API end point: https://nchess.careevolution.com/WebClient/api/Clover-PostData. It implements the STU3 FHIR version

Try it here.

See the terms of use

Supported resources

Supported compartments

Supported system operations

Standard identifier systems

Description System URI OID CareEvolution identifier type
CaregiverIdentifier https://www.cloverhealth.com/identifiers/CareEvolution/CaregiverIdentifier CareEvolution.IdentifierType.CaregiverIdentifier
Original FHIR Patient ID (FhirPatientID) https://www.cloverhealth.com/identifiers/CareEvolution/FhirPatientID CareEvolution.IdentifierType.FhirPatientID
HCID https://www.cloverhealth.com/identifiers/CareEvolution/HCID CareEvolution.IdentifierType.HCID
Last Four SSN Digits (LastFourSSN) https://www.cloverhealth.com/identifiers/CareEvolution/LastFourSSN CareEvolution.IdentifierType.LastFourSSN
MCID https://www.cloverhealth.com/identifiers/CareEvolution/MCID CareEvolution.IdentifierType.MCID
MedicaidID https://www.cloverhealth.com/identifiers/CareEvolution/MedicaidID CareEvolution.IdentifierType.MedicaidID
MemberID https://www.cloverhealth.com/identifiers/CareEvolution/MemberID CareEvolution.IdentifierType.MemberID
Medical Records Number (MRN) https://www.cloverhealth.com/identifiers/CareEvolution/MRN CareEvolution.IdentifierType.MRN
An identifier assigned to licensed and authorized insurance companies by the National Association of Insurance Commissioners (NAIC) (NaicCode) https://www.cloverhealth.com/identifiers/CareEvolution/NaicCode CareEvolution.IdentifierType.NaicCode
National Provider Identifier (NPI) http://hl7.org/fhir/sid/us-npi 2.16.840.1.113883.4.6 CareEvolution.IdentifierType.NPI
ProviderID https://www.cloverhealth.com/identifiers/CareEvolution/ProviderID CareEvolution.IdentifierType.ProviderID
Social Security Number (SSN) http://hl7.org/fhir/sid/us-ssn 2.16.840.1.113883.4.1 CareEvolution.IdentifierType.SSN
Tax Identification Number (TIN) urn:oid:2.16.840.1.113883.4.4 2.16.840.1.113883.4.4 CareEvolution.IdentifierType.TIN
UserName https://www.cloverhealth.com/identifiers/CareEvolution/UserName CareEvolution.IdentifierType.UserName

When mapping from FHIR the (optional) OID is considered equivalent to the corresponding system URI.

Standard coding systems

Code system System URI OID Writable Domains
C4 http://www.ama-assn.org/go/cpt 2.16.840.1.113883.6.12 -
CdcRaceAndEthnicity urn:oid:2.16.840.1.113883.6.238 - Race, Ethnicity
CDT http://www.ada.org/cdt 2.16.840.1.113883.6.13 -
CMSRemittanceAdviceRemarkCodes https://x12.org/codes/remittance-advice-remark-codes - NonPaymentReason
CVX http://hl7.org/fhir/sid/cvx 2.16.840.1.113883.12.292 -
DRG-FY2018 https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software - ClaimDrg, Drg
DRG-FY2019 https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software - ClaimDrg, Drg
DRG-FY2020 https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software - ClaimDrg, Drg
DRG-FY2021 https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software - ClaimDrg, Drg
DRG-FY2022 https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software - ClaimDrg, Drg
DRG-FY2023 https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/MS-DRG-Classifications-and-Software - ClaimDrg, Drg
HCPCS https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets 2.16.840.1.113883.6.14 -
HL7ActCode http://hl7.org/fhir/v3/ActCode - FacilityType, LocationType, ServiceLocation, AdmissionType, PatientType, InsurancePlanType
HL7AdmitSource http://hl7.org/fhir/admit-source 2.16.840.1.113883.4.642.1.253 - AdmitSource
HL7ConditionClinical http://hl7.org/fhir/condition-clinical 2.16.840.1.113883.4.642.1.74 - DiagnosisStatus
HL7DischargeDisposition http://hl7.org/fhir/discharge-disposition 2.16.840.1.113883.4.642.1.145 - DischargeType
HL7EncounterSpecialCourtesy http://hl7.org/fhir/v3/EncounterSpecialCourtesy 2.16.840.1.113883.5.40 - VipIndicator
HL7EncounterType http://hl7.org/fhir/encounter-type 2.16.840.1.113883.4.642.1.137 - PatientType
HL7GoalCategory http://hl7.org/fhir/goal-category 2.16.840.1.113883.4.642.1.411 - CareTaskCategory
HL7GoalPriority http://hl7.org/fhir/goal-priority 2.16.840.1.113883.4.642.1.151 - CareTaskPriority
HL7MaritalStatus http://hl7.org/fhir/v3/MaritalStatus 2.16.840.1.113883.5.2 - MaritalStatus
HL7MedicationStatementCategory http://hl7.org/fhir/medication-statement-category - OrderDepartment
HL7NullFlavor http://hl7.org/fhir/v3/NullFlavor 2.16.840.1.113883.5.1008 -
HL7ObservationInterpretation http://hl7.org/fhir/v2/0078 2.16.840.1.133883.18.31 - Acuity
HL7OrganizationType http://hl7.org/fhir/organization-type 2.16.840.1.113883.4.642.1.415 - CaregiverType
HL7ParticipantType http://hl7.org/fhir/participant-type 2.16.840.1.113883.4.642.1.139 - CaregiverRelationshipType
HL7ReasonMedicationGiven http://hl7.org/fhir/reason-medication-given 2.16.840.1.113883.4.642.1.188 - MedicationAdministrationReasonGiven
HL7ReasonMedicationNotGiven http://hl7.org/fhir/reason-medication-not-given 2.16.840.1.113883.4.642.1.187 - MedicationAdministrationReasonNotGiven
HL7RoleCode http://hl7.org/fhir/v3/RoleCode 2.16.840.1.113883.5.111 - LocationType
HL7SeverityObservationVocabulary http://terminology.hl7.org/CodeSystem/v3-ObservationValue -
HL7SpecimenType http://hl7.org/fhir/v2/0487 2.16.840.1.133883.18.311 - SpecimenType
HL7SubscriberRelationship http://hl7.org/fhir/policyholder-relationship - InsurancePlanType
HL7v3Religion http://hl7.org/fhir/v3/ReligiousAffiliation 2.16.840.1.113883.5.1076 -
HL7v3RequestPriority http://hl7.org/fhir/request-priority 2.16.840.1.113883.4.642.4.116 -
ICD-10-CM http://hl7.org/fhir/sid/icd-10-cm 2.16.840.1.113883.6.90 - DiagnosisCode
ICD-10-PCS http://www.cms.gov/Medicare/Coding/ICD10 2.16.840.1.113883.6.90 - ProcedureCode, ServiceCode
ICD-9-CM-Diagnosis http://hl7.org/fhir/sid/icd-9-cm 2.16.840.1.113883.6.42 - DiagnosisCode
ICD-9-CM-Procedure http://hl7.org/fhir/sid/icd-9-cm 2.16.840.1.113883.6.42 - ProcedureCode, ServiceCode
ImmunizationSite http://hl7.org/fhir/v3/ActSite 2.16.840.1.113883.5.1052 - MedicationAdministrationSite
InternetSocietyLanguage urn:ietf:bcp:47 - PreferredLanguage
LOINC http://loinc.org 2.16.840.1.113883.6.1 -
NDC http://hl7.org/fhir/sid/ndc 2.16.840.1.113883.6.69 -
NoImmunizationReason http://hl7.org/fhir/v3/ActReason 2.16.840.1.113883.5.8 - MedicationAdministrationReasonNotGiven
POS https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set 2.16.840.1.113883.6.50 - ServiceLocation
RouteOfAdministration http://hl7.org/fhir/v3/RouteOfAdministration 2.16.840.1.113883.5.112 - MedicationAdministrationRoute
RxNorm http://www.nlm.nih.gov/research/umls/rxnorm 2.16.840.1.113883.6.88 -
SNOMED http://snomed.info/sct 2.16.840.1.113883.6.96 -
Ub04PointOfOrigin https://www.nubc.org/CodeSystem/PointOfOrigin -
Ub04PointOfOriginNewBorn https://www.nubc.org/CodeSystem/PointOfOriginNewBorn -
Ub04PriorityOfAdmission https://www.nubc.org/CodeSystem/PriorityTypeOfAdmitOrVisit - AdmissionType
UBFacilityType https://rosetta.careevolution.com/UBFacilityType -
UBPatientDischargeStatus https://www.nubc.org/CodeSystem/PatDischargeStatus 2.16.840.1.113883.6.301.5 - PatientStatus
UBREV https://www.nubc.org/CodeSystem/RevenueCodes 2.16.840.1.113883.6.301.3 - RevenueCode
UBTOB https://www.nubc.org/CodeSystem/TypeOfBill 2.16.840.1.113883.6.301.1 - BillClass
UCUM http://unitsofmeasure.org 2.16.840.1.113883.6.8 -
UNII http://fdasis.nlm.nih.gov 2.16.840.1.113883.4.9 -
X12ClaimAdjustmentReasonCodes https://x12.org/codes/claim-adjustment-reason-codes - NonPaymentReason

When mapping from FHIR only the writable ones are mapped as-is, the other ones will be prefixed.
Also, when mapping from FHIR the (optional) OID is considered equivalent to the corresponding system URI.

CareEvolution concepts mapping

CareEvolution FHIR
Allergy AllergyIntolerance
AuditLogEntry AuditEvent
Caregiver Practitioner
CareTask CarePlan CareTeam Goal Task
CareTaskGroup CarePlan CareTeam
Claim Claim ExplanationOfBenefit
ClaimProblem Condition
ClaimProcedure Procedure
ClaimService Immunization
DataView List
DataViewInfo List
DemographicPicture Binary
Encounter Encounter
Insurance Coverage
LabObservation Observation
LabReport Binary DiagnosticReport Specimen
LabReportSpecimen Specimen
Location Location
Medication Claim ExplanationOfBenefit MedicationDispense
MedicationAdministration Immunization MedicationAdministration
MedicationProfile Immunization MedicationAdministration
Observation CareTeam Observation
Order MedicationRequest MedicationStatement ProcedureRequest
Patient Patient
PatientAssociatedParty RelatedPerson
PatientGroup Group
PatientGroupMember Group
Problem Condition Encounter
Procedure Procedure
RealTimeNotification Subscription
RecordAuthority Organization
RecordAuthoritySubset Organization
RecordGroup Patient
Referral ReferralRequest
ReferralProblem Condition
Report Binary DiagnosticReport DocumentReference
TermSubset ValueSet
UserInfo Person
ViewDefinition List

Import mappings

Mappings between FHIR resources and CareEvolution concepts used when importing FHIR data from other systems (i.e. via bulk import, provider connections and operations like $subit-data).

CareEvolution FHIR
Allergy AllergyIntolerance
Caregiver Practitioner Organization
CareTask Task Goal CarePlan
CareTaskGroup CarePlan
Claim ExplanationOfBenefit Claim
Encounter Encounter
Insurance Coverage
LabObservation Observation
LabReport Specimen DiagnosticReport
LabReportSpecimen Specimen
Location Location
Medication Medication MedicationDispense ExplanationOfBenefit Claim
MedicationAdministration Immunization MedicationAdministration
MedicationProfile Immunization Medication MedicationAdministration
Observation Observation
Order ProcedureRequest Medication MedicationRequest MedicationStatement
Patient Patient
PatientAssociatedParty RelatedPerson
Problem Encounter Condition
Procedure Procedure
RecordGroup Patient
Referral ReferralRequest
Report DiagnosticReport DocumentReference

Code terms

Domains and coding systems used to map FHIR codes value sets. List and manage them here.

FHIR value set Domain Coding system Default
address-use AddressType FhirCodes
administrative-gender Gender FhirCodes unknown
allergy-intolerance-category AllergyType FhirCodesAlternate1
allergy-intolerance-clinical-status AllergyClinicalStatus FhirCodesAlternate1
allergy-intolerance-criticality AllergySeverity FhirCodesAlternate1
allergy-intolerance-severity AllergyReactionSeverity FhirCodes
allergy-intolerance-type AllergySensitivity FhirCodes
allergy-intolerance-verification-status AllergyVerificationStatus FhirCodesAlternate1 unconfirmed
birth-sex Gender FhirCodesAlternate1 UNK
care-plan-intent CareTaskGroupIntent FhirCodes plan
care-plan-status CareTaskGroupStatus FhirCodesAlternate1 unknown
claim-type ClaimType FhirCodes professional
composition-status ReportStatus FhirCodesAlternate4 final
condition-clinical-status-codes DiagnosisStatus FhirCodesAlternate1
condition-clinical-status-codes DiagnosisStatusOnAdmission FhirCodesAlternate4
condition-clinical-status-codes ReferralStatus FhirCodesAlternate6
condition-verification-status DiagnosisStatusOnAdmission FhirCodesAlternate6 unknown
condition-verification-status DiagnosisVerificationStatus FhirCodes unknown
condition-verification-status ReferralStatus FhirCodesAlternate4 unknown
contact-point-system ContactInfoType FhirCodesAlternate1
contact-point-use ContactInfoUseCode FhirCodes
diagnostic-report-status ReportStatus FhirCodesAlternate1 partial
document-reference-status ReportStatus FhirCodesAlternate2
document-reference-status DocumentReferenceStatus FhirCodes
event-status ProcedureStatus FhirCodesAlternate1 unknown
explanation-of-benefit-status ClaimStatus FhirCodes active
f-h-i-r-device-status DeviceDataSourceStatus FhirCodesAlternate1 unknown
financial-resource-status-codes InsuranceStatus FhirCodes active
financial-resource-status-codes ClaimStatus FhirCodesAlternate1 active
goal-status CareTaskStatus FhirCodesAlternate2 in-progress
immunization-status-codes ClaimServiceStatus FhirCodesAlternate1 completed
immunization-status-codes MedicationAdministrationStatus FhirCodesAlternate1 completed
immunization-status-codes MedicationStatus FhirCodesAlternate5 completed
medication-administration-status MedicationAdministrationStatus FhirCodesAlternate2 in-progress
medication-dispense-status MedicationStatus FhirCodesAlternate1
medication-request-priority OrderPriority FhirCodesAlternate1
medication-request-status OrderStatus FhirCodesAlternate3
medication-statement-status OrderStatus FhirCodesAlternate8 active
name-use NameType FhirCodes
observation-status ObservationResultStatus FhirCodesAlternate1 unknown
old-diagnosis-role DiagnosisType FhirCodesAlternate5
old-encounter-participant-type CaregiverRelationshipType FhirCodesAlternate3
request-intent RequestIntent FhirCodes proposal
request-intent TaskIntent FhirCodes plan
request-priority CareTaskPriority FhirCodes routine
request-priority OrderPriority FhirCodesAlternate2
request-priority ReferralAcuity FhirCodes
request-status OrderStatus FhirCodesAlternate4
request-status ReferralStatus FhirCodesAlternate1 unknown
specimen-status SpecimenStatus FhirCodes
stu3-claim-care-team-role CaregiverRelationshipType FhirCodesAlternate2
stu3-claim-information-category SupportingInformationType FhirCodesAlternate1 other
stu3-condition-category DiagnosisType FhirCodesAlternate2 problem-list-item
stu3-encounter-class PatientClass FhirCodesAlternate1
task-status CareTaskStatus FhirCodesAlternate3 in-progress

Custom extensions

Code Card. Type Context Definition
allergyIntolerance-encounterID 0..1 Reference AllergyIntolerance resources The encounter associated to this allergy
auditEvent-durationMilliseconds 0..1 integer AuditEvent resources Duration of the event - e.g. page load
auditEvent-screenName 0..1 string AuditEvent resources The name of the screen during a page load
auditEvent-sessionID 0..1 string AuditEvent resources Unique Identifier for user session
careTaskGroup-type 0..1 CodeableConcept CarePlan resources Type of CareTaskGroup. For example: CareGap, General, etc..
careTeamParticipant-assignedGroup 0..1 string CareTeam resources Group for the CareTeam Participant
careTeamParticipant-assignedPerson 0..1 string CareTeam resources Name of CareTeam Participant
careTeamParticipant-note 0..1 string CareTeam resources Note about CareTeam Paticipant
careTeamParticipant-observationChildren 0..1 (complex) CareTeam resources Additional details for CareTeam participant
careTeamParticipant-status 0..1 CodeableConcept CareTeam resources Status of CareTeam Participant
claim-adjudicationDate 0..1 dateTime Claim resources The date/time the claim was adjudicated
claim-admitSource 0..1 CodeableConcept Claim resources Point of origin for admission
claim-amountPaid 0..1 decimal Claim resources Amount paid for service
claim-billClass 0..1 CodeableConcept Claim resources Billing class for claim
claim-controlNumber 0..1 string Claim resources Control number of the claim
claim-disposition 0..1 CodeableConcept Claim resources Disposition of the claim
claim-drg 0..1 CodeableConcept Claim resources Diagnosis Related Group (DRG) code
claim-encounterID 0..1 Reference Claim resources The encounter associated to this claim
claim-endDate 0..1 dateTime Claim resources The date/time the claim or claim service ended
claim-facilityType 0..1 CodeableConcept Claim resources Facility type where claim service or product was supplied
claim-innetwork 0..1 CodeableConcept Claim resources Indicator if Claim is in/out of network
claim-locationType 0..1 CodeableConcept Claim resources Type of service on the claim
claim-mrn 0..1 string Claim resources Medical record number of patient
claim-nonPaymentReason 0..1 CodeableConcept Claim resources Reason for non-payment
claim-paidDate 0..1 dateTime Claim resources The date/time the claim was paid
claim-patientPaid 0..1 decimal Claim resources $ paid by patient
claim-patientStatus 0..1 CodeableConcept Claim resources Discharge status
claim-problemDate 0..1 dateTime FhirLibrary.MultipleResourceExtensionContext Date of condition on the claim
claim-procedureType 0..1 CodeableConcept ExplanationOfBenefit resources Type of procedure on the claim
claimService-allowedamount 0..1 decimal Claim resources Claim line compensation amount
claimService-coinsuranceamount 0..1 decimal Claim resources Claim line coinsurance amount
claimService-copayamount 0..1 decimal Claim resources Claim line copay amount
claimService-deductibleamount 0..1 decimal Claim resources Claim line deductible amount
claimService-hsapaidamount 0..1 decimal Claim resources Claim line paid by patient HSA
claimService-nonPaymentReason 0..1 CodeableConcept Claim resources Reason for non-payment
claimService-notcoveredamount 0..1 decimal Claim resources Claim line not covered amount
claimService-patientresponsibleamount 0..1 decimal Claim resources Claim line for which the patient is responsible/liable
claim-status 0..1 CodeableConcept Claim resources Status of the claim or claim line status
claim-totalAllowed 0..1 decimal Claim resources Total $ allowed by payer
claim-totalcoinsuranceamount 0..1 decimal Claim resources Patient Coinsurance $
claim-totalcopayamount 0..1 decimal Claim resources Patient co-payment $
claim-totaldeductibleamount 0..1 decimal Claim resources Patient deductible $
claim-totalhsapaidamount 0..1 decimal Claim resources Claim $ paid by patient HSA
claim-totalnotcoveredamount 0..1 decimal Claim resources Claim $ not covered
claim-totalPaid 0..1 decimal Claim resources Total $ paid for claim
claim-totalPatientPaid 0..1 decimal Claim resources Total $ patient paid for claim
claim-totalpatientresponsibleamount 0..1 decimal Claim resources Claim $ for which the patient is responsible/liable
condition-claimReference 0..1 Reference Condition resources The claim associated with this condition
condition-eobReference 0..1 Reference Condition resources The explanation of benefit associated with this condition
condition-referralReference 0..1 Reference Condition resources The referral associated with this condition
coverage-authorizationDate 0..1 dateTime Coverage resources Authorization Date
coverage-authorizationNumber 0..1 string Coverage resources Authorization Number
coverage-authorizationSource 0..1 string Coverage resources Authorization Source
coverage-details 0..1 (complex) Coverage resources Details about the insurance
coverage-encounterID 0..1 Reference Coverage resources The encounter associated to this Insurance
coverage-groupEmpName 0..1 string Coverage resources Insurance Group Employee Name
coverage-insuredAltPhone 0..1 string Coverage resources Insured alternate phone
coverage-insuredDob 0..1 dateTime Coverage resources Insured Date of Birth
coverage-insuredGender 0..1 string Coverage resources Insured gender
coverage-insuredName 0..1 string Coverage resources Insured Name
coverage-insuredPhone 0..1 string Coverage resources Insured phone
coverage-insuredSsn 0..1 string Coverage resources Insured Social Security Number
coverage-medicaidCaseName 0..1 string Coverage resources Medicaid Case Name
coverage-medicaidCaseNumber 0..1 string Coverage resources Medicaid Case Number
coverage-medicareCardNumber 0..1 string Coverage resources Medicare Card Number
coverage-pharmacyCoverage 0..1 string Coverage resources Pharmacy Coverage in the insurance
coverage-policyNumber 0..1 string Coverage resources Insurance Policy Number
coverage-primaryCaregiver 0..1 Reference Coverage resources The primary caregiver associated to this Insurance
coverage-product 0..1 CodeableConcept Coverage resources Code or name for a package of coverage benefit
coverage-productgroup 0..1 CodeableConcept Coverage resources Category/groups of similar products
coverage-rateCode 0..1 CodeableConcept Coverage resources Insurance Rate Code
coverage-segment 0..1 CodeableConcept Coverage resources Insured Segment
coverage-sponsor 0..1 string Coverage resources Sponser for the insurance
coverage-type 0..1 CodeableConcept Coverage resources Insurance Type
dataSource 0..1 (complex) FhirLibrary.MultipleResourceExtensionContext Data source
derived 0..* Reference BackboneElement elements Reference to a possible resource derived from this element
domain 0..1 string Uri elements Coding system domain
encounter-drg 0..1 CodeableConcept Encounter resources Diagnosis Related Group (DRG) code
explanationOfBenefit-priority 0..1 CodeableConcept ExplanationOfBenefit resources Disposition of the claim