Payer and Vendor List

Integrated and Non-Integrated Payers

This is a list of all payers for which Defacto Health has assessed or integrated their CMS-required Provider Directory APIs. 

  • Integrated payers have included sufficient information within their FHIR APIs to allow members and prospective members to use the data to determine whether a provider participates with a specific plan (i.e., whether they are in-network for the plan).
  • Non-integrated payers have issues in their Provider Directory APIs preventing members from using the data to support in-network provider search and health plan comparison use cases that the CMS Final Rule on Interoperability and Patient Access describes. 
If you are a payer and your API shows as ‘Not Integrated’ with issues, contact us or learn how we assess your API. We can reproduce the issue live, and discuss the steps you can take to resolve the issue so that we can integrate and flip your status to ‘Integrated’ on this table.
 

Payer

Integration Status

Issues

Aetna

Integrated

None

AgeWell New York

Not Integrated

Practitioner and Practitioner Roles Missing

Alaska Medicaid

Integrated

None

AllyAlign

Not Integrated

Unavailable Query Parameters

AlohaCare

Integrated

None

American Health Advantage

Not Integrated

Practitioner-Plan Relationships Missing

Amerihealth Caritas

Not Integrated

Practitioner-Plan Relationships Missing

Arkansas Medicaid

Integrated

None

AultCare

Not Integrated

Practitioner-Plan Relationships Missing

AvMed

Not Integrated

Practitioner-Plan Relationships Missing

Blue Cross and Blue Shield of Alabama

Integrated

None

Blue Cross and Blue Shield of Kansas City

Integrated

None

Blue Cross and Blue Shield of Minnesota

Not Integrated

API Querying Not Performant

© copyright Defacto Health 2025