Please note, this communication applies to Healthy Blue + Medicare^SM (HMO D-SNP) offered by Blue Cross and Blue Shield of North Carolina (Blue Cross NC).

The Centers for Medicare & Medicaid Services (CMS) issued an Interoperability and Patient Access Policy to reduce the burden of certain administrative processes. The CMS policy requires providers to implement application programming interfaces (APIs) to improve the electronic exchange of healthcare data between patient, provider and payer. The policy reiterates that in partnership with the Office of the National Coordinator for Health Information (ONC), CMS identified Health Level 7^® (HL7) as the foundational standard to support data exchange via secure API. Implementation of this CMS mandate is expected by July 1, 2021.

The Clinical Data Acquisition Group for Blue Cross NC integrates admission, discharge and transfer (ADT) data from facility providers, health information exchanges and third-party aggregators. ADT data exchange helps Blue Cross NC:

• Better support members with care coordination and discharge planning – leading to healthier outcomes for our members, your patients.
• Proactively manage care transitions to avoid waste.
• Close care gaps and educate members about appropriate care settings.

Blue Cross NC would like to digitally exchange HL7 ADT messaging data for our members using secure data collection and transmission capabilities currently in use by facility systems. Facilities with network connections through vendors or health information exchanges can integrate ADT data with Blue Cross NC through these channels as well. Near real-time HL7 ADT messaging data – or at least within 24 hours of admission, discharge or transfer – enables Blue Cross NC to most effectively manage care transitions.

Email the Clinical Data and Analytics team to get started today.

Visit our provider page for more details on member eligibility, claim status, claims entry and more.

BNCCARE-0112-21 June 2021                                   518933MUPENMUB