Baylor Scott & White Health Plan (BSWHP) Interoperability APIs are developer-friendly, standards-based, secure APIs that enable third-party application vendors to connect their application programs to access BSWHP data.
BSWHP Interoperability API Functionality
- Enable developers to register member-facing applications
- Enable members to provide consent for an application to access their data
- Use the Fast Healthcare Interoperability Resources (FHIR)
- Use the OAuth 2.0 / Open ID Connect standard for member authorization using Microsoft platform.
Developers Portal
The BSWHP Interoperability API Developer Portal provides third-party applications and payers access to documentation, registration services, and developer services related to Healthcare Interoperability APIs provided by BSWHP, pursuant to the Centers for Medicare & Medicaid Services Interoperability and Patient Access Final Rule (CMS-9115-F). The Patient Access API will allow third-party applications to retrieve data, including but not limited to adjudicated claims, encounters, and any clinical data maintained by BSWHP for both past and present members.
Privacy
BSWHP appreciates that your medical information is personal, and we are committed to helping you understand how to protect and secure your health information. Please review our privacy notice related to Interoperability and the use of third-party applications.
Non-urgent Prior Authorization requests*
| Type of decision | Reporting level | Number of occurences | Total requests | Percentage |
|---|---|---|---|---|
| Request approved | FirstCare CHIP, FirstCare STAR, SWHP RightCare |
17,035 | 18,258 | 93.3% |
| Request approved after appeal | 82 | 200 | 41% | |
| Request approved after time extended | 369 | 515 | 72% | |
| Request denied | 1,223 | 18,258 | 6.7% |
Urgent Prior Authorization requests**
| Type of decision | Reporting level | Number of occurences | Total requests | Percentage |
|---|---|---|---|---|
| Request approved | FirstCare CHIP, FirstCare STAR, SWHP RightCare |
1,502 | 1,617 | 92.89% |
| Request approved after appeal | 8 | 14 | 57.14% | |
| Request approved after time extended | 14 | 19 | 73.68% | |
| Request denied | 115 | 1,617 | 7.11% |
Time between receiving a Prior Authorization request and sending a decision
| Prior Authorization request type | Average time (in days) | Median time (in days) |
|---|---|---|
| Non-urgent* | 0.72 | 0.67 |
| Urgent** | 0.53 | 0.38 |
*Response due to provider within 7 calendar days
**Response due to provider within 72 hours