Independence Blue Cross

Independence Blue Cross Patient Access FHIR API

HL7 FHIR R4 (4.0.1) Patient Access API published to satisfy the CMS Interoperability and Patient Access final rule (CMS-9115-F). Enables Independence Medicare Advantage and Keystone HMO CHIP members (or their personal representatives) to consent and share clinical, claims, encounter, coverage, medication, immunization, and demographic data with registered third-party applications. Conforms to the CARIN for Blue Button (CARIN BB), Common Payer Consumer Data Set (CPCDS), US Core 3.1.1, and Da Vinci PDex profiles. Secured by SMART App Launch 1.0.0 over OAuth 2.0 / OpenID Connect; production access requires developer registration and CMS-aligned attestation.

Independence Blue Cross Patient Access FHIR API is one of 5 APIs that Independence Blue Cross publishes on the APIs.io network, described by a machine-readable OpenAPI specification.

This API exposes 2 machine-runnable capabilities that can be deployed as REST, MCP, or Agent Skill surfaces via Naftiko and 3 JSON Schema definitions.

Tagged areas include Patient Access, FHIR, SMART On FHIR, Medicare Advantage, and CHIP. The published artifact set on APIs.io includes API documentation, an OpenAPI specification, 2 Naftiko capability specs, and 3 JSON Schemas.

Documentation GitHub OpenAPI

Documentation

https://devportal.ibx.com/documentation/

Specifications

https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/openapi/independence-blue-cross-patient-openapi.yml

Schemas & Data

https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/json-schema/independence-blue-cross-patient-schema.json

https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/json-schema/independence-blue-cross-coverage-schema.json

https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/json-schema/independence-blue-cross-explanation-of-benefit-schema.json

Other Resources

https://devportal.ibx.com/

https://www.ibx.com/scripts/custom/swagger/cmsSwagger.json

CapabilityStatement

https://eapics.ibx.com/patient/v1/fhir/metadata

SmartConfiguration

https://eapics.ibx.com/patient/v1/fhir/.well-known/smart-configuration

https://member.ibx.com/patientaccesssvc/oauth2/v1/authorize

https://eapics.ibx.com/oauth2/v2/token

https://devportal.ibx.com/cmssignin/

https://www.ibx.com/htdocs/custom/tnc/Developer%20Portal%20TandC.pdf

https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/mailto:[email protected]

https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/rules/independence-blue-cross-rules.yml

NaftikoCapability

https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/capabilities/independence-blue-cross-patient-access.yaml

NaftikoCapability

https://raw.githubusercontent.com/api-evangelist/independence-blue-cross/refs/heads/main/capabilities/independence-blue-cross-claims-and-eob.yaml

OpenAPI Specification

openapi: 3.0.3
info:
  title: Independence Blue Cross Patient Access FHIR API
  version: 1.0.0
  description: HL7 FHIR R4 (4.0.1) Patient Access API published by Independence Blue Cross to satisfy the CMS Interoperability
    and Patient Access final rule (CMS-9115-F). Provides member-authorized access to clinical, claims, encounter, coverage,
    medication, immunization, and demographic resources for Independence Medicare Advantage and Keystone HMO CHIP members.
    Conforms to the CARIN for Blue Button (CARIN BB), Common Payer Consumer Data Set (CPCDS), US Core 3.1.1, and Da Vinci
    PDex profiles. Secured by SMART on FHIR / OAuth 2.0 / OpenID Connect with PKCE.
  contact:
    name: Independence Interoperability Support
    email: [email protected]
    url: https://devportal.ibx.com/
  license:
    name: Independence Developer Portal Terms & Conditions
    url: https://www.ibx.com/htdocs/custom/tnc/Developer%20Portal%20TandC.pdf
servers:
- url: https://eapics.ibx.com/patient/v1/fhir
  description: Production FHIR endpoint
tags:
- name: Patient Access
  description: FHIR R4 Patient Access resources for member-authorized access.
paths:
  /metadata:
    get:
      summary: Get Capability Statement
      operationId: get_metadata
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /.well-known/smart-configuration:
    get:
      summary: Get SMART Configuration
      operationId: get_.well-known_smart-configuration
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Patient:
    get:
      summary: Search Patient
      operationId: get_Patient
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Patient/{rid}:
    get:
      summary: Read Patient By ID
      operationId: get_Patient_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Coverage:
    get:
      summary: Search Coverage
      operationId: get_Coverage
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Organization:
    get:
      summary: Search Organization
      operationId: get_Organization
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Organization/{rid}:
    get:
      summary: Read Organization By ID
      operationId: get_Organization_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Practitioner:
    get:
      summary: Search Practitioner
      operationId: get_Practitioner
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Practitioner/{rid}:
    get:
      summary: Read Practitioner By ID
      operationId: get_Practitioner_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Location:
    get:
      summary: Search Location
      operationId: get_Location
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Location/{rid}:
    get:
      summary: Read Location By ID
      operationId: get_Location_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /PractitionerRole:
    get:
      summary: Search PractitionerRole
      operationId: get_PractitionerRole
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /PractitionerRole/{rid}:
    get:
      summary: Read PractitionerRole By ID
      operationId: get_PractitionerRole_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /AllergyIntolerance:
    get:
      summary: Search AllergyIntolerance
      operationId: get_AllergyIntolerance
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /AllergyIntolerance/{rid}:
    get:
      summary: Read AllergyIntolerance By ID
      operationId: get_AllergyIntolerance_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Immunization:
    get:
      summary: Search Immunization
      operationId: get_Immunization
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Immunization/{rid}:
    get:
      summary: Read Immunization By ID
      operationId: get_Immunization_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /MedicationDispense/{rid}:
    get:
      summary: Read MedicationDispense By ID
      operationId: get_MedicationDispense_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Observation:
    get:
      summary: Search Observation
      operationId: get_Observation
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Observation/{rid}:
    get:
      summary: Read Observation By ID
      operationId: get_Observation_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /DiagnosticReport:
    get:
      summary: Search DiagnosticReport
      operationId: get_DiagnosticReport
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /DiagnosticReport/{rid}:
    get:
      summary: Read DiagnosticReport By ID
      operationId: get_DiagnosticReport_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /CarePlan:
    get:
      summary: Search CarePlan
      operationId: get_CarePlan
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /CarePlan/{rid}:
    get:
      summary: Read CarePlan By ID
      operationId: get_CarePlan_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Condition:
    get:
      summary: Search Condition
      operationId: get_Condition
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Condition/{rid}:
    get:
      summary: Read Condition By ID
      operationId: get_Condition_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Encounter:
    get:
      summary: Search Encounter
      operationId: get_Encounter
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Encounter/{rid}:
    get:
      summary: Read Encounter By ID
      operationId: get_Encounter_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Goal:
    get:
      summary: Search Goal
      operationId: get_Goal
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Goal/{rid}:
    get:
      summary: Read Goal By ID
      operationId: get_Goal_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Medication:
    get:
      summary: Search Medication
      operationId: get_Medication
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Medication/{rid}:
    get:
      summary: Read Medication By ID
      operationId: get_Medication_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /MedicationRequest:
    get:
      summary: Search MedicationRequest
      operationId: get_MedicationRequest
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /MedicationRequest/{rid}:
    get:
      summary: Read MedicationRequest By ID
      operationId: get_MedicationRequest_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /Procedure:
    get:
      summary: Search Procedure
      operationId: get_Procedure
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /Procedure/{rid}:
    get:
      summary: Read Procedure By ID
      operationId: get_Procedure_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
  /ExplanationOfBenefit:
    get:
      summary: Search ExplanationOfBenefit
      operationId: get_ExplanationOfBenefit
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
  /ExplanationOfBenefit/{rid}:
    get:
      summary: Read ExplanationOfBenefit By ID
      operationId: get_ExplanationOfBenefit_rid
      tags:
      - Patient Access
      responses:
        '200':
          description: OK
          content:
            application/fhir+json: {}
        '400':
          description: Bad Request
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '404':
          description: Not Found
      parameters:
      - name: rid
        in: path
        required: true
        description: FHIR resource id
        schema:
          type: string
components:
  securitySchemes:
    smart_on_fhir:
      type: oauth2
      flows:
        authorizationCode:
          authorizationUrl: https://member.ibx.com/patientaccesssvc/oauth2/v1/authorize
          tokenUrl: https://eapics.ibx.com/oauth2/v2/token
          scopes:
            launch/patient: Patient context launch
            patient/*.read: Read all patient-scoped FHIR resources
            openid: OpenID Connect identity
            offline_access: Long-lived refresh token
security:
- smart_on_fhir:
  - patient/*.read