Connecting Your Healthcare
Interoperability and Patient Access Application Programming Interface (API)
Your health information is easier to access than ever.
The Interoperability and Patient Access Final Rule (CMS-9115-F) and the Interoperability and Prior Authorization Final Rule (CMS-0057-F) help you get your health records when you need them.
Now you can:
See your health records right on your phone using an app or on a website
Keep track of your care and treatments
Find helpful services and resources more easily
This means you are more in control of your health, which is a big step forward!
What is an API?
An API is a safe way for computer systems to share information. These APIs do not change your care or your benefits. They help you see your health information. They can also help you share it with an app you choose. If you change health plans, they may help move some records with you.
Share your health information with an app
The Patient Access API lets you connect an app or website to your health plan information. You must sign in first. You must also give permission. Then the app may show claims, coverage, providers, and some health records your plan keeps.
Your records can move with you
Payer-to-Payer API helps your health information follow you when you change health plans.
If you change plans, you can ask us to share your records.
Your new plan can use the records to help with your care.
Sharing with your provider
The Provider Access API helps share some health information with your in-network providers when they treat you. This may help them see your care history, recent services, claims, and prior approvals. This can help them support your care.
We only share your information with in-network providers who care for you. Your health plan checks the provider first. You do not need to choose an app for this type of sharing.
Your consent matters
You are in control. Before an app or another health plan gets your information, you may need to sign in. You may need to review what will be shared. You must give permission first. For the Provider Access API, we may share information with checked in-network providers who treat you. You can choose not to share this information by following the steps under “How to start and stop sharing your information.”
You can change your mind. If you no longer want to share your information, follow the steps in your member account or in the app. You can also call Member Services. If you opt out of provider sharing, your health plan will stop sharing your information through the Provider Access API.
What health information can you see?
You may be able to see claims, provider information, and some health records your health plan keeps. This may include records from January 1, 2016, and later.
Some of this information may include:
- Medicines that may cause an allergic reaction
- Other things that may cause a reaction
- Health concerns
- Shots and vaccines
- Procedures
- Medicines
- Lab tests and results
- Care plans
- Care notes
- People on your care team
Some rules apply only to certain health plans. What you can see may depend on your plan. It may also depend on the records AmeriHealth Caritas Ohio has.
Why this matters:
Seeing your health information in one place can help you:
- Better understand your health
- Make choices about your care
- Keep track of your health
- Avoid repeated tests or paperwork
You can use the apps below to see and share your health information. Choose an app. Then choose your health plan to connect your data at no cost. If your app is not listed, let us know. We may be able to add it.
Apps for Sharing Health Information
Third Party Mobile Applications | API Type |
|---|---|
Lexis Nexis Risk Solutions (LNRS) | Patient Access API |
Mpowered Health | Patient Access API |
1up Health Connect API | Patient Access API |
CLICQ | Patient Access API |
OneRecord | Patient Access API |
Bwell | Patient Access API |
Marble API | Patient Access API |
Flexpa | Patient Access API |
Graici | Patient Access API |
Third-Party App Privacy
You have the right to see your health information from AmeriHealth Caritas Ohio through some websites and mobile apps. AmeriHealth Caritas Ohio does not control these websites or apps. On this page, we use the word app for both websites and mobile apps.
Apps can see and use your health information after you say yes. They may not protect your information the same way AmeriHealth Caritas Ohio does. Before you choose an app, read its privacy policy. This can help you know how the app will use, share, and protect your information.
If you want to stop sharing your information with an app, you may need to do that in your member account, in the app, or both.
Questions to ask before you choose an app
Ask these questions:
- Does the app have a privacy policy?
- Will it sell or share your information?
- Can you stop sharing later?
- Can you ask the company to delete your information?
- Does it collect other data, like your location?
- How does it keep your information safe?
- If there is a problem, how do you file a complaint?
The information shared with an app may include visits, claims, tests, and other health records. It may also include private information. This can include mental health care, treatment for drug or alcohol use, HIV/AIDS care, or other health conditions.
How an app gets your health information
When you choose an app, you can connect it to a secure AmeriHealth Caritas Ohio system. The app will ask you to sign in. It will also ask for permission before it gets your information. After you say yes, the app may get claims, coverage details, and some health records.
How to get your information
- Choose an app or website you trust.
Look for an app that clearly explains its privacy and security rules. You can search online for an app. Before you connect to it, read its privacy policy. - Download the app or open the website. Make an account and connect to AmeriHealth Caritas Ohio.
Follow the app steps. Choose AmeriHealth Caritas Ohio when asked. Sign in with your member portal username and password if needed. - Say “yes” to share your information.
Read the app screen that asks for permission. If you want to connect to the app, choose Allow or Continue. - Use your information.
After you connect, you may be able to see claims, doctors, and some health records in one place. Check your settings from time to time. Turn off access if you no longer want the app to use your information.
How to start and stop sharing your information
You can stop sharing your information in a few ways. The "VIDEO TITLE" video shows you how. You can also call AmeriHealth Caritas Ohio Member Services at 1-833-764-7700 (TTY 1-833-889-6446). Member Services will confirm it is you. They will collect the needed information. Then they will send the opt-in or opt-out request to you.
Learn more about app privacy and security
HIPAA is a law that helps protect your health information. Some groups must follow HIPAA rules. These groups include health plans, doctors, hospitals, and companies that help send health information. AmeriHealth Caritas Ohio must follow HIPAA rules.
Learn more about your HIPAA rights.
Learn how to file a complaint with OCR.
Most apps you use to see your health information from AmeriHealth Caritas Ohio are not covered by HIPAA. This means they do not have to follow HIPAA privacy and security rules. They must follow their own privacy policies.
The Federal Trade Commission, or FTC, helps watch over many third-party apps. These may include health apps, fitness trackers, wellness apps, and connected devices. These apps may collect health information. They are not run by a HIPAA-covered health plan, doctor, hospital, or clearinghouse.
The FTC checks to see if apps are being honest with you. For example, if an app says it will keep your health information private, the app must do what it says. If it does not, the FTC may take action.
The FTC also helps protect you from unfair or dishonest business practices. This may include apps that give confusing privacy notices. It may also include apps that share your health information without permission, do not protect it, or do not tell you how they use it.
The FTC also has a rule for some health apps that are not covered by HIPAA. If your private health information is shared or seen by someone who should not have it, the app may have to tell you. It may also have to tell the FTC and sometimes the public.
You can file a complaint with the FTC if you think a third-party app did not protect your health information. You can also file a complaint if you think the app was not honest about how it uses your information. To file a complaint, go to ReportFraud.ftc.gov and select “Report Now.”
You can also file a complaint with AmeriHealth Caritas Ohio. Call Member Services at 1-833-764-7700 (TTY 1-833-889-6446).