Provider Directory

References

 

General

BlueCross BlueShield of Minnesota (BCBS-MN) offers 2 APIs giving you the ability to build applications for our customers. The BlueCross BlueShield of Minnesota Provider Directory API provides insights into Medicaid and Medicare providers, as well as the pharmacies and dentists servicing the Medicaid/Medicare populations.

The Provider Directory API allows BCBS-MN customers access to our provider directory. There is no security required to access this API.

The BCBS-MN Provider Directory is based on the Da Vinci PDEX Plan Net implementation guide. The capability statement provides insights into our implementation of the DaVinci PDEX Plan Net implementation guide.

Exceptions to the DaVinci PDEX Plan Net Implementation Guide

We were able to implement all of the SHALL queries documented in the DaVinci PDEX Plan Net Implementation Guide. Unfortunately, we do not have all of the information required to be 100% in accordance. The following section documents the 3 areas where information is lacking and how it impacts our implementation.

  1. The API is unable to support the Endpoint resource. Therefore, the following SHALL queries are not supported:
     
    /HealthcareService?endpoint=[endpoint]
    /HealthcareService?[parameter=value]&_include=HealthcareService:endpoint
    /Location?[parameter=value]&_include=Location:endpoint
    /Location?endpoint=[endpoint]
    /Organization?[parameter=value]&_include=Organization:endpoint
    /Organization?[parameter=value]&_revinclude=Endpoint:organization
    /Organization?endpoint=[endpoint]
    /OrganizationAffiliation?[parameter=value]&_include=OrganizationAffiliation:endpoint
    /OrganizationAffiliation?endpoint=[endpoint]
    /PractitionerRole?[parameter=value]&_include=PractitionerRole:endpoint
    /PractitionerRole?endpoint=[endpoint]
  2. Coverage Area information is un-available and therefore the following SHALL queries are not supported:
     
    /HealthcareService?[parameter=value]&_include=HealthcareService:coverage-area
    /HealthcareService?coverage-area=[coverage-area]
    /InsurancePlan?[parameter=value]&_include=InsurancePlan:coverage-area
    /InsurancePlan?coverage-area=[coverage-area]
    /Location?[parameter=value]&_revinclude=InsurancePlan:coverage-area
    /Organization?[parameter=value]&_include=Organization:coverage-area
    /Organization?coverage-area=[coverage-area]
  3. The information to support ‘partof’ queries is  un-available and therefore the following SHALL queries are not supported:
     
    /Location?[parameter=value]&_include=Location:part of
    /Location?partof=[partof]
    /Organization?[parameter=value]&_include=Organization:part of
    /Organization?partof=[partof]
  4. Exceptions to the DaVinci: when using _lastUpdated the timestamp is required (for example: 2021-06-21T09:57:43.133-04:00); results may be incorrect if only YYYY-MM-DD is used.

Base URLs 

Pre-Production: https://preview-api.bluecrossmn.com/fhir/provider 

Production: https://api.bluecrossmn.com/fhir/provider