57 schemas across 12 categories

Categories

Behavioral

1 schema

Claims

3 schemas

Clinical

17 schemas

Dental

1 schema

Federal

5 schemas

Marketplace

7 schemas

Medicaid

7 schemas

Medicare

7 schemas

Pharmacy

1 schema

Publichealth

5 schemas

Vision

1 schema

Direct schemas

Healthcare Resources Schema

Core healthcare resources derived from FHIR

23 types

Healthcare FHIR Types

FHIR-derived type definitions for healthcare schemas

20 types

Behavioral Health Benefits Schema

Behavioral health benefits including mental health, substance use, ABA therapy, crisis, telehealth, and parity

8 types

Healthcare Institutional Claim Schema

Institutional healthcare claims derived from UB-04 structure

12 types

Healthcare Professional Claim Schema

Professional healthcare claims derived from CMS-1500 structure

4 types

Healthcare Claims Common Types

Reusable type definitions for healthcare claims

10 types

Healthcare Clinical Allergy Intolerance Schema

Clinical allergy/intolerance resource derived from FHIR R4/R5

2 types

Healthcare Clinical Appointment Schema

Clinical appointment resource derived from FHIR R4/R5

2 types

Healthcare Clinical Care Plan Schema

Clinical care plan resource derived from FHIR R4/R5

3 types

Healthcare Clinical Care Team Schema

Clinical care team resource derived from FHIR R4/R5

2 types

Healthcare Clinical Claim Schema

Clinical claim resource derived from FHIR R4/R5

12 types

Healthcare Clinical Coverage Schema

Clinical coverage (insurance policy) resource derived from FHIR R4/R5

4 types

Healthcare Clinical Device Schema

Clinical medical device resource derived from FHIR R4/R5

6 types

Healthcare Clinical Diagnostic Report Schema

Clinical diagnostic report resource derived from FHIR R4/R5

2 types

Healthcare Clinical Document Reference Schema

Clinical document reference resource derived from FHIR R4/R5

4 types

Healthcare Clinical Explanation of Benefit Schema

Clinical explanation of benefit (EOB/remittance) resource derived from FHIR R4/R5

19 types

Healthcare Clinical Goal Schema

Clinical goal resource derived from FHIR R4/R5

2 types

Healthcare Clinical Immunization Schema

Clinical immunization (vaccination) resource derived from FHIR R4/R5

5 types

Healthcare Clinical Medication Schema

Clinical medication resource derived from FHIR R4/R5

3 types

Healthcare Clinical Medication Administration Schema

Clinical medication administration resource derived from FHIR R4/R5

3 types

Healthcare Clinical Medication Request Schema

Clinical medication request (prescription) resource derived from FHIR R4/R5

3 types

Healthcare Clinical Procedure Schema

Clinical procedure resource derived from FHIR R4/R5

3 types

Healthcare Clinical Service Request Schema

Clinical service request (orders/referrals) resource derived from FHIR R4/R5

1 type

Dental Benefits Schema

Dental benefit management including plans, benefits, procedures, orthodontia, waiting periods, and providers

7 types

CHAMPVA Schema

Civilian Health and Medical Program of the VA

7 types

Federal Employees Health Benefits Schema

FEHB program structures

8 types

Indian Health Service Schema

IHS health care system structures

7 types

TRICARE Schema

TRICARE military health system structures

9 types

Veterans Affairs Health Care Schema

VA health care system structures

8 types

Health Insurance Marketplace Application Schema

Marketplace application structures

7 types

Health Insurance Marketplace Eligibility Schema

Marketplace eligibility determination for QHP, APTC, and CSR

8 types

Health Insurance Marketplace Enrollment Schema

Marketplace plan enrollment and effectuation

11 types

ACA Exemptions Schema

Individual Shared Responsibility exemptions

17 types

Qualified Health Plan Schema

QHP certification and plan data structures

12 types

Special Enrollment Period Schema

SEP structures and qualifying events

9 types

Health Insurance Marketplace Types Schema

Common types for ACA Marketplace operations

12 types

Medicaid Benefits Schema

Medicaid covered services and benefits

9 types

CHIP Schema

Children's Health Insurance Program structures

6 types

Medicaid Eligibility Schema

MAGI and categorical Medicaid eligibility determination

7 types

Medicaid Enrollment Schema

Medicaid application and enrollment processes

9 types

Medicaid Managed Care Schema

MCO/PIHP/PAHP/PCCM structures

8 types

Medicaid Provider Schema

Medicaid provider enrollment and participation

14 types

Medicaid Common Types

Reusable type definitions for Medicaid schemas

12 types

Medicare Advantage Schema

Medicare Advantage (Part C) plan data

5 types

Medicare Eligibility Schema

Medicare entitlement determination and eligibility verification

6 types

Medicare Enrollment Schema

Medicare Part A, B, C, D enrollment processes

5 types

Medicare Part D Schema

Medicare prescription drug coverage (Part D) plan data

9 types

Medicare Provider Enrollment Schema

Medicare provider enrollment and certification

11 types

Medicare Supplemental (Medigap) Schema

Medicare Supplement Insurance (Medigap) policies

6 types

Medicare Common Types

Reusable type definitions for Medicare schemas

10 types

Pharmacy Benefits Schema

Pharmacy benefit management including formulary, prior auth, pricing, PBM, rebates, and specialty

10 types

Public Health Emergency Schema

Public health emergency structures and declarations

7 types

Immunization Schema

Immunization records and registry structures

8 types

Reportable Conditions Schema

Notifiable diseases and conditions reporting

10 types

Disease Surveillance Schema

Disease surveillance and syndromic surveillance structures

7 types

Vital Records Schema

Birth and death certificate structures

4 types

Vision Benefits Schema

Vision benefit management including plans, benefits, frequency, allowances, providers, and medical vision

7 types