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.
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 |