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

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Servicing

Molina Healthcare - All Health Plans
NY - Senior Whole Health by Molina Healthcare
AZ - Molina Complete Care
VA - Molina Complete Care
FL - Molina Healthcare
MA - Senior Whole Health by Molina Healthcare
Passport Advantage
​Senior Whole Health by Molina Healthcare

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 MyHealth Connections Solutions provide the basis for building healthcare applications, such as mobile, that deliver HL7® FHIR® data to members and providers on demand.  Some example applications use cases could be to view test results, check on medications, and review 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. 

Key third party resources and links:

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

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Clinical

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

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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.

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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

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As an example, you can obtain member profile data based on tenant enrollment ID, subscriber ID and profile group by making an API 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"
        }
    }
}
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About us

Molina Healthcare, Inc., a FORTUNE 500 company, provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces. Through its locally operated health plans in 15 states, Molina Healthcare served approximately 4.0 million members as of December 31, 2020. In addition, in connection with the acquisition of Magellan Complete Care on December 31, 2020, Molina Healthcare added approximately 200,000 members, and now operates health plans in 18 states. These health plans are generally operated by Molina Healthcare’s respective wholly owned subsidiaries in those states.

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© 2021 Cognizant TriZetto Software Group, Inc. All rights reserved. Cognizant and TriZetto are registered trademarks of Cognizant and its affiliates.

Cognizant Supplemental Terms

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].

*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/