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The Importance of Health Plan Information and Identity

WEBDefacto Health has been reviewing health insurers’ Provider Directory APIs in terms of availability, issues, and use cases for almost a year now. This post is a …

Actived: 9 days ago

URL: https://defacto.health/2022/05/26/the-importance-of-health-plan-information-and-identity/

Payer Compliance: Provider Directory APIs in the first six months …

WEBThe CMS Final Rule on Interoperability and Patient Access requires payers to publish provider directory APIs and has been enforceable since July 1, 2021. CMS …

Category:  Health Go Health

Responses to the CMS RFI on National Healthcare Directory

WEBIn response to CMS’s RFI on a National Healthcare Directory (responses were due Thurs 12/6/2022), over 600 responses were submitted (around 50% of these …

Category:  Health Go Health

Health equity and languages spoken – Defacto Health

WEBThe Need for Linguistically-Appropriate Services. On April 20, 2022, CMS released an action plan that establishes health equity as a ‘first pillar’ of its strategic …

Category:  Health Go Health

A Review of the CMS RFI on National Healthcare Directory

WEBExecutive Summary: CMS describes a National Healthcare Directory that will streamline provider data collection and promote interoperability. Years of industry …

Category:  Health Go Health

Hire healthcare data to do a job – Defacto Health

WEBApplying Job-to-be-done Theory to Healthcare Data. I believe that when a customer purchases a product, they are “hiring” that product to do a job.

Category:  Health Go Health

About Us – Defacto Health

WEBOur Team. Defacto Health leadership has over a decade of experience in provider data, interoperability, and payer transparency. We have a track record of collaborating with …

Category:  Health Go Health

The REAL Health Providers Act – Defacto Health

WEBA significant portion of the REAL Health Providers Act reflects the No Surprises Act (which governs commercial health plans) and extends similar directory …

Category:  Health Go Health

2022 – Defacto Health

WEBIn response to CMS’s RFI on a National Healthcare Directory (responses were due Thurs 12/6/2022), over 600 responses were submitted (around 50% […]

Category:  Health Go Health

Embracing real-world uncertainty with Monte Carlo simulations – …

WEBIn a previous post we saw how Monte Carlo simulations increase the usefulness of your model in making good decisions in an uncertain world, by …

Category:  Health Go Health

Provider Directory API’s Supporting Role in the 2024 CMS Interop …

WEBIt follows that payers could also use Provider Directory API (or, upstream source-of-truth provider data management systems) to verify network status for a …

Category:  Health Go Health

What indoor healthcare wayfinding taught me about the …

WEBHow well does it work? The short answer is ‘it depends’. Those hospitals that have provided enough resourcing to the ongoing maintenance of their wayfinding …

Category:  Health Go Health

Articles – Defacto Health

WEBUsing Payer APIs to Improve Mental Health Networks. by Ron Urwongse. May 18, 2023.

Category:  Health Go Health

Understanding Mental Health ‘Ghost’ Networks – Defacto Health

WEBThis is the first of a two-part series on mental health ghost networks. In the first post, we will assess the information presented on May 3rd at the Senate Finance …

Category:  Health Go Health

For Payers – Defacto Health

WEBThis information is used by patients to search for in-network providers and evaluate health plan networks. Providers also use this information to assist with referring patients to …

Category:  Health Go Health

Epic partners with Mapquest: EHR and location awareness

WEBBy Ron Urwongse December 19, 2021 Data at Work. Last week, Epic announced it is partnering with Mapquest to ‘enable location services within its EHR system’. Three …

Category:  Health Go Health

Analysis of top 50 payers’ Provider Directory APIs

WEBRegistration: Of the 40 payers that have published, only 19 conformed to CMS’s requirement of making their provider directory APIs publicly accessible (i.e., …

Category:  Health Go Health

Contact – Defacto Health

WEBSelect one or more. Schedule a Demo; Request Data Set / Spec; No-cost evaluation of my API; Other inquiries

Category:  Health Go Health

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