Payers and health plans face a number of data exchange challenges. Bidirectional data exchange between payers’ downstream applications and external trading partners including providers, Health Information Exchanges (HIEs), and members, requires a robust interoperability solution that can:
Benefits of Rhapsody and Corepoint Interoperability Solutions
For Health Plans, a robust, healthcare-purposed integration engine allows you to gain a greater understanding of your data repository by helping you gather data to:
Compliance with the CMS Interoperability and Patient Access Final Rule
This level of complex data exchange is no longer simply a “nice to have.” It is a matter of compliance for payers and providers.
On March 9, Centers for Medicare and Medicaid Services (CMS) released its much-anticipated final rule on interoperability. The rule mandates that as a condition of participation in Medicare, payers must offer:
The rule specifies the use of HL7 FHIR® for transferring administrative data, such as claims data. Historically, this data has been shared between health plans and providers through different methods.
Healthcare Data Requires Healthcare-Specific Solutions
Achieving this level of payer-provider data exchange requires an interoperability solution designed specifically for healthcare enterprises.
Rhapsody and Corepoint Health interoperability solutions have the robust features that health plans and payers require to securely move data between external trading partners and downstream applications, such as claims management systems, population health systems, and others. Both products were purpose-built for healthcare and have been the most trusted interoperability platforms for healthcare organizations for almost 20 years.