Additional Use Case: Real-Time Benefits

COMPANY PLEDGE: We pledge to the CMS Interoperability Framework and to deliver accurate, real-time, patient-specific cost and coverage information across both prescription and medical benefits through standardized, interoperable APIs, including the Consumer Real-Time Pharmacy Benefit Check (RTPBC) FHIR IG and the SBC insurance profile of the CARIN Digital Insurance Card FHIR IG. We commit to exposing digital insurance coverage and structured plan design via FHIR APIs, ensuring responses are patient-specific, accurate, and real-time, and reducing reliance on portals, call centers, and manual workflows. We believe these open standards will help providers get paid the money they are owed and give consumers lower out-of-pocket costs and more transparency on their benefits.