Developers and payers must register with Opala before they are able to interact with Opala's Patient Access API.
Developers can use Opala’s APIs to create applications that interact with electronic health data using the HL7® FHIR® standard, including clinical and claims data. Opala provides a RESTful API for Patient Access, Provider Directory, Member Attribution (ATR), and others within our growing network.
These APIs fully support FHIR and provide rich programmatic access to electronic medical record data for patients and the companies and institutions who serve them.
The Opala platform is HIPAA compliant.
When a patient switches payers, the member and their beneficiaries should be able to take their health data with them using a streamlined process. CMS-regulated payers are required to exchange certain patient clinical data (specifically the U.S. Core Data for Interoperability (USCDI) version 1 data set ) at the patient’s request, enabling the patient to take their information with them to another payer. Therefore, upon a member’s request, subject payers are mandated to send USCDI (version 1) data to another payer that covers the enrollee at any time during coverage or up to 5 years after coverage ends.
For a payer’s data to be available to members for transfer, either from or to, the payer must be registered with Opala.
When a payer registers with Opala, Opala obtains and records Payer Patient Access API information from that payer. When Opala registers with a payer (not covered in this documentation set), the payer obtains Opala’s Payer Patient Access API information. In this way, member information flows from previous and current payers to the member through a third-party application.