Clinical and Claims data of patients is soon required to be exposed as Fast Healthcare Interoperability Resources (FHIR) compliant APIs to the patients themselves, or to third-party systems that the patient selects. The systems that access these APIs can be healthcare apps that the patient consents to and uses, or they can be a separate healthcare insurer or provider that the patient transfers to.
Building on the foundation established by ONC’s final rule, the CMS Interoperability and Patient Access final rule requires health plans in Medicare Advantage, Medicaid, CHIP, and through the federal Exchanges to share claims data electronically with patients.
The CMS final rule establishes a new Condition of Participation (CoP) for all Medicare and Medicaid participating hospitals, requiring them to send electronic notifications to another healthcare facility or community provider or practitioner when a patient is admitted, discharged, or transferred.
These notifications can facilitate better care coordination and improve patient outcomes by allowing a receiving provider, facility, or practitioner to reach out to the patient and deliver appropriate follow-up care in a timely manner. Additionally, CMS is requiring states to send enrollee data daily beginning April 1, 2022 for beneficiaries enrolled in both Medicare and Medicaid, improving the coordination of care for this population.
This ensures beneficiaries are getting access to appropriate services and that these services are billed appropriately the first time, eliminating waste and burden. Beneficiaries will get the right services at the right time at the right cost, with no administrative burden to rebill services.
Nubes Opus can help you to unlock critical data from EMR/EHR and empower your practice with capabilities like below:
- HL7 Standards Compliance to Store and Retrieve Admission, Discharge, Transfer data and Observation Results data.
- FHIR R4 US Core Condition APIs to Capture Patient demographic, Allergy Intolerance, Observation and Condition information.
- CMS Interoperability and Patient Access final rule compliance that can help you to connect to any EMR/EHR systems securely.