Payer Member Portal

FHIR is at the core of all our products, so PMP seamlessly integrates with the latest and greatest FHIR-based APIs to satisfy regulatory mandates. All while lessening the administrative burden and expense of providing comprehensive live data. In turn, members can access and interact with their complete health history—and the insights needed to make informed decisions that reduce claims and improve health outcomes.

PMP is designed to work with our other FHIR-based Smile offerings that meet regulatory compliance. One example? Our Payer-to-Payer solution allows you to engage your members, extend capabilities, and get the most out of your resources by securely transferring member data between insurance carriers.

Members access PMP through a white-labelled user interface for a consistently on-brand experience that fosters stronger member-payer connections.

By compensating members with monetary incentives or physical gifts to participate in surveys or programs, they are encouraged to be more involved in their care. And you do your part to nurture relationships, realize efficiencies, and improve overall health.

Facilitate educated choices and develop loyalty by alerting specific member groups (for example, those with a chronic condition like diabetes) to significant changes or events that may affect their care or claims.

Members can access their clinical records, including lab results and medication history, across different providers for insight into their conditions—allowing for more effective communication and advocacy with health professionals. They can also view medical claims, including the detailed explanation of benefits, and plan allowances to monitor and prudently allocate health spending for greater value. It’s a level of transparency that fosters connections, loyalty, and retention.

Peace of mind begins at log-in. PMP supports single sign-on from other portals for seamless and fully secure access.

 

 

 

 

The portal, coupled with Smile’s FHIR repository, puts members in the driver’s seat as they manage what SMART on FHIR applications have access to their health data.

 

With the searchable provider directory, members can quickly find both in and out-of-network medical professionals and sidestep unforeseen out-of-pocket expenses and bottlenecks in access to care.

 

When individuals must entrust their health to a caregiver or loved one, PMP allows users to work with their payer to identify a delegate, like a relative or power of attorney, to access data on behalf of a member. It’s a simple way to oversee a vulnerable member’s health and potentially bridge gaps in care

Members can send and receive support messages from payer administration, allowing for responsive and personal interactions that nurture relationships.