Compliance with CMS Advancing Interoperability and Improving Prior Authorization Processes

The CMS Interoperability Rule aims to promote greater interoperability, patient access, and innovation in the healthcare industry, while also improving the quality and cost-effectiveness of care. Technically these goals are supported by multiple APIs that are required to be provided:

  • Patient Access API

  • Provider Access API

  • Provider Directory API

  • Payor-to-Payor API

  • Prior Authorization Requirements, Documentation and Decision (PARDD)

Firely Server aims to support all mandatory requirements out-of-the-box. The following ImplementationsGuides built the foundation of the APIs mentioned above.

Firely Server CMS Interoperability Mandatory IGs

API

FHIR v4.0.1

US Core

SMART App Launch

Bulk Data Access

  • Patient Access API

X

X

X

Not needed

  • Provider Access API

X

X

X

X

  • Provider Directory API

X

X

X

Not needed

  • Payor-to-Payor API

X

X

X

X

  • PARDD API

X

X

X

Not needed