Difference between revisions of "Blue Button"

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(Explainer)
(Questions and Answers)
 
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==Questions and Answers==
 
==Questions and Answers==
 
Where does the data provided by the Blue Button 2.0 API come from?
 
Where does the data provided by the Blue Button 2.0 API come from?
  The BlueButton 2.0 API leverages the the Beneficiary FHIR Data (BFD) server, which receives data from the Chronic Condition Warehouse (CCW).
+
  The BlueButton 2.0 API leverages the [https://github.com/CMSgov/beneficiary-fhir-data Beneficiary FHIR Data (BFD) server], which receives data from the [https://www2.ccwdata.org/web/guest/home/Chronic Condition Warehouse (CCW)].
  
 
How often is the data refreshed for the Blue Button 2.0 API?
 
How often is the data refreshed for the Blue Button 2.0 API?
 
  API users can expect data (Part A, B and D) to be refreshed on a weekly cadence.  
 
  API users can expect data (Part A, B and D) to be refreshed on a weekly cadence.  
  New data is loaded from the Chronic Condition Warehouse (CCW) every weekend - though in some cases it may be delayed. In the event of a delay, there will be an announcement in the Blue Button 2.0 Google group with updates on when data will be refreshed.  
+
  New data is loaded from the Chronic Condition Warehouse (CCW) every weekend - though in some cases it may be delayed. In the event of a delay, there will be an announcement in the [https://groups.google.com/g/developer-group-for-cms-blue-button-apiBlue Button 2.0 Google group] with updates on when data will be refreshed.  
  
 
How recent are the claims data coming out of the Blue Button 2.0 API? How soon after a claim is filed will it appear in the data from the API?
 
How recent are the claims data coming out of the Blue Button 2.0 API? How soon after a claim is filed will it appear in the data from the API?
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Per Section 6404 of the Affordable Care Act, the maximum period for submission of all Medicare fee-for-service claims has been reduced to no more than 12 months (1 calendar year) after the date services were furnished. CMS typically receives claims 3-4 weeks after care has been provided.  
 
Per Section 6404 of the Affordable Care Act, the maximum period for submission of all Medicare fee-for-service claims has been reduced to no more than 12 months (1 calendar year) after the date services were furnished. CMS typically receives claims 3-4 weeks after care has been provided.  
  Once received by CMS, it is possible for claims to undergo more than one round of processing to make adjustments, edits and cancellations. Data will only be available via the API once a claim has been approved. For more details on claims submission and approval timeframes, read this whitepaper which outlines the lifecycle of a Medicare claim as well as timeframes for submission and approval (pages 11, 12 and 22 have details on month over month stats).  
+
  Once received by CMS, it is possible for claims to undergo more than one round of processing to make adjustments, edits and cancellations. Data will only be available via the API once a claim has been approved. For more details on claims submission and approval timeframes, [https://www2.ccwdata.org/documents/10280/19002256/medicare-claims-maturity.pdf read this whitepaper] which outlines the lifecycle of a Medicare claim as well as timeframes for submission and approval (pages 11, 12 and 22 have details on month over month stats).  
 
  Anecdotally, we have heard from some API partners that PDE claims are typically available ~1 week after the prescription is filled, though it is possible it could be less than 1 week depending on alignment with the weekly BFD data update.
 
  Anecdotally, we have heard from some API partners that PDE claims are typically available ~1 week after the prescription is filled, though it is possible it could be less than 1 week depending on alignment with the weekly BFD data update.
  

Latest revision as of 08:46, 3 August 2022

Full Title

Context

As far as what data is available, there are over 400 data elements that can be provided. They are broken down into FHIR Resources: Explanation of Benefits (EOB), Patient, and Coverage. These data points include, but are not limited to: claim type, medications, diagnoses, procedures, payment and provider information, Medicare patient demographic data, Medicare coverage start/end dates, and contract numbers.

Explainer

Error Codes

Following is the curl call to refresh access token if it is expired. Thanks to Brady Fausett.

  1. Token Refresh CURL Example:BB_SERVER="<BB2 sandbox or prod URL>"
  2. BB_CLIENT_ID="<your app's client ID>"
  3. BB_CLIENT_SECRET="<your app's client SECRET>"REFRESH_TOKEN="<your refresh token associated with a previously granted access token>"curl -s -w # # "% {http_code}" -X POST "${BB_SERVER}/v1/o/token/" \
    1. -u "${BB_CLIENT_ID}:${BB_CLIENT_SECRET}" \
    2. -d "grant_type=refresh_token&client_id=${BB_CLIENT_ID}&refresh_token=${REFRESH_TOKEN}"EXAMPLE RETURN FROM CURL COMMAND: {"access_token": # "wlRtbVkXzUdE9Kcjc8wWnpRmJ7KuuC", "expires_in": 36000, "token_type": "Bearer", "scope": "patient/ExplanationOfBenefit.read patient/Coverage.read", "refresh_token": "gzKxj0JkKamuaOWZRaIAJyfL3e9CZW", "patient": "-19990000000003"}200

Questions and Answers

Where does the data provided by the Blue Button 2.0 API come from?

The BlueButton 2.0 API leverages the Beneficiary FHIR Data (BFD) server, which receives data from the Condition Warehouse (CCW).

How often is the data refreshed for the Blue Button 2.0 API?

API users can expect data (Part A, B and D) to be refreshed on a weekly cadence. 
New data is loaded from the Chronic Condition Warehouse (CCW) every weekend - though in some cases it may be delayed. In the event of a delay, there will be an announcement in the Button 2.0 Google group with updates on when data will be refreshed. 

How recent are the claims data coming out of the Blue Button 2.0 API? How soon after a claim is filed will it appear in the data from the API?

Given that Blue Button 2.0 API shares Medicare claims data, please consider that claims data availability rely on how quickly a claim has been submitted, processed and approved.

Per Section 6404 of the Affordable Care Act, the maximum period for submission of all Medicare fee-for-service claims has been reduced to no more than 12 months (1 calendar year) after the date services were furnished. CMS typically receives claims 3-4 weeks after care has been provided.

Once received by CMS, it is possible for claims to undergo more than one round of processing to make adjustments, edits and cancellations. Data will only be available via the API once a claim has been approved. For more details on claims submission and approval timeframes, read this whitepaper which outlines the lifecycle of a Medicare claim as well as timeframes for submission and approval (pages 11, 12 and 22 have details on month over month stats). 
Anecdotally, we have heard from some API partners that PDE claims are typically available ~1 week after the prescription is filled, though it is possible it could be less than 1 week depending on alignment with the weekly BFD data update.

References