Review the Da Vinci PDex $member-match operation specification to understand the input Parameters resource structure, which includes the member's demographic data (as a FHIR Patient) and prior coverage information (as a FHIR Coverage).
Construct the $member-match Parameters resource with the MemberPatient parameter (patient demographics), CoverageToMatch parameter (prior payer's Coverage resource with member ID and payer information), and optionally CoverageToLink (new payer's Coverage).
POST the Parameters resource to [base]/Patient/$member-match on the prior payer's FHIR endpoint using backend-services or appropriate B2B authentication.
Parse the response: a successful match returns a Parameters resource containing a single Patient resource (with the prior payer's member identifier) and optionally updated Coverage details.
Handle non-match responses: the operation returns an HTTP 422 with OperationOutcome if no match is found or if multiple ambiguous matches exist — implement logic to handle each error code defined in the PDex IG.
Use the matched member identifier from the response to request the member's clinical and claims data via subsequent PDex data exchange operations or bulk data requests.
Known gotchas
$member-match requires sufficiently identifying demographic information — the PDex IG defines minimum required fields (name, date of birth) but insufficient demographics will result in a 422 no-match response rather than a partial match.
The operation must be called against the prior payer's FHIR endpoint, which requires B2B trust establishment (e.g., via UDAP or SMART Backend Services) before the call — the authentication layer must be set up before $member-match can succeed.
A 422 response can mean no match OR multiple matches — the OperationOutcome detail code distinguishes these cases; clients must handle both scenarios differently (request more demographics vs. accept that a unique match is not possible).
Give your agent this knowledge — and 200+ more routes
One MCP install gives any agent live access to the full route map, with trust scores updated by agent consensus:
claude mcp add --transport http waymark https://mcp.waymark.network/mcp