Helios FHIR Server​

Provider Directory

The Helios FHIR Server – Provider Directory is a commercial-grade, clinical data solution based on the HL7® FHIR® standard that provides out-of-the-box support for the Provider Directory requirements of the CMS Interoperability and Patient Access Final Rule. (CMS-9115-F)

The health insurance industry is facing a major change with new legislation with the CMS Interoperability & Patient Access Final Rule and the 21st Century Cures Act.

Payers have increased responsibility in patient data access and their ability to operate with 3rd party healthcare applications. Payers are now required to offer a FHIR-based Provider Directory by July 1st, 2021.

There are several ways payers can meet this important deadline:

Legacy Interface Approach

Offering a FHIR interface to payer’s existing provider directory is one solution.  However, often these legacy interfaces are not easy to access internally, or they may not have the performance that a FHIR-based mobile application will require.  Also, many payers don’t have just a single existing provider directory and rely on several internal vendors to maintain provider information for various plan types and parts of their business.  In other words, a “simple” FHIR interface isn’t so simple in reality.
A legacy interface

Custom Approach

Another option is to hire a consulting team to build a custom solution to do all of this for you, but this is rather costly, time is of the essence with the CMS deadline fast approaching and this option isn’t right for everyone.
A custom FHIR solution

There Is A Better Way​

Another option is to use the Helios FHIR Server – Provider Directory, a complete software, and services solution that will meet the regulatory deadline.

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Software

The Helios FHIR Server – Provider Directory is a commercial-grade, clinical data solution based on the HL7® FHIR® standard that provides out-of-the-box support for the Provider Directory requirements of the CMS Interoperability and Patient Access Final Rule. It implements and has been tested for compliance with the HL7® FHIR® DaVinci PDEX Plan Net Implementation Guide.

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Services

Helios Software services engineers will transform your provider data sources – originating in any format – to FHIR. Our preconfigured provider directory is fully FHIR compliant so you can worry about the things that matter most.
We’ve made the process as simple as possible – you send us your provider directory in whatever form they’re in and we’ll do it all for you.
Provider directory can transform any provider data

The Importance of a FHIR Compliant Provider Directory​

A provider directory enables 3rd parties to develop applications that consumers and providers can query the participants in a payer’s network. This fulfills one of the core requirements of the CMS Final Rule and the 21st Century Cures Act. The CMS Final Rule focuses heavily on interoperability. It aims to start the process of liberating data and ensuring patients are the primary beneficiary of this process, and a provider directory is exactly what you need to accomplish this interoperability.

On January 2021, the CMS Interoperability and Patient Access Final Rule will begin to take effect (with a 6-month discretionary period due to the pandemic). By July 2021, CMS requires a new standard for both a patient access API and provider access API.

The patient access API impacts payer organizations in a significant way. It requires them to implement, test, and monitor a secure standard-based API that is accessible to third-party apps and developers. Importantly, these must be FHIR based APIs.

Eligible Plans for the Provider Directory CMS Rule

helios provider directory

Meet CMS Provider Directory Requirements with Ease

The Challenge

Lack of seamless data exchange in healthcare that has led to a fractured healthcare system resulting in data that is siloed into individual systems.  This leads to disconnected care, worse health outcomes and higher costs.

The Solution

Interoperable healthcare data exchange enables coordinated care, improves healthcare outcomes, and reduces costs.

Get Started With Helios FHIR Server Today