Bulk Claims Data Ingestion Into Data Cloud

The Beneficiary Claims Data API (BCDA) gives organizations the insights to provide high-quality, coordinated care. BCDA uses the FHIR standard for Medicare Shared Savings Program, ACO REACH, and other Alternative Payment Model participants to receive Medicare Part A, B, and D claims data for the attributed patients. The API uses the FHIR Bulk Data Implementation Guide to expose FHIR Explanation of Benefits resources for the patients.

Our integration uses the BCDA API to synchronize attributed members’ claims data directly into Salesforce Data Cloud, offering a streamlined process for managing patient records. This connection improves data accuracy and accessibility for healthcare organizations and provides a longitudinal view of the patients for multiple downstream analytics and segmentation processes.

The Integration is for any Payer system that exposes an FHIR Bulk Data Implementation Guide-compliant endpoint, as desired by CMS, with the Provider Access API requirement.