Welcome to Horizon Interoperability
Developer Portal

Enabling APIs to leverage access to a patient’s clinical and administrative data.

Data APIs available

APIs for interoperability comprised of USCDI clinical data, CARIN administrative data, Da Vinci Formulary Drug data and Da Vinci Provider Directory data

How Do I Start?

The APIs of Horizon Connected Interoperability Solution provide the basis for building healthcare applications, such as mobile, that deliver HL7® FHIR® data to members and providers on demand. Example of application use cases can include viewing test results, checking on medications, and reviewing recent office visits.

Our APIs allow access to clinical, administrative and formulary drug plan information about a patient, as well as provide detailed provider directory information. Applications will securely interact with this data on behalf of the patient in order to deliver patients real-time access to their healthcare data.

For a set of data sharing principles and best practices for healthcare applications, read the CARIN code of conduct.

To get started with the Developer Portal, read the Developer Portal User Guide.

Key third party resources and links:

Patient Access API
- United States Core Data for Interoperability (USCDI)
  Definition for the clinical data implementation guide
- Da Vinci Payer Data Exchange US Drug Formulary*
  Definition for Drug Formulary implementation guide
- Consumer Directed Payer Data Exchange (CARIN IG for Blue Button)**
  Definition for administrative data implementation guide
Provider Directory API
- Da Vinci Payer Data Exchange Plan Net Directory*
  Definition for provider directory implementation guide

Our APIs

Administrative

APIs that will connect a patient to their administrative data such as claim, explanation of benefits, member and coverage information that supports the Carin Consumer Directed Payer Data Exchange implementation guide.

Clinical

APIs that will connect a patient to their clinical data, such as lab or diagnostic results, medications, consultation and
referral notes and more that support the USCDI implementation guide.

Provider Directory

APIs that will give detailed information about a payer’s network of physicians and facilities with the goal of connecting patients to care providers that supports the Da Vinci Payer Data Exchange Plan Net Directory implementation guide.

Drug Formulary

APIs that will allow a patient to explore their drug plan and understand drug tiers and cost sharing information that support the Da Vinci Payer Data Exchange US Drug Formulary implementation guide.

Example Endpoint Call

As an example, you can obtain member profile data based on tenant enrollment ID, subscriber ID and profile group by making an API endpoint call to
/profile-fxi-data/get-member-tenantenrollmentid().

On the API page, you can test-execute this operation by clicking the “Try it” link and following the instructions. In this case, you’ll receive an example set of member profile data in the returned response.

GET /member/{tenantenrollmentid}
{
    "type": "object",
    "properties": {
        "tenantEnrollmentId": {
            "type": "string",
            "description": "Unique ID assigned."
        },
        "subscriberId": {
            "type": "string",
            "description": "The subscriber's ID."
        },
        "profileGroups": {
            "$ref": "#/definitions/profileGroups"
        }
    }
}

Explore API Library

_____________________

Products and services are provided by Horizon Blue Cross Blue Shield of New Jersey, Horizon Insurance Company, Horizon Healthcare of New Jersey, Braven Health, and/or Horizon Healthcare Dental, Inc., each an independent licensee of the Blue Cross and Blue Shield Association. Communications may be issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. The Braven Health℠ name and symbols are service marks of Braven Health.

This website is operated by Cognizant on behalf of Horizon Blue Cross Blue Shield of New Jersey. Cognizant is independent from and not affiliated with Horizon Blue Cross Blue Shield of New Jersey.

Contact Support | Online Privacy Statement | Online Terms & Conditions | Cognizant Supplemental Terms

*HL7 Da Vinci Project: Da Vinci is a private sector initiative that addresses the needs of the Value Based Care Community by leveraging the HL7 FHIR platform.
**The CARIN alliance: https://www.carinalliance.com/about-us/
HL7® and FHIR® are the registered trademarks of Health Level Seven International and the use does not constitute endorsement by HL7. More information may be found [here].
© 2021 Cognizant TriZetto Software Group, Inc. All rights reserved.

Welcome to Horizon InteroperabilityDeveloper Portal