The Various Facets of FHIR
FHIR has taken the healthcare industry by storm. Health plans are rushing to incorporate FHIR into their systems to not just evade penalties but also to attain the end goal…
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data management
Reducing Burden with FHIR APIs – Part 2
With the latest Interoperability and Patient Access rule, the proposals to reduce provider and patient burden, FHIR-based APIs have become the talk of the town. The latest proposed rule works towards enhancing health information…
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What’s So Great About FHIR? Find Out Here
Affordable healthcare is the need of the hour and interoperability is the means to that end. The healthcare ecosystem is looking into ways they can enable this affordability as soon as possible, and…
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The Genesis of FHIR
The need for interoperability was first highlighted back in the 1980s when payer organizations had to expand to working with data from more than one system. They needed a foolproof method of…
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Lost in Provider Management? Here Are a Few Ways Out
In the previous blogs, we’ve covered payment models and the processes involved in provider network management. However, in practical world scenarios, managing a provider network can be tedious and repetitive. In this blog, we shall…
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Transparency in Coverage Rules and Consolidate Appropriations Act: The Latest Updates that Payers Must Know
Do you comply well with the frequent updates of the Transparency in Coverage Rules and Consolidated Appropriations Acts? Having a hard time managing everything on your own? Don’t fret! First,…
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Here’s What You Need to Know About Provider Network Management
Having provider networks is a necessity. This is true for health plans and providers or hospitals, and especially, for the enrolled members. Managing provider networks can be a lot of work. Identifying the providers and hospitals according to the parameters mentioned in…
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Watch Out for these Anchors Holding you Back from Compliance
The proposed rule is currently titled ‘Reducing provider and patient burden’. However, the proposed rules do not promise any reduction of burden for payers. Payers must make sure their systems…
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Here’s How You Can Implement Transparency in Coverage
In the previous blogs, we have defined the Transparency of Coverage rule’s compliance requirements and their corresponding solutions. Now that the expectations from the solution is set, here we are looking at the implementation. Let’s cut straight to it. The implementation approach will depend on various technological factors such as cloud platforms,…
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Complying with Public Disclosure Requirements
As the dates set for public disclosure requirements, Jan of 2022, draws close with every passing day, it is best for everyone involved if health plans got themselves aligned with…
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Solutions for Transparency in Coverage
The Department’s guidelines on ensuring transparency in coverage are quite elaborate on the context and objective of disclosing information. Our previous blogs outline the disclosure requirements for both the Participants, Beneficiaries, or Enrollees, and the public.…
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Meandering Through Member Engagement: Save Yourselves a Setback
It has been reiterated time and again by the CMS that member engagement is crucial to both the health plans and members. To the health plans, engaging with members contributes to their shared…
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