“Standardizing an interface between health care providers and insurance companies would be a huge win.”
There is a government mandated interface and it’s found at http://www.x12.org in the form of the 837, 835, 276/277, and 271/272 among some others. There are also paper equivalents in the CMS1500 and CMS1450.
These are truly one of the main culprits of the problem because of how old, woefully inadequate, and rigid they are but cannot be easily changed as the speech between these two entities are highly regulated via these specs.
The HL7 Da Vinci Project has defined modern FHIR based standards for many interactions between payers and providers. Some of these standards are now incorporated into CMS/ONC interoperability rules.
There is a government mandated interface and it’s found at http://www.x12.org in the form of the 837, 835, 276/277, and 271/272 among some others. There are also paper equivalents in the CMS1500 and CMS1450.
These are truly one of the main culprits of the problem because of how old, woefully inadequate, and rigid they are but cannot be easily changed as the speech between these two entities are highly regulated via these specs.