The Centers for Medicare & Medicaid Services (CMS) recently released CMS Interoperability and Prior Authorization rule (CMS-0057-F). This rule applies to impacted
payers with an implementation date of January 1, 2027 (some rule requirements have a January 1, 2026 date).
BNETAL is pleased to offer our SureFHIR®, SureEDI® and SureDeliver® to help our clients meet the regulatory requirements of CMS-0057-F and its precursor CMS-9115-F.
BNETAL SureFHIR® has robust support for HL7 FHIR 4.0.1 and Da Vinci Prior Authorization Profiles. This includes a FHIR data repository with the APIs needed to meet the prior authorization
API requirements including Prior Authorization, Patient Access, Provider Access and Payer-to-Payer APIs. SMART on FHIR authentication and authorization support gives strong layer of security
around the FHIR repository. Data masking support give strong privacy features. More information on SureFHIR® is in our SureFHIR® solution brochure.
BNETAL SureEDI® has a robust EDI/X12 engine with ready templates for X12 278, X12 275 for entities wanting to implement a FHIR-X12 or X12 only approach but offer out FHIR APIs as an option.
BNETAL SureDeliver® has ACA mandated CAQH CORE Operating Rules needed for the FHIR-X12 or X12 only options for compliance. SureDeliver can also help enforce strong access control around SureFHIR®.
Our solutions work well together or in stand-alone mode, and also integrate with other solutions. Depending on client environment and business requirements, we can tailor end-to-end solutions that not only address
regulatory requirements but also solve business problems using automation.
Our solutions are backed by industry veterans in healthcare data exchange interoperability, security and regulatory compliance, with operational experience from large nationwide projects and initiatives such as CDC Public Health
Information Network, HHS ONC Nationwide Health Information Network, CMS esMD, CAQH CORE and others. Our clients have trusted us to achieve ther business data automation and compliance objectives.
For more information on SureFHIR® and our other solutions please email info@BNETAL.com, or call 770-399-0433 or 315-391-0716.