns with CARIN BB, CPCDS, US Core 3.1.1, and Da Vinci PDex. Provider Directory implements
Da Vinci PDex Plan-Net. Drug Formulary implements Da Vinci USDF.
- name: Developer Portal Self-Service
description: devportal.ibx.com provides documentation, registration (`/cmssignin/`), sandbox services, and per-app credentials.
App onboarding support is at AppOnboardingSupport@ibx.com.
- name: Transparency In Coverage Machine-Readable Files
description: Monthly published in-network rate, allowed amount, and prescription drug JSON files for Keystone Health Plan
East, QCC Insurance Company, and Independence Assurance Co, Inc. at `www.ibx.com/cmstic/?brand={khpe|qcc|iac}`.
- name: No Public GitHub Organization
description: Independence Blue Cross does not maintain a public api-evangelist-discoverable GitHub organization for its
FHIR developer surface; SDKs, sample code, and documentation are distributed through the dev portal rather than open-source
repositories.
- type: UseCases
data:
- name: Member Health Record Aggregation
description: Consumer health apps allow Independence Medicare Advantage and Keystone HMO CHIP members to consent to share
their clinical, claims, encounter, medication, and immunization history with third-party personal health record (PHR)
apps.
- name: Provider Directory Lookups
description: Member-facing tools, broker apps, and care navigation tools query the public Da Vinci Plan-Net Provider Directory
FHIR API to find in-network Practitioners, PractitionerRoles, Organizations, and Locations across southeastern PA.
- name: Drug Formulary Browsing
description: Members, prescribers, and pharmacy apps query the public USDF Drug Formulary FHIR API to confirm whether
a medication is covered, the tier, and any prior authorization requirements before filling.
- name: Payer-To-Payer Data Sharing
description: When a member switches plans, the Patient Access surface can inform payer-to-payer exchange workflows aligned
with Da Vinci PDex to migrate clinical history.
- name: Price Comparison & Cost Transparency
description: Researchers, employers, and consumer cost-transparency tools ingest the monthly Transparency in Coverage
machine-readable files for Keystone Health Plan East, QCC, and IAC to compare in-network rates and allowed amounts.
- name: Clinical & Quality Reporting
description: Population health partners ingest member-authorized FHIR data to support HEDIS measure capture, risk adjustment,
care-gap closure, and SDOH reporting.
- type: Integrations
data:
- name: Independence Health Group
description: Independence Blue Cross is a subsidiary of Independence Health Group, Inc., the 2013 holding company that
also owns AmeriHealth (commercial) and majority-owns AmeriHealth Caritas (Medicaid managed care).
- name: AmeriHealth Caritas
description: Majority-owned (61.3%) by Independence with Blue Cross Blue Shield of Michigan as a 38.7% co-owner; runs
Medicaid managed care, CHIP, D-SNP, LTSS, and Marketplace plans across thirteen states plus DC.
- name: AmeriHealth New Jersey
description: Independence operates AmeriHealth Insurance Company of New Jersey, a commercial payer serving roughly 209,000
New Jersey members.
- name: AmeriHealth Administrators
description: National third-party administrator (TPA) serving self-funded health plans, carriers, and administrators with
business process outsourcing.
- name: Tandigm Health
description: Independence-affiliated value-based primary care enablement company supporting coordinated, proactive care
for primary care physicians.
- name: Blue Cross Blue Shield Association
description: Independence Blue Cross is an independent licensee of the Blue Cross Blue Shield Association serving Bucks,
Chester, Delaware, Montgomery, and Philadelphia counties in PA.
- name: CMS Interoperability Framework
description: APIs exist to satisfy the CMS-9115-F Interoperability and Patient Access final rule for Medicare Advantage
and Children's Health Insurance Program (CHIP) populations.
- name: HL7 FHIR R4
description: All three APIs implement HL7 FHIR 4.0.1 with SMART App Launch 1.0.0 security, CARIN BB, Da Vinci PDex / Plan-Net,
and Da Vinci USDF guidance.
- name: SMART on FHIR / OAuth 2.0 / OIDC / PKCE
description: Standard SMART App Launch authorization code flow and PKCE flow back the Patient Access security model. SMART
configuration is published at the well-known endpoint on eapics.ibx.com.
- name: Carrier Brands
description: Underwriting carriers include Keystone Health Plan East, QCC Insurance Company, Independence Assurance Co,
Inc., and Keystone Health Plan East HMO products. Each publishes its own Transparency in Coverage machine-readable files.
- type: Solutions
data:
- name: Commercial Health Plans
description: Group commercial coverage for individuals, families, small and mid-sized businesses, large employers, municipalities,
unions, and education boards in southeastern Pennsylvania.
- name: Medicare Advantage
description: Keystone 65 HMO, Personal Choice 65 PPO, and related Medicare Advantage products including PA and re-entered
NJ MA markets in 2024. Patient Access FHIR API is required for this population under CMS-9115-F.
- name: Children's Health Insurance Program (CHIP)
description: Keystone HMO CHIP covers eligible children in southeastern Pennsylvania under the Pennsylvania CHIP program;
CHIP members are in scope for the Patient Access API.
- name: Medicaid (Through AmeriHealth Caritas)
description: Medicaid managed care delivered through the AmeriHealth Caritas subsidiary family (Keystone First, AmeriHealth
Caritas Pennsylvania, AmeriHealth Caritas DC, AmeriHealth Caritas Delaware, AmeriHealth Caritas Louisiana, AmeriHealth
Caritas North Carolina, AmeriHealth Caritas New Hampshire, AmeriHealth Caritas Ohio, AmeriHealth Caritas Florida, First
Choice by Select Health of South Carolina, and Blue Cross Complete of Michigan).
- name: Dental
description: IBX Dental coverage offered through Keystone and United Concordia networks for commercial, Medicare, and
individual buyers.
- name: Vision
description: Vision coverage and provider network delivered through partner vision networks for commercial and Medicare
buyers.
- name: Behavioral Health
description: Behavioral health benefits embedded in commercial, Medicare Advantage, and Medicaid lines; PerformCare (operated
by AmeriHealth Caritas) supports PA behavioral health.
- name: Pharmacy Benefits
description: Pharmacy benefits administration including the covered drug list (formulary) surfaced via the Drug Formulary
FHIR API.
- type: Blog
url: https://news.ibx.com/feed/
maintainers:
- FN: Kin Lane
email: kin@apievangelist.com
Kin Score
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