Clinical data is a two-way street for payers. These organizations require timely and accurate patient data from their healthcare provider partners. Likewise, payers are mandated by the Centers for Medicare & Medicaid Services to make member data available to external stakeholders via application program interfaces.
These bidirectional payer connections with mobile apps or to a provider’s electronic health records systems and practice management systems include clinical data exchange use cases such as patient access, payer-to-payer data exchange, claims, prior authorization and data sharing to consumers. However, these aren’t the only clinical data exchange functions payers should know.
This article is the first in a three-part series designed to inform payers about technology options for efficient sharing of members’ data. Payers have options, and the first step is to be informed.