The Solution for the CMS Interoperability Mandate

The Abacus Insights Interoperability solution is compliant with the CMS Interoperability and Patient Access rule. The solution ingests and organizes healthcare data from disparate sources using the FHIR® resource model and enables data sharing using FHIR APIs. Empowering payers with insights, enabling providers to make informed decisions and reducing administrative burden while helping members make better, personalized health choices.

Reducing Barriers to
Data Exchange

Patient Access API

Patient Access API

Ingest, consolidate, and link all member claims across medical, pharmacy, dental, behavioral health and skilled nursing
Ingest, consolidate and link all member clinical, digital and governed data by health plan
Ingest formulary data
Translate data to FHIR resource data model

Provider Directory API

Provider Directory API

Ingest and consolidate provider organization, professional and facilities data
Translate data to FHIR resource data model

Provider Directory API

Security

Implement, manage and monitor OAuth 2 authorization standards
Implement, manage and monitor IDP identity standards

Provider Directory API

Payer-to-Payer Enablement

Display clinical data through FHIR APIs to other payers
Extract clinical information out of claims data

Provider Directory API

Consent

Implement and manage IT developer consent model and process
Implement and manage patient consent model