InterSystems Payer Services Data Sheet

This document is a product data sheet for InterSystems Payer Services, focusing on FHIR interoperability in compliance with the CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F). It outlines the necessity for health plans to enhance digital experiences for members and providers while operationalizing key capabilities such as Patient Access, Provider Access, Payer-to-Payer, and Prior Authorization interfaces. The data sheet details the modular platform's ability to build a governed longitudinal member health record, which supports care management, analytics, and reporting. It describes the four APIs required by CMS-0057-F, emphasizing their compliance with HL7 FHIR Release 4 and relevant implementation guides. Additionally, the document explains the features of the electronic prior authorization API, including coverage guidance and documentation capture. It also highlights the governance, consent, and auditing mechanisms that ensure secure access to information and compliance with regulatory standards. The deployment options for InterSystems Payer Services are also discussed, including managed services that alleviate infrastructure management responsibilities.