WellCare FHIR Patient Access API
The WellCare FHIR Patient Access API enables members and authorized third-party applications to securely access and exchange health data including medical, pharmacy, dental, and vision claims and clinical information. The API supports HL7 FHIR R4 standards and SMART on FHIR authorization, providing access to up to 5 years of historical health information. Required under CMS Interoperability and Patient Access final rule (CMS-9115-F) for Medicaid and Medicare Advantage plans.
Documentation
Specifications
Schemas & Data
JSONSchema
json-schema/wellcare-fhir-patient-schema.json
JSONSchema
json-schema/wellcare-fhir-eob-schema.json
JSONStructure
json-structure/wellcare-fhir-patient-structure.json
Examples
Example
examples/wellcare-fhir-patient-access-api-getPatient-example.json
Example
examples/wellcare-fhir-patient-access-api-listExplanationOfBenefit-example.json
Other Resources
Portal
https://partners.centene.com/apis
SpectralRuleset
rules/wellcare-health-plans-rules.yml
NaftikoCapability
capabilities/shared/fhir-patient-access.yaml
OpenAPI
#Healthcare
#FHIR
#Interoperability
#Patient Access
#Managed Care
#Medicaid
#Medicare