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NPHIES Integration API

Overview

This section details the API integration with the National Platform for Health and Insurance Exchange Services (NPHIES).

Core Resources

Eligibility

  • Check Eligibility: POST /api/nphies/eligibility/check
  • Verify Coverage: GET /api/nphies/coverage/{id}

Claims

  • Submit Claim: POST /api/nphies/claims/submit
  • Check Status: GET /api/nphies/claims/{id}/status

Authentication

All NPHIES endpoints require a valid JWT token signed with your organization's private key.

{
  "Authorization": "Bearer <your_token>"
}

FHIR R4 Compliance

Our API is fully compliant with FHIR R4 standards as mandated by CHI (Council of Health Insurance).

Documentation in progress. Please refer to the NPHIES Official Guide for standard specifications.