Cigna Patient Access API

openapi: 3.1.0
info:
  title: Cigna Patient Access API
  description: >-
    FHIR R4 API exposing Cigna member health information including coverage,
    claims, encounters, observations, conditions, medications, and immunizations
    for authorized third-party applications acting on behalf of a member. Implements
    the HL7 Da Vinci PDex implementation guide and the CMS Interoperability and
    Patient Access final rule (CMS-9115-F).
  version: '1.0'
  contact:
    name: Cigna Developer Support
    url: https://developer.cigna.com/support
externalDocs:
  description: Patient Access Implementation Guide
  url: https://developer.cigna.com/docs/service-apis/patient-access/implementation-guide
servers:
  - url: https://fhir.cigna.com/PatientAccess/v1
    description: Cigna Patient Access Production
  - url: https://fhir.cigna.com/PatientAccess/v1-devportal
    description: Developer Sandbox
tags:
  - name: Patient
  - name: Coverage
  - name: ExplanationOfBenefit
  - name: Encounter
  - name: Observation
  - name: Condition
  - name: MedicationRequest
security:
  - smartOnFhir: []
paths:
  /metadata:
    get:
      operationId: getCapabilityStatement
      summary: Retrieve the FHIR capability statement
      tags: [Patient]
      responses:
        '200':
          description: FHIR CapabilityStatement
  /$userinfo:
    get:
      operationId: getUserInfo
      summary: Retrieve the authenticated member's identifier
      tags: [Patient]
      responses:
        '200':
          description: User info with member identifier
  /Patient:
    get:
      operationId: searchPatient
      summary: Search the authenticated member's Patient resource
      tags: [Patient]
      parameters:
        - name: _id
          in: query
          schema:
            type: string
      responses:
        '200':
          description: FHIR Bundle of Patient resources
  /Coverage:
    get:
      operationId: searchCoverage
      summary: Retrieve coverage records for the authenticated member
      tags: [Coverage]
      parameters:
        - name: patient
          in: query
          schema:
            type: string
      responses:
        '200':
          description: FHIR Bundle of Coverage resources
  /ExplanationOfBenefit:
    get:
      operationId: searchExplanationOfBenefit
      summary: Retrieve EOB claims data for the authenticated member
      tags: [ExplanationOfBenefit]
      parameters:
        - name: patient
          in: query
          schema:
            type: string
      responses:
        '200':
          description: FHIR Bundle of ExplanationOfBenefit resources
  /Encounter:
    get:
      operationId: searchEncounter
      summary: Retrieve encounter records for the authenticated member
      tags: [Encounter]
      responses:
        '200':
          description: FHIR Bundle of Encounter resources
  /Observation:
    get:
      operationId: searchObservation
      summary: Retrieve clinical observations for the authenticated member
      tags: [Observation]
      responses:
        '200':
          description: FHIR Bundle of Observation resources
  /Condition:
    get:
      operationId: searchCondition
      summary: Retrieve condition records for the authenticated member
      tags: [Condition]
      responses:
        '200':
          description: FHIR Bundle of Condition resources
  /MedicationRequest:
    get:
      operationId: searchMedicationRequest
      summary: Retrieve medication requests for the authenticated member
      tags: [MedicationRequest]
      responses:
        '200':
          description: FHIR Bundle of MedicationRequest resources
components:
  securitySchemes:
    smartOnFhir:
      type: oauth2
      description: SMART on FHIR authorization with patient-context launch
      flows:
        authorizationCode:
          authorizationUrl: https://r-hi2.cigna.com/mga/sps/oauth/oauth20/authorize
          tokenUrl: https://r-hi2.cigna.com/mga/sps/oauth/oauth20/token
          scopes:
            'patient/*.read': Read all patient-context FHIR resources
            'launch/patient': Launch in patient context
            'offline_access': Receive a refresh token
            'openid': Receive an OpenID Connect identity token
            'fhirUser': Receive the user resource identifier