FAQ
How does Flexpa work?
What are the primary use cases for Flexpa?
Flexpa helps apps obtain authorization directly from patients to access their PHI from health plan payers. Many of the use cases for Flexpa focus around accessing claims histories (see our Explanation of Benefits guide).
- Open enrolment
- Health wallet data sources
- Decentralized clinical trials
- Payer data exchange
- Digital provider insurance onboarding
- Medicare plan recommendation
- Release of information
Which data sources can Flexpa connect to?
Flexpa focuses on health plan payer patient access APIs. Flexpa Link + Flexpa API support Patient Access APIs from:
- UnitedHealthcare
- Anthem
- CVS Aetna
- Cigna
- Humana
- Kaiser Permanente
Does Flexpa work with provider data sources?
Flexpa focuses on connectivity to health plan payers and does not integrate with provider data sources today. Are you interested in provider data? Let us know.
What data is available?
Patient Access APIs are HTTP-based APIs with HL7 FHIR interfaces and JSON document responses.
HL7 FHIR is a healthcare interoperability standard supporting most Patient Access APIs in production by health plan payers today.
Data is formatted according to schemas defined in the base R4 FHIR implementation guide and according to Implementation Guides such as US Core and CARIN BlueButton IG. Flexpa API exclusively supports the JSON content type.
Read more about this standard in our Patient Access guide and in Flexpa API.
What time periods is data available for? How lively is data? When does it get updated?
Patient authorizations happen on a single-source basis. Data availability is best from 2016 onwards for a given source. Most claims history specific SLAs provided by health plan payer implementations are 24 hours after processing the claim.
Who can trigger the authorization workflow?
Health plan members dictate how their data can be used and by whom, with identity and authorization controlled by the health plan payer.
How do patients without login credentials authorize access?
A member ID card and identifiable information are required to complete account setup in the identity systems (SMART App Launch) implemented by the health plan payers.
Can Flexpa pull pharmacy benefits?
Flexpa can be used to check pharmacy benefit claims histories via the Explanation of Benefits resource.
How is Flexpa priced?
Live mode requires an agreement with us to be in place. Contact us for pricing
Does Flexpa store PHI?
Flexpa does not store or persist PHI. Read more about our privacy policy.
Can Flexpa show customers which claims are in the process of adjudication?
Typically claims histories are available via Explanation of Benefits statements after claim processing.
What does the roadmap look like for Flexpa?
Our changelog maintains up to date notes about what's new and next.