Plan Contacts

Datasets

Part of the Payer Plans group of the Drug Formulary feed, built to Da Vinci PDex US Drug Formulary STU 2.1.0. The feed's data conventions apply.

Dataset	US Drug Formulary STU 2.1.0 target element
`plan_contacts`	`InsurancePlan.contact` of the Payer Insurance Plan

plan_contacts

One row per contact a plan publishes: the member services line, the marketing site, the benefit summary, the printable formulary, a billing or press office. A plan has several, so they are rows here rather than columns on payer_plans. Each row becomes one contact entry on the plan's InsurancePlan.

Column	Required	Format / values	Example
`contact_id`	Yes	your stable key for the contact	`CT-DSNP-MEMBERS`
`plan_id`	Yes	key from `payer_plans`	`PLAN-DSNP`
`contact_purpose`	Yes	see Purposes	`PATINF`
`contact_name`	Recommended	text; the name of the office, site or document	`Member Services`
`phone`	If available	10 digits; several `;`-separated	`8885551002;8885551099`
`fax`	If available	10 digits; several `;`-separated
`email`	If available	email addresses, `;`-separated	`members@example.org`
`url`	If available	web addresses, `;`-separated	`https://example.org/plans/dsnp`
`address_line1`	If available	text	`123 Main St`
`address_line2`	If available	text
`city`	If available	text	`Anytown`
`state`	If available	2-letter USPS	`NY`
`zip`	If available	5 digits, as a string	`12345`
`is_deleted`	If retracting	`true` retracts this row	`true`

A row needs a contact_name or at least one of phone, fax, email, url; otherwise it describes nothing and is rejected. contact_name becomes the contact's name text, each value in the telecom columns one telecom entry of its system, so a contact may list several numbers, and the address columns the contact's address.
The IG expects three document contacts on every drug plan: the marketing page, the benefit summary and the printable formulary. Members' apps look for them by purpose, so send each as its own row with a url.
Not collected: the contact's structured name parts (family, given, prefix, suffix); the profile marks only name.text must-support.
Several rows may share a purpose, for instance two member lines. They all become contacts; the profile does not rank them.

Purposes

contact_purpose is bound to PlanContactTypeVS, which joins the generic FHIR contact types with three the Formulary IG adds.

Value	Contact is	Defined by
`PATINF`	member information, the member services line	FHIR contact entity type
`MARKETING`	the plan's marketing information page	Formulary IG
`SUMMARY`	the plan's summary of drug benefits	Formulary IG
`FORMULARY`	the plan's printable formulary	Formulary IG
`BILL`	billing	FHIR contact entity type
`ADMIN`	administrative	FHIR contact entity type
`HR`	human resources	FHIR contact entity type
`PAYOR`	payor	FHIR contact entity type
`PRESS`	press	FHIR contact entity type

These resources are served by Patient Access.