Interoperability and Patient Access

New Options for Managing Your Digital Medical Records

In 2021, a new federal rule made it easier for our members to manage their digital medical records.
The Interoperability and Patient Access rule (CMS-9115-F) focuses on interoperability and patient access, making it easier for members to get their health records when they need it most in a way they can best use it.

For more information about this rule, visit the CMS website.

This new rule makes it so you can easily find information* on:

  • claims (paid and denied)
  • healthcare providers
  • specific parts of your clinical information

*Applies to Medicare Advantage (MA), Medicaid, CHIP, and Qualified Health Plan (QHP) issuers on the Federally facilitated Exchanges (FFEs).

Samples of Data We Maintain:

Patient Information
  • first name
  • last name
  • previous name
  • middle name
  • suffix
  • birth sex
  • date of birth
  • race
  • ethnicity
  • preferred language
Allergies & Intolerances
  • substances (medications)
  • substances (drug class)
  • reaction
Contact Information
  • current address
  • previous address
  • phone number
  • phone number type
  • email address
Health Concerns
Immunizations
Procedures
Medications
Laboratory Tests & Results
Assessment & Treatment Plan
Care Team Members

Next Steps for Current Members:

The new rule allows you to use an app from a third party application developer (a company with no connection to Magellan Health) to look up your health information. Visit the Member Portal and sign in to view a list of approved third party applications, download the application to your mobile phone (Android or iOS), and manage your health care information from there.

 

Frequently Asked Questions

How do I find the right third party app?

Read our Frequently Asked Questions or call the number on the back of your member ID card.

How does the new Interoperability and patient access rule affect me?

To learn more, call the number on the back of your member ID card.

How many years will my health information go back?

You will have access to health information with a date of service of January 1, 2016 or later.

Can I access my health information if I go to a different health plan or provider?

Yes. You will be able to access your health information no matter what health plan or provider you see.

Do I have to use an app from Magellan Health?

No. The app is not affiliated with Magellan Health. Visit the Member Portal and sign in to view a list of approved third party applications. Download the application to your mobile phone (Android or iOS) and manage your health care information from there.

 

Do I have to use an app to get my health information?

No. You do not have to use an app to access your health information. You can contact your provider or health plan for information.

What health data will the app collect?

This is dependent on what app you choose to use. Some apps will collect your health data, this includes, but is not limited to:

  • claims
  • medications
  • diagnoses
  • procedures
  • doctor visits

You’ll have to give the app permission to collect your health information when you sign up for it. The app’s Notice of Privacy Practices will tell you what information it collects.

Will the app collect non-health data from my device, such as my location?

The app’s Notice of Privacy Practices will tell you what information it collects.  Apps do have the ability to collect non-health data, such as your location. Some apps give you the option to provide that information or not. We suggest that you ask your app provider.

Does sharing my data with this app have an impact on my family members?

If a family member is linked to your health account, there is a chance that their health information will be shared.

How do I correct mistakes in my health data?

You will need to contact your provider or health plan. The app only makes data available from healthcare sources. The app does not create this data.

What are my rights when it comes to my data collected on this app?

We suggest that you request a Notice of Privacy Practices from the app provider to understand your rights.

How do I stop sharing my data?

The best way to stop sharing data is through the member portal, using the revoke access function through the app, or by contacting the app’s support.