Interoperability and Patient Access

 


Connecting Your Healthcare:

New options for managing your digital medical records
 


Starting in 2021, a new federal rule made it easier for Ambetter from Arizona Complete Health members* to manage their digital medical records.

The Interoperability and Patient Access rule (CMS-9115-F) makes it easier for members to get their health records when they need it most. You now have full access to your health records on your mobile device.  This allows you to manage your health better and know what resources are available to you.

Starting in 2022, the Payer-to-Payer Data Exchange portion of the rule* will allow former and current members to request that their health records go with them as they switch health plans. For more information about this rule, visit the Payer-to-Payer Data Exchange section found on this web page. 

Imagine:

  • You go to a new healthcare provider because you don’t feel well and you can show that provider your health history from the past five years
  • The provider uses that information to diagnose you and quickly find the right specialist by checking an up-to-date provider directory
  • You have a question about a claim, so you go to your computer or mobile device and, in minutes,  you see if it’s paid, denied, or still being processed
  • You can take your health history with you as you switch health plans

The new rule makes it so you can easily find information** on:

  • claims (paid and denied)
  • healthcare providers
  • pharmacy directory data***
  • specific parts of your clinical information

* Applies to Medicare Advantage, Medicaid and CHIP Managed Care, and federally funded ACA exchange plans.

** Data will be available for dates of service on or after Jan. 1, 2016; data for Payer-to-Payer only covers clinical data

*** For Medicare Advantage Prescription Drug (MAPD) plans.