generated: '2026-07-25'
method: derived
source:
- openapi/sun-life-dentaquest-fhir-patient-access-openapi.json
- openapi/sun-life-dentaquest-fhir-provider-directory-openapi.json
- https://api.dentaquest.com/FhirPatientAccess/v1/metadata
model: HL7 FHIR R4 (4.0.1)
note: Entity list is derived from the resource collections actually exposed in each published OpenAPI.
  Relationship edges are the FHIR R4 reference elements defined by the implementation guides the APIs
  declare conformance to (US Core 7.0.0-ballot, Da Vinci PDex Plan-Net 1.1.0) — the exported OpenAPI carries
  only a generic "Body" schema, so no field-level schema was available to derive from.
domains:
- name: Patient Access (member compartment)
  api: DentaQuest FHIR Patient Access API
  entities:
  - Coverage
  - Organization
  - Patient
  - Practitioner
  - RelatedPerson
- name: Provider Directory (plan network)
  api: DentaQuest FHIR Provider Directory API
  entities:
  - Endpoint
  - HealthcareService
  - InsurancePlan
  - Location
  - Organization
  - Practitioner
  - PractitionerRole
entities:
- name: Patient
  domain: patient-access
  id: FHIR logical id
  note: The authorized member; bound to the token via launch/patient context.
- name: Coverage
  domain: patient-access
  note: The member dental benefit plan.
- name: Organization
  domain: both
  note: Payer, plan sponsor or provider organization.
- name: Practitioner
  domain: both
  note: Individual dentist or hygienist.
- name: RelatedPerson
  domain: patient-access
  note: Personal representative acting for the member.
- name: PractitionerRole
  domain: provider-directory
  note: PDex Plan-Net join of practitioner, organization, location and network.
- name: Location
  domain: provider-directory
- name: HealthcareService
  domain: provider-directory
- name: InsurancePlan
  domain: provider-directory
  note: The dental product / network.
- name: Endpoint
  domain: provider-directory
  note: Technical endpoint for a directory entry.
relationships:
- from: Coverage
  to: Patient
  type: belongs_to
  via: Coverage.beneficiary
  basis: FHIR R4 / US Core
- from: Coverage
  to: Organization
  type: belongs_to
  via: Coverage.payor
  basis: FHIR R4
- from: Coverage
  to: RelatedPerson
  type: has_one
  via: Coverage.subscriber
  basis: FHIR R4
- from: RelatedPerson
  to: Patient
  type: belongs_to
  via: RelatedPerson.patient
  basis: FHIR R4
- from: PractitionerRole
  to: Practitioner
  type: belongs_to
  via: PractitionerRole.practitioner
  basis: PDex Plan-Net 1.1.0
- from: PractitionerRole
  to: Organization
  type: belongs_to
  via: PractitionerRole.organization
  basis: PDex Plan-Net 1.1.0
- from: PractitionerRole
  to: Location
  type: has_many
  via: PractitionerRole.location
  basis: PDex Plan-Net 1.1.0
- from: PractitionerRole
  to: HealthcareService
  type: has_many
  via: PractitionerRole.healthcareService
  basis: PDex Plan-Net 1.1.0
- from: HealthcareService
  to: Location
  type: has_many
  via: HealthcareService.location
  basis: PDex Plan-Net 1.1.0
- from: HealthcareService
  to: Organization
  type: belongs_to
  via: HealthcareService.providedBy
  basis: PDex Plan-Net 1.1.0
- from: InsurancePlan
  to: Organization
  type: belongs_to
  via: InsurancePlan.ownedBy
  basis: PDex Plan-Net 1.1.0
- from: InsurancePlan
  to: Organization
  type: belongs_to
  via: InsurancePlan.administeredBy
  basis: PDex Plan-Net 1.1.0
- from: Organization
  to: Endpoint
  type: has_many
  via: Organization.endpoint
  basis: PDex Plan-Net 1.1.0
- from: Location
  to: Organization
  type: belongs_to
  via: Location.managingOrganization
  basis: FHIR R4
access_patterns:
- pattern: search
  shape: GET /{Resource}?<search params> -> Bundle(searchset)
- pattern: read
  shape: GET /{Resource}/{id} -> resource
- pattern: vread
  shape: GET /{Resource}/{id}/_history/{vid} -> historical version
- pattern: history
  shape: GET /{Resource}/_history and /{Resource}/{id}/_history -> Bundle(history)