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Pre-configured REST APIs

Updated on April 23, 2021

The Foundation provides following pre-configured REST APIs for commonly referenced Resources that can be used to connect with your source of truth systems.

Pega Foundation for Healthcare
RESTAPIREST Connector data page nameData type (class)name
GetAuthorizationD_ConnectAuthorizationPegaHC-Data-Authorization
GetMemberAuthorizationsD_ConnectMemberAuthorizationsPegaHC-Data-Authorization
GetBenefitCoverageD_ConnectBenefitCoveragePegaHC-Data-Benefit- Coverage
GetPlanDetailsD_ConnectGetPlanDetailsPegaHC-Data-Plan
GetContractD_ConnectContractPegaHC-Data-Contract
GetMemberD_ConnectMemberPegaHC-Data-Party- Member
GetPayerD_ConnectPayerPegaHC-Data-Party-Payer
GetPolicyD_ConnectPolicyPegaHC-Data-Policy
MemberPoliciesD_ConnectMemberPoliciesPegaHC-Data-Policy
MemberPoliciesByIDD_ConnectMemberPoliciesByIDPegaHC-Data-Policy
GetProviderD_ConnectProviderPegaHC-Data-Party-Provider
GetBusinessAffiliationD_ConnectBusinessAffiliationPegaHC-Data-BusinessAffiliation
BusinessAffiliationD_ConnectBusinessEntitiesPegaHC-Data-Party-BusinessEntity
MemberNetworksD_ConnectMemberNetworksPegaHC-Data-Network
GetNetworkD_ConnectNetworkPegaHC-Data-Network
PlanNetworksD_ConnectPlanNetworksPegaHC-Data-Network
ProviderNetworksD_ConnectProviderNetworksPegaHC-Data-Network
RateSheetD_ConnectRateSheetPegaHC-Data-RateSheet

To navigate to the pre-configured external data pages:

  1. Log in to the application as Administrator using the password that you specified when you enabled this operator; to enable Pega-provided operators, see Enabling operators.
  2. Navigate to Dev Studio > Data Model > View external data entities.

    To view REST API data model schema:

  3. Log in to the application as Administrator using the password that you specified when you enabled this operator; to enable Pega-provided operators, see Enabling operators.
  4. Navigate to Configure > Healthcare > Healthcare API > Business Requests entities.
  5. Click on the desired Resource Link to view the pre-configured REST methods as well as the schema data model associated with each Resource API.

For additional information, refer to the Healthcare API Technical Specifications document on the Pega Foundation for Healthcare product page. Use the Integration worksheet in the Implementation Planning Workbook to record your decisions on APIs any schema model changes needed for your application.

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