Given the complexity of the healthcare landscape today, access to care as well as efficient communication and coordination between healthcare stakeholders have never been so important. Many industries, namely healthcare, have refined specialties over the years. Providers have built deep expertise in certain knowledge areas and now the industry is trying to bridge these specialties together for more holistic care. The same is true for healthcare technology. The current set-up remains reminiscent of the entrance into the digital area – with different pockets of data from different technological systems. With this longstanding precedent of data silos and closed health IT systems, the exchange of information between health plans and providers remains extremely slow, manual and tedious. As a result, health plans expend significant resources to exchange vital administrative and clinical information manually. What is the next era of healthcare technology? What will help the industry jump into the next generation of technology to achieve efficient communication and interoperability? One piece to this puzzle is Application Programming Interfaces (APIs)—implementing this technology can aid improved connectivity for all stakeholders.
APIs help to provide secure connectivity, between stakeholders – such as providers, revenue cycle organizations and payers. We recently announced updates to our NaviNet Open platform, with enhanced API abilities to further interoperability between these stakeholders. APIs enable faster information retrieval and easier payer access through a secure, real-time and HIPAA-compliant gateway. Payers can also access other NaviNet platforms, like NaviNet Open Document Exchange, in a secure and flexible manner with the addition of the API technology. In data-rich industries like healthcare where applications are constantly pulling and pushing streams of data, APIs are critically important for saving time, storage and overcoming any differences in design or language. As an essential enabler to efficiently and effectively bridge these various systems, API’s are continuously being developed to streamline access to important information, while creating better functionality and user experience.
One of the key benefits of APIs includes allowing providers and revenue cycle companies to increase efficiencies by connecting directly to payers from their core electronic medical record (EMR) and billing systems, virtually eliminating manual or double data entry and outbound telephone inquiries. This improves the speed and accuracy of billing and collection while improving patient experience, health outcomes and the overall cost of care. Another key benefit of APIs is that third-party vendors can access and share data for enhanced payer-provider collaboration on revenue cycle management, prior authorization management as well as value-based care coordination. APIs also allow payers to distribute and collaborate with providers on closing care gaps, improve hierarchical condition category (HCC) coding, assure timely access to fee schedules and aid a variety of other information exchange scenarios critical to optimizing value-based care and patient outcomes. Check out how NaviNet Open is bringing this additional functionality to our network of health plans and providers.
