Ever Heard of Interoperability?
Long word, long process; here’s the short story
Unless you work in the healthcare industry, you’re probably living your life without knowing what interoperability means. But soon, if you use health and wellness services at all, you’ll need to know at least a little bit about what it means.
Good to Know
Interoperability means that healthcare information and data can be connected among doctors, facilities, service providers, insurers, and others so that you have access to your health information wherever and whenever you need it. If you’ve ever changed providers or needed to see a specialist, you know that your medical records can take a while to catch up with you. That’s all going to change.
To get technical about it, this transfer of data will happen through application programming interfaces (APIs). Eventually, rather than waiting weeks for your medical records to move between providers’ offices, files will transfer almost instantaneously. That’s progress!
Need to Know
Opening these channels of information is actually a federal requirement for businesses in healthcare. So, as an insurance company, we’re required to create a secure information network that gives you access to your health information in real-time. This kind of accessibility helps you get more efficient and accurate care. It will enable your providers to identify problems more quickly and allow them to make quicker and more informed decisions.
Interoperability is a huge change in how the entire health industry works, and it won’t happen overnight, but the first steps are about to begin. In early July, 2021, Health Options will support electronic access to your claims through third-party applications in your mobile device or browser. For additional information, please click here.
But don’t worry. You’re still in control. Health data applications that you choose to connect will have access to your name, date of birth, plan information, providers used, medical, pharmacy and lab claims, and other data. See a list of the healthcare applications here. If you choose not to share your access – your information remains private. You turn data sharing on and off via your health and wellness application on your personal device. If you don’t download an app and turn on permission, nothing changes.
More to Know
You might never have given a single thought to healthcare data connections, or maybe you thought all your data dots were connecting behind the scenes already. Either way, knowledge is power. At its very basic level, this data sharing will help you and your providers make informed choices, eliminate wasted time and resources, and streamline healthcare services. This might mean fewer redundant blood tests and X-rays in the future, and we can all connect with that idea.
When it comes to health insurance, the strength of a health plan’s network helps to determine its value, and you want to be sure the care you need is never far away. That’s why Community Health Options’ network stretches across Maine, and includes many providers in New Hampshire, Vermont and even Massachusetts, comprising 48,000 clinicians, hospitals and pharmacies—no matter which plan you choose.
When you buy auto insurance, you really don’t give much thought to who might fix your car if you have an accident, because you’re hoping you never need it. But health insurance is different. You’ll use it no matter what, whether you are healthy and need screenings to stay that way, or need care to manage chronic illness, behavioral health issues or complex care.
So, when it comes to health insurance, the strength of a health plan’s network helps to determine its value, and you want to be sure the care you need is never far away.
That’s why Community Health Options’ network stretches across Maine, and includes many providers in New Hampshire, Vermont and even Massachusetts, comprising 48,000 clinicians, hospitals and pharmacies—no matter which plan you choose. Notably, all Maine hospitals*, most in New Hampshire and Centers of Excellence in Massachusetts are all in-network and considered preferred for in-patient services on tiered HMO plans. Additionally, if you live outside of Maine part-time, often travel across the country or have a child away at college, national plans offer providers through our partnership with First Health®. And most recently, Community Health Options has been adding emergency medical services to its network, giving Members better EMS coverage, thanks to the adoption of a 2023 Maine law making that possible.
Coverage for virtual care includes telehealth options that begin with your own providers if they offer that service. If you are 18 or older—and looking for a primary care provider—you can choose a traditional in-network provider or opt for a virtual-first primary care team through Firefly Health. Firefly provides 24/7 access to a primary care team, anytime, anywhere, making it easier to access care right from your cell phone, whether you need preventive and routine care, or help managing more complex issues. Learn more about Firefly Health and download the app here.
Members also have access to urgent care telehealth sometimes. So, when you’re hurt or sick, or need care right away, of course head to the emergency room or call 911 if your condition is serious or life-threatening. However, you can save time and money using Amwell 24/7 for urgent care telehealth from the comfort of your home—at $0 cost share on non-HSA plans, and $64 on HSA plans ($0 after deductible). Amwell also offers behavioral health services like therapy and psychiatry. Scheduling is easy and you can do so online after registering, or by calling (844) 733-3627 for support.
Perhaps most important, Community Health Options supports its network with Maine-based care teams who help Members get access to providers, including virtual care, and who have on-the-ground knowledge of local resources.
Community Health Options’ care teams are available for any question through our Member Services team. If you have questions, please call (855) 624-6463 between 8 a.m. and 6 p.m., Monday through Friday.
