NEHEN 3.0 is the project name for the creation of the future HL7® FHIR®* version of NEHEN, a cost-effective, collaborative, open standards-based exchange of clinical and administrative data, implementing priority use cases to move the community forward toward automation for prior authorization and quality measurements. It will meet customers where they are currently and provide a pathway to the future by supporting both X12 EDI and FHIR®-based clinical and administrative exchange.
*FHIR® is a registered trademark of Health Level Seven International. Its use does not constitute endorsement by HL7.
Overview
NEHEN 3.0 represents the next phase of healthcare data exchange. Our goal is to combine the proven reliability of X12 EDI services with the modern flexibility of FHIR®, offering our members a powerful, multi-purpose data exchange platform that’s ready for the future.
- Simplifies and consolidates the infrastructure for clinical and administrative health information exchange in a multi-payer, multi-provider collaborative setting.
- Brokered API transactions between payers and providers allowing for a single API connection.
- Supports both current X12-based (HIPAA-mandated) EDI transactions and new FHIR®/API-based use cases, including electronic prior authorization (ePA), quality measures support, provider and patient access, and payer-to-payer exchange.
- Supports prior authorization requirements in the Interoperability and Patient Access Final Rule (CMS-0057-F).
- Optionally supports the Patient Access, Provider Access, Payer to Payer and Provider Directory API requirements under the CMS-0057 rule.
- Operates under a community-wide governance model to guide future features and use cases, maximizing value for participants.
- Vendor partners: Cognizant/TriZetto (X12 EDI) and ZeOmega (FHIR®)
