CMS FHIR Interop

Solve CMS FHIR Interoperability

A fully integrated suite of Healthcare FHIR Resources
Medicare, Medicaid and Marketplace across 18 states
Processing 10M+ Claims, Enrollments, Eligibility and Claims payment
Hospital Remittance & Revenue Management
Reconciling 20M Claims payments per year
DHCS Full File Compare
Compare Medicare, Medicaid and DHCS Full file with QNXT and update changes
Medicare HETS Real time Eligibility
Check eligibility with HETS CMS across all channels and multiple systems
Clams & Encounter Management
L1-L7 Validations, Medicare and state rules for covered and not covered code sets. Improved data quality


Why Choose HiPaaS?

We envision HiPaaS to focus on improving patient and revenue outcomes by implementing AI driven use cases.

Sandeep Deokule

Enable FHIR Server with USCI and Bluebutton resources. Allergy, Observation, CarePlan, Patient, Encounter, Immunization, Location, Condition, Diagnostic Report, Explanation of Benefits, Procedure and more US Core Extensions mapped
Enable CARIN Profiles. All mandate required CARIN Profiles mapped - Explanation of Benefit, Plan, Claim, Coverage and others
Out of box DVinci use cases. Payer Exchange, Provide Directory, Clinical Use Cases, Formulary Drug and Network Implementation​
Out of box Blue button Implementation. Blue button compatible FHIR resources and server
Payer to Payer interfaces and Integration as per USCDI standards
Use Consent Management 3rd Party Consent Management. App on boarding process. Oauth security
Flows for onboarding 3rd Party FHIR Apps. Validating the app and generating Client secret key.
FHIR Oauth Integration to access API.
Pre-built mappings to healthcare standard extracts for claims, inpatient, professional, pharmacy, provider directory, eligibility, coverage and more..
HiPaaS SHIR CMS repository is in production and already tested with all leading Client Apps