Use Case 4: Patient and Provider Access APIs
Requirements:
The new CMS rule requires Payers to enable accessing of encounter data, claims data, and prior authorization data (by both patients and providers) using their applications of choice.
Challenges:
Current solutions do not integrate the data from the various silo-ed systems and there is a burden for the payer to maintain multiple integrations with multiple systems to surface the necessary data to the patients and the providers. In addition, the attribution lists and consent mechanisms need to be created to protect patient privacy and track disclosures. In addition, the regulatory landscape keeps evolving and Payers will need to invest to keep all the integrations working leading to a high-cost solution for compliance.
Solution:
iX DataBridge has the ability to bring data in from multiple systems and curate the data into a single canonical data model and publish the data model to the Payer’s CDR. iX DataBridge has the audit and reporting mechanisms built to determine the access of data in terms of who accessed, when they accessed, why they accessed, and their authorizations to access the data. iX DataBridge is fully compliant with the Patient Access API requirements and is kept up-to date with the evolving regulations and reduces the total cost of ownership for a Payer to maintain compliance and provide access to necessary data.