The implementation of the CMS Interoperability mandate has proven challenging for many Health Plans. The rule requires publishing a standards-based Patient Access and Provider Directory APIs, and initiating payer-to-payer data exchange. Are you facing issues maintaining your API platform? Is your vendor responsive? Is your current vendor sunsetting their support? You may be considering your […]
The latest Proposed rule from CMS addressing Prior Authorization (December 13, 2022) also expands the Patient Access API and adds a Provider API. Provider Access API and Patient Access API are two types of application programming interfaces (APIs) that allow different types of users to access member health information. Both are based on HL7 Fast […]
October 6th, 2022 was a momentous day. A milestone for ONC Information blocking rules was reached. The definition of Electronic Health Information is no longer limited to the US Core Data for Interoperability version 1 (USCDI v1). Is this signaling a coming FHIR Storm for EMR systems?
Prior Authorization: A Business Problem In Need Of Regulation. Regulations must address how providers can discover whether a prior authorization is required and, if required, what information needs to be sent with the request
The Data Retention rules for the Legacy systems of Covered Entities may be in conflict with the member data access rules of the CMS Interoperability and Patient Access Rule. Onyx addresses this collision with SAFHIR.