Access information about Insurance Plans, Coverage, Network
What is a provider directory?
Provider directory access is a supported feature in Sero, contact fou[email protected]if you need provider directory data
Provider directories are databases containing information about insurance plans, practitioners (like doctors and specialists) and their roles (the specific services offered).
Provider directories play a critical role in enabling identification of individual providers and provider organizations, as well as characteristics about them. Provider directories support a variety of use cases.
Provider directories help to answer questions about:
Finding specialist service providers for specific medical services
Which providers, primary care doctors, specialists, pharmacies, facilities are "in network" for a given plan
Accessibility and scheduling information, office hours, spoken languages
Organizations that provide health care services, available insurance plans, coverage locations
How do provider directories work?
In the United States, CMS regulated health plans are required to publish a public-facing FHIR API. Major plan payers like Humana, Aetna, and Optum have implemented a specific API called Da Vinci PDex Plan Net.
Provider directories typically implement these FHIR Resources: