Community First Interoperability APIs

Community First Interoperability APIs are developer-friendly, standards-based APIs that enable third party application vendors to connect their application programs to access Community First Health Plans and Community First Insurance Plans data.

These APIs enable current and former Community First Members to consent to have their data shared with third-party applications. It also allows third-party application owners to connect to non-member data (non-PHI), such as provider and pharmacy directories.

Community First Interoperability APIs provide the functionality listed below:

Enable developers to register member-facing applications
Enable members to provide consent for an application to access their data
Use the HL7 Fast Healthcare Interoperability Resources (FHIR) standard for member data
Use the OAuth 2.0 / Open ID Connect standard for member authorization

Community First – Patient Access API

In 2020, the Centers for Medicare & Medicaid Services (CMS) introduced the Interoperability and Patient Access rule (CMS-9115-F). In order to increase patients’ access to their health data, the rule prohibits information blocking and requires health insurance plans to give members access and the ability to share their health plan data via an API endpoint with third-party applications of their choice. The deadline for health plans to comply with this mandate was July 1st, 2021. This rule simplifies how you can access and share your health data. For instance, you can use a smartphone application to view details about claims or medications, etc.

How Community First is Addressing the New Regulations

Community First has taken steps to meet the new CMS Interoperability and Patient Access final rule (CMS-9115-F) regulations, by making available all of your claims and clinical data contained in their systems via an API endpoint. Community First contracted Inovalon, a HIPAA-compliant industry leader in healthcare data integration; Inovalon utilizes the Fast Healthcare Interoperability Resources (FHIR) data standard to provide members with access and the ability to share their data via an API.

The API endpoint is compliant with the CMS FHIR standards and allows the Community First members to share data with third-party applications of their choosing. Member’s can choose to share/integrate their healthcare data with 3rd-party applications such as MyCharts, Apple Health and Google Smart Health. The Inovalon platform adheres to strict security standards, allowing the Members to complete verification of their identity and authentication prior to Community First sharing their healthcare data with the 3rd-party application.