Technology Solutions for

Healthcare Payers

Healthcare plans and payers have more responsibility than ever to ensure patient access to their health information. This creates healthcare technology challenges payers have never faced before. And often healthcare technology development focuses first on providers and patients.

But KMS Healthcare has payers, well, covered.

Deliver Intuitive Member Experiences that Drive Value-Based Care

Our technology teams are ready to help you meet payer-specific requirements and prepare your APIs for secure and compliant EHI exchange.

KMS Healthcare is a technology leader in healthcare, providing software development, quality assurance, and technology strategies, and advanced analytics.

Our teams have the extensive healthcare industry expertise to tackle the growing technology needs of healthcare payers leading the next era of value-based care.

Confidently Meet Your Cure Act Technology Compliance Deadlines

The 21st Century Cures Act places heavy responsibility on health plans and payers to adopt technologies that create a more comprehensive view of data reflecting a patient’s journey.

Now the payer community wrestles with tight compliance timelines for publishing outward-facing APIs that provide the free exchange of electronic health information to patients. The Cures Act calls for three distinct APIs focused on three specific problems:

Patient Access API
Provider Directory API
Payer-to-Payer API
The Cares Act also directs the adoption of FHIR standards for data exchange among healthcare systems.

Leap Forward to Compliance, Interoperability, and Better Patient Access​

We have tools that no one else does to help you make FHIR APIs available that provide members and patients access to their health information:

Opening Your Digital Front Door to Keep Members Healthier and Happier

Patients want more transparency to make informed decisions about their care options, payments, and billing plans. 

For payers, this means creating digital solutions to provide answers to member questions:
“Is my doctor in-network?”, “Is this surgery covered?”, “Are these drugs or tests covered?” and “Is it cheaper to go to the emergency room or urgent care?”

If you can provide fast answers and health information to members on their computers and phones, they will revisit your “digital front door” for future inquiries and requests.

Such member access solutions for payers focus on the patient’s interaction with their health plan. Trusted healthcare information tools grant patients the power to navigate their wellness at the lowest possible cost with the best possible outcomes. 

Payers also look to digital technology solutions such as wearables to help patients monitor and treat chronic conditions and reduce comorbidities. These care management technologies can discern a patient’s condition, reactions to treatments, and propensity to heal. 

KMS Healthcare will work with you (and your other technology vendors) to create the right digital healthcare access and monitoring tools that are easy to use and responsive to patient needs. Partner with us for digital transformation that will improve member satisfaction and retention, promote overall wellness, and reduce costs.

Exceed Member Expectations with KMS

Commitment to Compliance and Patient Data Security for Payers

We commit as your partner to protect health information. KMS Healthcare requires in-depth training on U.S. healthcare IT regulations for our teams. This helps ensure compliance with BAAs and other HIPAA guidelines for confidentiality. Employees also get background checks, as well as education and standards for cyber-security and anti-phishing.

We act to remove access to PHI/PII and develop healthcare technology solutions in secure environments under compliance with BAAs and HIPAA laws. We use anonymized synthetic data for testing. Our HIPAA and privacy trained U.S.-based implementation teams vigorously protect patient data and identifiable information.

Our Employees are Experts in

Leverage Expert Healthcare Developers to Accelerate Your Delivery

Imagine expanding your team with elite software developers who understand clinical workflows, interoperability, FHIR, and how to protect patient healthcare data.

Our experts bring you:

HL7 & FHIR

Expertise in HL7 and FHIR development and integration

EHR

Understanding the complexities of EHR implementation​

Interoperability

Knowledge and clear guidance on payer requirements for global interoperability

Patient APIs

Mastery at executing patient access APIs​

KMS Healthcare
by the Numbers

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platform integrations supported
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patient records managed
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provider records managed
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patient visits managed

Deliver an Intuitive, Transparent Healthcare Experience

Meet regulatory requirements and exceed member expectations—start today.