Provider Directory API
Plan-Net
The PDEX Payer Network (a.k.a., Plan-Net) Implementation Guide is, conceptually, based on the Validated Healthcare Directory Implementation Guide (VHDir IG), an international standard, which in turn is based on FHIR Version 4.0. The primary changes made by Plan-Net are:
- Removal of the validation and restriction resources
- Use of US Core for R4 as the base suite of profiles (where possible)
- Elimination of extensions that are unnecessary for this use case
- Introduction of additional constraints (e.g., search criteria, cardinality, value-set bindings, and MustSupport) where appropriate.
Note: Alignment with VhDir is maintained by adapting VhDir content where possible.
The Plan-Net IG was written for a US audience, and describes resources from US Core STU 3.1 where available (Practitioner, Organization, Location), and from R4 (OrganizationAffiliation, PractitionerRole, HealthCareService, Endpoint) otherwise.
The Network profile is based on USCore Organization, since there is no contradiction between the USCore profile and the Plan-Net requirements; however, the NPI and CLIA identifier types, which are Must-Support, are intended for provider organizations only and are not expected to be populated for other organization types.
Note: The PractitionerRole profile from US Core was not used because it is overly constrained for use in a Provider Directory based on Payer information.