CNSI Interoperability Solution
Unparalleled expertise in payer data to help you meet CMS rule requirements and empower patients
The Innovative Solution Breaking Down Healthcare Barriers
Empowering Patients. Informing Providers. Enabling Payers.
Interoperability in the health information ecosystem means greater safety and better outcomes for patients, along with a boost in efficiency and serious cost savings all around. With the release of The Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient Access final rule on March 9, 2020, CMS aims to deliver on the promise of interoperability.
The CNSI Interoperability Solution helps payers meet rule requirements by making claims data via a secure API, while utilizing HL7® FHIR®, USCDI, and CARIN Blue Button® standards.
Improve Patient Experience
Retrieve and present longitudinal individual health records based on payer claims and demographics
Enable Efficient Access
Provide secure access to payer claims data for any third-party app
Leverage pre-built solution components to meet the mandated CMS timelines
The CNSI Interoperability Solution provides a comprehensive approach in meeting the rule requirements to create more meaningful data for consumers.
CMS Patient Access API Requirements
Technology Used to Facilitate
CNSI Interoperability Solution
Implementation Guide (IG)
Claims and Encounter Data
- Explanation of Benefits (EOB)
- Enrollee identifiers
- Dates of service
- Payment information
- Enrollee cost-sharing
- Provider remittances
CARIN Alliance Blue Button® IG and Common Payer Consumer Data Set (CPCDS)
- Patient Access API
- Authentication and authorization
FHIR Server leveraging HL7® FHIR® Release 4.0.1 and SMART on FHIR
- Standardized patient data
FHIR Ready Payer Data Repository (FPDR) leveraging USCDI, CPCDS & HIPAA EDI
Providing the FHIR® Expertise You Need
Leveraging Over 25 Years’ Experience Processing Health Claims
CNSI continues to lead the health IT industry in delivering meaningful and transformative solutions to our customers. Our experienced team is an authority on developing and implementing interoperability solutions to improve the future of healthcare. As interoperability demands shift, we are translating our wealth of expertise to meet new HL7® FHIR® standards and requirements. CNSI pioneered modular, open-access, cloud-based platforms, which have helped states and the federal government expand coverage, reduce costs, operate more efficiently, and improve quality of care. Through our deep knowledge of Medicaid and other programs, we provide a trusted partnership with our clients to help them identify the right solution and adapt to their specific requirements and frequently changing regulations.
WHO WE WORK WITH
WHAT OUR CUSTOMERS SAY
"The CNSI team has consistently provided fantastic service and support throughout numerous initiatives. Not only did they complete required tasks on time, they also proactively identified a business need and delivered new visualization data to help us better track encounter data submissions. CNSI’s commitment and dedication to the CMS mission is evident and much appreciated."Contract Office Representative, Centers for Medicare & Medicaid Services (CMS)
"The CNSI staff…have brought a level of skill, expertise, dedication and sheer determination that was amazing and is even more impressive in retrospect."Director Medicaid Payments Division, State of Michigan
"Meeting the demands of an ever-increasing technology-driven society is a top priority for state government. This innovative approach to providing Michigan residents with easy access to their own personal information is a great example of utilizing technology to meet those needs."Management and Budget Director, State of Michigan
Let’s Build Something Impactful Together
Frequently Asked Questions
Get the Answers You Need About Interoperability
On March 9, 2020, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for health IT (ONC) released policies that give patients better access to their health information through greater interoperability.
According to the CMS, the "final rule" is focused on driving interoperability and patient access to health information by liberating patient data using CMS authority to regulate Medicare Advantage (MA), Medicaid, CHIP, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs).
The new policies include:
- Patient Access API (applicable January 1, 2021)
- Provider Directory API (applicable January 1, 2021)
- Payer-to-Payer Data Exchange (applicable January 1, 2022)
- Improving the Dually Eligible Experience by Increasing the Frequency of Federal-State Data Exchanges (applicable April 1, 2022)
- Public Reporting and Information Blocking (applicable late 2020)
- Digital Contact Information (applicable late 2020)
- Admission, Discharge, and Transfer Event Notifications (applicable spring 2021)
- Medicare Advantage (MA) plans
- Medicaid Fee-For-Service (FFS) programs
- CHIP FFS programs
- Medicaid managed care organizations (MCOs)
- CHIP managed care entities
- Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs)
- (excluding issuers offering only stand-alone dental plans (SADPs)
- Federally-Facilitated Small Business Health Options Program (SHOP) plans
- Due to the impact of the coronavirus pandemic, the deadline for enforcement has been pushed to July 1, 2021
- How APIs can help achieve better outcomes in Medicaid: Best Principles and Guiding Principles
- CMS Interoperability and Patient Access final rule
- ONC 21st Century Cures Act final rule
- Federal Register: 21st Century Cures Act: Interoperability, Information Blocking, and the ONC health IT Certification Program
Schedule a Discussion
We’re excited to learn more about your interoperability needs. Please share your name, email and any questions you may have, and we’ll connect you with one of our experts.