VillageCare received raw data from their third-party administrator (TPA) that required monthly manual updates to create and distribute provider directories
COLUMBIA, Md. – August 19, 2021
The Challenge: VillageCare’s numerous provider data operations were time-consuming to maintain and error-prone.
VillageCare received raw data extracts from their third-party administrator (TPA) that necessitated monthly master list updates through an unwieldy manual process to create and disseminate provider directories to their members. The process resulted in time delays and data inaccuracies that frustrated VillageCare and its members. There were data disconnects between the web search experience and which doctors were actually in network and at what locations.
Meanwhile, The CMS Interoperability and Patient Access Final Rule requires managed care plans to make a FHIR-compliant provider directory available to patients. New Managed-Care Organization (MCO) rules also require that the user interface (UI) for a provider directory be compliant with the Policy for Section 508 Compliance and Accessibility of Information and Communications Technology (ICT).
To solve for these multiple challenges and meet the new requirements, VillageCare needed a UI that would provide improved, 508-compliant accessibility and search parameter capabilities, and which could smoothly integrate with their new provider directory FHIR APIs.
The Solution: Leap Orbit’s modern provider search experience UI uses VillageCare’s FHIR 4.0.1 API
The mobile-responsive provider search solution integrates with VillageCare’s new FHIR server, enabling the combination of multiple FHIR resources (Practitioner, Practitioner Role, Organization, and Affiliations). Leap Orbit’s design is simple, with an accessibility-first approach. It is 508 compliant and adheres to current WCAG standards. To preserve VillageCare’s ability to comply with the requirement to furnish hard copies of the directories, Leap Orbit implemented access to their partner, Command Direct to the FHIR server to continue the printing and distribution of provider directories to members.
The Outcome: VillageCare’s provider search now always has its most current provider data, showcasing its network for all beneficiaries to access
This allowed VillageCare to eliminate additional steps it needed to update its previous search experience. All its data validation and update requirements now focus on producing their API which will be used for other similar use cases in the future. Leap Orbit’s search expereince also happens to be “white-labeleable” and customizable for any carrier’s FHIR API. Click here to try out VillageCare’s new provider search experience.
"…it was really great to find someone that was ready to go with this standard [FHIR] format"
Ku’uipo Curry, Director IT Data Management, VillageCare
Learn more about Convergent and how it can help consolidate your provider data operations and create an improved member search experience.
About Leap Orbit
Founded in 2015, Leap Orbit is the trusted innovation partner to many of the market-leading health data networks, including CRISP, Manifest MedEx, and NEHII. Leap Orbit’s philosophy is to run toward healthcare’s biggest challenges, providing technology and solutions to assist with the opioid crisis and patient data privacy. Through its health organization partners, Leap Orbit’s work reaches at least 45 million patients from Alaska to Maryland. For more information, visit LeapOrbit.com and follow on LinkedIn.
About VillageCare
VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and rehabilitation services.
Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has provided health care services to individuals residing within New York City for over 40 years.