CleanVues Payer To Payer Solutions
Streamlined, secure, and compliant data transfer between payers.
CMS COMPLIANCE FOR P2P EXCHANGE
If you are looking for a complete and proven solution to the Payer to Payer data exchange requirements, the CleanVues Payer-to-Payer solution meets all of them and then some.
HOW IT WORKS
The CleanVues Payer-to-Payer solution fully complies with the Payer-to-Payer APIs and requirements of the CMS-0057-F Rule. It adheres to the Da Vinci Payer Data Exchange (PDex) Implementation Guide (IG), enabling seamless data exchange between payers on both the requesting and source sides of the transaction. This solution also empowers members with control over their own data.
Complete Interoperable Exchange
Consent and Privacy Protocols
Performance, Scale and Accuracy
Complete Interoperable Exchange
Built on FHIR and leveraging the Da Vinci PDex IG, CleanVues solution enables seamless data exchange across payer systems and is scalable to meet future requirements. The platform offers flexibility for payers in capturing opt-in and consent, whether during the enrollment process or through member portal applications. It handles authentication, member matching, and record retrieval, securely storing imported data. The Payer-to-Payer API facilitates the sharing of both native member records and those imported from other payers via a Bulk FHIR exchange endpoint.
Consent and Privacy Protocols
Leveraging OAuth 2.0 and SMART Backend Services Authorization, CleanVues solution provides secure authorization, allowing members to share healthcare data without compromising sensitive information. The consent infrastructure records and enforces member consent preferences on the source payer side. Cleanvue ensures that both payers work with the same member records by using a member-matching operation with customizable rules.
Performance, Scale and Accuracy
CleanVues solution can bulk ingest over 2 billion FHIR resources in under 26 hours, processing at an impressive speed of 255,000 transactions per second. It incorporates advanced features that protect confidential data from exposure to unverified third-party applications, ensuring that the right information is securely transferred to the right individuals.
Watch how CleanVues facilitates the seamless exchange of claims, encounter data, and prior authorization information, enabling secure, efficient, and compliant data sharing across payer and provider networks.
GO BEYOND COMPLIANCE WITH CLEANVUE'S CMS SUITE
CleanVues Payer-to-Payer solution, part of our comprehensive CMS Suite, meets all compliance requirements. Built on our FHIR-based Health Data Platform, the CleanVues Payer-to-Payer and CMS Suite solutions ensure compliance is embedded from the ground up during the data ingestion and integration phases. This allows payers to establish a true data modernization strategy that consolidates workflows, operations, and data streams. With the CleanVues Health Data Platform, payers can maximize their CMS-0057-F investment by optimizing data unification, enrichment, and elevation, unlocking greater business value.
WHY CHOOSE CLEANVUES HEALTH
In 2021, CleanVues successfully implemented CMS-9115-F requirements for over 20 payers, impacting more than 100 million U.S. lives. Our payer clients selected us as their #1 vendor of choice. CleanVues proven compliance ensures that your organization remains aligned with CMS regulations.
The platform’s scalability allows you to manage large volumes of data efficiently, while maintaining industry-leading security, advanced privacy and consent tools.
CleanVues API-driven flexibility captures opt-in consent and executes the data exchange process smoothly, adapting seamlessly to member preferences and regulatory requirements.
CleanVues Digital Health achieved Drummond certification after passing rigorous interoperability testing of our end-to-end functionality, validating our commitment to seamless data exchange and compliance with industry standards.
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Whether you want to meet just the payer-to-payer API Specifications, the complete CMS-0057-F requirements, or invest in a solution that helps you build your data modernization strategy, Cleanvue has you cibvered.