Interoperability at Aledade

March 1, 2024

Integration supported


Aledade aims to provide the best data enabling its ACO members to better manage their patient health and reduce healthcare costs

Claims Interface

Claims data provide a powerful insight into services already performed by Primary Care on their patients. Understanding which services are yet to be performed helped our Physicians ensuring a timely ordering of the services that are still needed to keep their patients staying healthy!
Connectivity Supported.

Aledade offers support in both Vendor-hosted SFTP or Aledade-hosted SFTP. Your choice!

For details connectivity specifications, find it here.

Interface Specification.
Interface Direction
An automated unidirectional interface to Aledade
Message Type
  • FQHC or RHC: 837 Professional (837P) and 837 Institutional (837I)
  • All other types of practices: 837 Professional (837P)
Delivery Frequency
Daily or when claims are generated
Data Preferences
  • Pre-adjudicated claims
  • Last two-service years backload or the data gap from when last manual backload was delivered to when the production interface is activated
  • Live feed

Claims 837 Data Specifications

Aledade’s claims data follows ANSI ASC x12 5010 standards. For detailed specs to purchase, vendors can inquire via WPC-EDI.

 

Data Element

Specifications

File name

No specific file naming convention required

Primary claims (from primary payor)

Required 

Secondary claims (from secondary payor, if applicable)

Required 

Patient demographic data

First, last, middle initial, dob, sex, race, ethnicity, phone (home, work, cell), email, address

Patient address

Address 1, Address 2, City, State, Postal Code

Payor information

Payer name, payer type, member id, group number, secondary payer name, type, secondary member id (MRN)

Claims data
  • admission source code
  • admission type code
  • admitting diagnosis code
  • attending npi
  • billing provider name, tin, npi
  • principal diagnosis; additional diagnoses
  • facility npi
  • facility address
  • operating npi
  • payer claim id
  • place of service code
  • referring npi
  • total charge amount

For each claim, line item data
  • charge amount
  • charge unit
  • DOS
  • dx1 - dx4 - index of relevant diagnosis code from the list of diagnoses
  • modifier
  • quantity
  • rendering npi
  • service code
Scheduling data provide a powerful insight into appointments already made by Primary Care on their patients. The primary goal is for Primary Care Physicians to provide an Annual Wellness Visit with each of their patients to prevent health issues.
Connectivity Supported.
Aledade offers support in VPN (TCP/IP), Vendor-hosted SFTP or Aledade-hosted SFTP. Your choice! For details connectivity specifications, find it here.
Interface Specification.
Interface Direction
An automated unidirectional interface to Aledade
Message Type
Delivery Frequency
  • Live feed: near real-time
  • Backload: one-time
Data Preferences
  • Up to one-year future appointments already scheduled in the system
  • Live feed: new, update, cancel appointments
Data Elements
  • Patient Demographic: MRN, First Name, Last Name, Gender, DOB, Postal Code
  • Appointment details: Appointment ID, Date/Time stamp, Duration, Visit/Appointment Type, Provider Name, Provider NPI, Appointment Status
  • Required Visit Type: Wellness Visit*
*Specify visit type that represents a Wellness Visit

Clinical Interface

Clinical data is a rich source of information regarding a patient state of health. The data is powerful to manage patients’ health such as diabetes management, cardiac health, etc.
Connectivity Supported.

Aledade offers support in VPN (TCP/IP), Vendor-hosted SFTP, Aledade-hosted SFTP, XDS.b, or Direct Messaging (XDM). Your choice!

For details connectivity specifications, find it here.

Interface Specification.
Interface Direction
An automated unidirectional interface to Aledade
Message Type
  • CCDA in XML format
  • Prefer longitudinal but will accept encounter-based
Delivery Frequency
  • Live feed: near real-time when an encounter is signed, but will accept a daily batch
  • Backload: one-time
Data Preferences
  • Up to two-years backload CCDA
  • Live feed: new, update CCDA
  • Trigger: encounter closing and lab update
Data Elements
  • Vital sign: BP values, BMI
  • Lab results: LDL, A1C, eGFR
  • Screening: Depression, fall risk, colorectal cancer, mammogram
  • Social History: tobacco use, smoking status
  • Medications

 

ADT (Admit, Transfer, and Discharge) data provides notifications on patient stay in acute or post acute facilities. The primary goal is for Primary Care Physicians to follow-up with patients upon admission and discharges from an emergency or inpatient visit.
Connectivity Supported.

Aledade offers support in

  • Patient panel: Vendor-hosted SFTP or Aledade-hosted SFTP.
  • ADT interface: VPN (TCP/IP)

For details connectivity specifications, find it here.

Interface Specification.
Interface Direction
An automated unidirectional interface to Aledade
Message Type
ADT
Delivery Frequency
  • Patient panel: every 1st Monday of the month
  • ADT live feed: near real-time
Data Preferences
ADT live feed, no backload requires
Data Elements
  • Patient Demographic: MRN, First Name, Last Name, Gender, DOB, SSN (if available), Address, Postal Code
  • Episode / Encounter ID
  • Message ID
  • Admit Type
  • Event Code: admit, discharge, transfer, update, cancel admit, cancel discharge
  • Facility Name: Name, CCN, Address, Phone Number, Facility Type (Hospital, Urgent Care, SNF, etc.) Admit Date / Time
  • Patient Class: Emergency, Outpatient, Inpatient
  • Admit Reason
  • Discharge Disposition
  • Dx Codes
  • Death Indicator / Date of Death if discharged as decreased
Questions: adt@aledade.com

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Start planning your value-based care journey now

Thousands of your primary care peers are choosing Aledade as their value-based care partner. Let our experts show you why.

Connect with us!

Start planning your value-based care journey now

Thousands of your primary care peers are choosing Aledade as their value-based care partner. Let our experts show you why.