Provider Directory API’s Supporting Role in the 2024 CMS Interop Rule
Key Takeaways: Re-Cap of the 2024 Rule Our previous post included a summary of the 2024 CMS Interoperability and Prior Authorization Final
Author: Ron Urwongse
A Review of the 2024 CMS Interoperability Rule through the Lens of Directory Use Cases
Yesterday, 13 months after proposing it, CMS finalized its Interoperability and Prior Authorization Rule. As CMS worked towards publishing this rule, payers,
The REAL Health Providers Act
Last week, the Requiring Enhanced and Accurate Lists (REAL) of Health Providers Act was introduced by Senators Wyden D-Ore., Bennet D-Colo., and
How payers can think about competition as network and price transparency expands
Regulatory Requirements on Network and Price Transparency Transparency-related federal rules are causing a seismic shift in the healthcare industry, compelling payers to
Payers are switching Provider Directory API vendors
Two years after the effective date of the CMS Final Rule on Patient Access and Interoperability, payers are reassessing their Provider Directory
Using Payer APIs to Improve Mental Health Networks
In our last article, we explored mental health ‘ghost’ networks as discussed in the May 3rd Senate Finance Committee hearing. We summarized
Understanding Mental Health ‘Ghost’ Networks
This is the first of a two-part series on mental health ghost networks. In the first post, we will assess the information
How many payer contracts do providers have?
Knowing the number of payers that providers contract with is important for a few reasons. Reason 1: It is a proxy for
What a good developer experience looks like: VA Lighthouse
In our previous post, we reviewed the status of payer provider directory APIs and learned that some payers take a compliance-only mindset
Provider Directory APIs: Beyond a Compliance-Only Mindset
State of Payer Compliance on Provider Directory APIs It has been 18 months since the July 2021 effective date of the CMS