Using Integration Platforms

Integration platforms like Redox or Mulesoft provide a seamless connection between Cerner and Blue Cross Blue Shield (BCBS), allowing for automatic data transfer between the two systems without the need for extensive coding. These integrations offer a variety of triggers and actions, enabling you to automate workflows and improve efficiency in healthcare data management.

Using APIs

Another approach to integrate Cerner and BCBS is by directly utilizing their APIs. By integrating both APIs, you empower healthcare providers and insurance teams with real-time patient insights, fostering improved communication and a superior workflow. To employ this method, refer to their respective API documentation.

Cerner and BCBS Integration via HL7 Interface

Automating workflows between Cerner and BCBS through HL7 interfaces involves setting up triggers in Cerner that lead to actions in BCBS systems. This streamlined approach ensures efficient communication channels between healthcare providers and insurance companies.

• New Patient Registered in Cerner -> Send Eligibility Check to BCBS
• Encounter Created in Cerner -> Send Pre-authorization Request to BCBS
• Procedure Completed in Cerner -> Submit Claim to BCBS
• Discharge Summary Completed in Cerner -> Send Clinical Documentation to BCBS for Review

For comprehensive details on implementing these integrations, consult with Cerner's interoperability team and BCBS's provider integration resources.

Direct Integration between Cerner and BCBS

Some insurance providers, including certain BCBS entities, may offer direct integrations with major EHR systems like Cerner. These integrations can provide real-time eligibility checks, streamlined claims submission, and automated pre-authorization processes. Check with your local BCBS representative to see if they offer a direct integration solution with Cerner.

Considerations for Integration

• HIPAA Compliance: Ensure all integrations maintain patient data privacy and security in compliance with HIPAA regulations.
• Data Standardization: Use standard formats like HL7 or FHIR to ensure consistent data exchange between systems.
• Workflow Optimization: Design integrations to streamline existing workflows and reduce manual data entry.
• Scalability: Choose integration solutions that can handle increasing data volumes as your healthcare organization grows.

For more information on healthcare system integrations, visit the HealthIT.gov Interoperability page.