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Enable CMS Interoperability Rules
and FHIR API

Implement  CMS Interoperability and Patient Access Final Rule (CMS-9115-F).

Enable Prior Authorization Final rule (CMS-0057-F) .

Enable Payer to Payer Integration

Speed & HIPAA Security

Gen AI Plugins

Scale and Flexibility

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Enable CMS Interoperability Rules and APIs
for your Healthcare organization

Enable CMS Interoperability Rules and FHIR API. Implement CMS Interoperability and Patient Access Final Rule (CMS-9115-F) and Prior Authorization Final Rule (CMS-0057-F)

CMS Interoperability and Patient Access Final Rule (CMS-9115-F)

Convert and load 5 years of Patient Data for Medicare Advantage (MA), Medicaid, Children's Health Insurance Program (CHIP), and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs).

  • Enable Patient Access API

  • Enable CARIN Consumer Directed Payer Data Exchange IG (also referred to as the CARIN IG for Blue Button®)  

  • HL7 FHIR Da Vinci PDex IG

  • HL7 US Core IG

  • HL7 FHIR Da Vinci

  • PDex US Drug Formulary IG

Enable Prior Authorization Support (PAS) API (CMS-0057-F)

Enable Prior Auth final rule integrating with existing 278 EDI transactions. Manage attachment and prior auth requests.

  • 278 Prior Auth real time and batch

  • Manage prior auth queue

  • Approve and Deny Prior auth

  • Manage Attachments 

  • Manage Case notes

  • AI driven confidence code

  • Check eligibility

  • Integrated with Pega, QNXT, Facets, HealthRules

Enable  Provider API,
Payer to Payer API

  • Enable CARIN Consumer Directed Payer Data Exchange IG (also referred to as the CARIN IG for Blue Button®)

  • HL7 FHIR Da Vinci PDex IG

  • HL7 US Core IG

  • HL7 FHIR Da Vinci

  • PDex US Drug Formulary IG

  • Enable Da Vinci Payer Data Exchange

  • Enable HL7 FHIR Da Vinci

  • PDex Plan Net IG

Load  5 Years of Member and Patient Data

Harness the potential of seamless data transformation with our advanced FHIR Data Converter!

Manage Claims Adjudication requirements of data loads

Simply point, connect, and convert any data with HiPaaS Converter.

HiPaaS seamlessly integrates with various EHR systems such as Athena, Cerner, eCW, EHRs and others. It connects to databases or API sources, allowing the conversion of diverse input data formats like CCDA, HL7, CSV, Json, XML, and more.

Enable FHIR API, Member and Patient Access and 3rd Party App

  • Enable all required FHIR APIs for CMS Interoperability.

  • Enable required security for Member and Patient login

  • Oauth2.0 .

  • Enable 3rd Party Registration of applications and Consent Management

Enable FHIR Validation Rules and Lookups

Add various input data validation rules and data cleansing , or conversion rules via simple configuration.

Apply the rules to entire map or at field level

Clean Data before loading

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HiPaaS AI Platform to Manage any Healthcare data

HiPaaS Intelligence is a comprehensive, AI-driven platform that revolutionizes the way healthcare organizations operate,communicate, and engage with patients. Our suite of solutions addresses critical needs across various areas, enabling healthcare providers to streamline operations, enhance data exchange, and deliver superior patient care

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