openapi: 3.2.0 info: contact: name: Interoperability Developer Support email: InteroperabilityDeveloperSupport@aetna.com description: 'Retrieve Insurance Plan resource based on Coverage Area (Coverage area is a 2-digit state abbreviation). Both Provider and Pharmacy data are available on this resource.' x-ibm-name: v1providerdirectoryinsuranceplan title: /v1/providerdirectory/ Insurance Plan API version: 1.0.0 servers: - url: https://apif1.aetna.com/fhir/v1/providerdirectory security: - FHIR_Application_Oauth: - Public - FHIR_Application_Oauth: - NonPII - FHIR_User_AccessCode_Oauth: - patient/Patient.read - FHIR_User_AccessCode_Oauth: - patient/Patient.* - FHIR_User_AccessCode_Oauth: - patient/*.read - FHIR_User_AccessCode_Oauth: - patient/*.* tags: - name: Insurance Plan paths: /InsurancePlan: get: summary: Retrieve InsurancePlan resource based on Coverage Area (Coverage area is a… description: Returns insurance plans and network keys for a specific state operationId: GET responses: '200': description: This response returns a Bundle of InsurancePlan(s) information based on the input received. content: application/json: schema: $ref: '#/components/schemas/Bundle' example: entry: - search: mode: match resource: identifier: - system: http://terminology.hl7.org/CodeSystem/v2-0203 use: official assigner: display: Aetna Better Health of New Jersey type: coding: - system: http://terminology.hl7.org/CodeSystem/v2-0203 code: XV display: Health Plan Identifier value: Aetna Better Health of New Jersey - NJ period: start: '2020-01-01T00:00:00Z' end: '2020-12-31T23:59:59Z' language: en type: - coding: - system: http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS code: medihmo display: Medicaid HMO administeredBy: display: Aetna Better Health of New Jersey network: - reference: Organization/0000000000000212937 display: Aetna Better Health of New Jersey - reference: Organization/0000000000000212938 display: Aetna Assure Premier Plus (HMO D-SNP) - reference: Organization/0000000000000212939 display: Aetna Assure Premier Plus (HMO D-SNP) meta: lastUpdated: '2020-10-23T00:00:00.000+00:00' versionId: 4.0.1 profile: - http://hl7.org/fhir/us/davinci-pdex-plan-net/StructureDefinition/plannet-InsurancePlan contact: - address: city: Princeton line: - 3 Independence Way - Suite 400 postalCode: 08540-6626 state: NJ name: use: official text: ABH New Jersey telecom: - system: phone use: work value: 1-855-232-3596 name: Aetna Better Health of New Jersey id: 0000000000000212936 ownedBy: display: Aetna Better Health of New Jersey resourceType: InsurancePlan status: active coverageArea: - display: NJ fullUrl: https://apif1.aetna.com/fhir/v1/providerdirectory/InsurancePlan/0000000000000212936 total: 1 link: - url: https://apif1.aetna.com/fhir/v1/providerdirectory/InsurancePlan?address-state=nj&page=1 relation: self id: 32ed03f463dd540f05fbb9f1 type: searchset resourceType: Bundle '400': description: A required parameter isn’t provided, or an unknown parameter is provided. content: application/json: schema: $ref: '#/components/schemas/OperationOutcome' example: issue: - severity: error code: required details: coding: - system: http://hl7.org/fhir/ValueSet/operation-outcome code: MSG_RESOURCE_ID_MISSING display: Resource Id Missing id: 14c27ea91f91d8f01234 resourceType: OperationOutcome '500': description: Internal Server Error. Failures on the server side. content: application/json: schema: $ref: '#/components/schemas/OperationOutcome' example: issue: - severity: fatal diagnostics: Backend service failure code: exception details: coding: - system: http://hl7.org/fhir/ValueSet/operation-outcome code: MSG_SVC_FAILURE display: Error occurred while processing response id: 53c27ea45fd8f0ff0af91f91 resourceType: OperationOutcome parameters: - in: query name: address-state description: 'The state code of the InsurancePlan''s coverage State will be 2 letter abbreviation.' required: true schema: type: string servers: - url: https://apif1.aetna.com/fhir/v1/providerdirectory tags: - Insurance Plan components: schemas: OperationOutcome: description: 'See the appropriate Implementation Guide for proper documentation to use This is the HL7 FHIR Release 4.0.1 OperationOutcome resource. Full Documentation is available at: http://hl7.org/fhir/operationoutcome.html' type: object InsurancePlan: description: 'See the appropriate Implementation Guide for proper documentation to use This is the HL7 FHIR Release 4.0.1 InsurancePlan resource. Full Documentation is available at: http://hl7.org/fhir/insuranceplan.html For the DaVinci PDEX Plan Net 1.0.0 InsurancePlan resource documentation is available at: http://hl7.org/fhir/us/davinci-pdex-plan-net/STU1/StructureDefinition-plannet-InsurancePlan.html For the DaVinci PDEX Plan Net 1.1.0 InsurancePlan resource documentation is available at: http://hl7.org/fhir/us/davinci-pdex-plan-net/STU1.1/StructureDefinition-plannet-InsurancePlan.html' type: object Entry: description: An entry in a bundle resource - will contain a resource(s) returned in the bundle type: object properties: resource: $ref: '#/components/schemas/InsurancePlan' Bundle: description: 'See the appropriate Implementation Guide for proper documentation to use This is the HL7 FHIR Release 4.0.1 Bundle resource. Full Documentation is available at: http://hl7.org/fhir/bundle.html' type: object properties: entry: type: array items: $ref: '#/components/schemas/Entry' securitySchemes: FHIR_User_AccessCode_Oauth: type: oauth2 flows: authorizationCode: scopes: patient/Patient.*: '' patient/Patient.read: '' patient/*.read: '' patient/*.*: '' authorizationUrl: /Authorize tokenUrl: /Token FHIR_Application_Oauth: type: oauth2 flows: clientCredentials: scopes: NonPII: '' Public: '' tokenUrl: /Token externalDocs: description: HTTP Common Error Codes url: https://eaintegrationgovernance.github.io/APIC-Common-Error-Codes.github.io/ x-ibm-configuration: phase: realized enforced: true testable: true x-ibm-endpoints: - endpointUrl: https://qahapi.aetna.com/fhir/qapath3 type: - production - development - endpointUrl: https://qaehapi.aetna.com/fhir/qapath3 type: - production - development