Enable scalable Epic Payer Platform connectivity across enterprise workflows
InterSystems Payer Connector™ creates a single integration hub between Epic Payer Platform and other systems where health plan work happens: across claims, care management, utilization management (UM), quality, analytics, and member engagement. It transforms and routes data between Epic Payer Platform and downstream workflows with secure, scalable exchange, reducing one-off integrations and accelerating time to value - supported by proven integrations and healthcare expertise from InterSystems, with demonstrated success at enterprise scale.
Integration That “Speaks Epic”
InterSystems Payer Connector provides integration that standardizes the way Epic®-supported data moves between Epic Payer Platform and your clinical and administrative applications. It combines configurable data transformation and routing—validate, transform, enrich, route, and deliver - with centralized security and compliance controls, including role-based access control and comprehensive audit trails. Using Epic’s published interfaces, schemas, and formats, it normalizes, transforms, and bi-directionally routes information with the stability, scalability and reliability required.
Application security and operations are centralized, including OAuth 2.0 IDs and scopes, encryption in transit and at rest, role-based access, end-to-end monitoring, audit logs, message tracing, and controlled resubmission. With end-to-end observability, including tracing, retries, queue transparency with controlled resubmission and service level monitoring, your teams can troubleshoot and tune flows with confidence and trust. Change is managed safely with versioned configurations and environment promotion. InterSystems Payer Connector coexists with existing queues, APIs, and integrations to standardize connectivity without a need to rip-and-replace existing systems.
Initial connections typically include member enrollment rosters to support clinical exchange, ADT notifications for care and utilization management, delivery of C-CDA and Clinical Analytics Document (CAnD), and Additional Detail Request (ADR) documents from Epic Payer Platform to downstream health plan systems and back. Given the bi-directional exchange of information, data such as identified care gaps can be sent back to Epic Payer Platform for visibility to providers.
Key Features
- Shared, centralized connections that eliminate one-off integrations and centralize business rules for routing and transformation.
- Configuration-driven mappings to keep transformations consistent, governed and repeatable.
- Visual process design for business process orchestration, including fault and compensation handling for robust error recovery.
- Standards-friendly adapters to forward requests to external endpoints when required.
- Schema validation with quarantine and clear error feedback; support for custom schemas when needed.
- Multi-target delivery across web application programming interfaces, message queues, event streaming platforms, and secure file exchange.
- Resubmission and suspension handling so failed messages can be inspected, corrected, and resent under operational control.
- Centralized security policies with role-based access.
- Comprehensive protections: authentication, authorization, audit logging, and encryption.
- End-to-end message tracing for rapid investigation.
- Operational alerts and log monitoring to surface thresholds and important events.
- Versioned configurations, environment promotion, and safe rollout options to manage change with confidence under centralized operational control.
Benefits and Capabilities to Meet Your Needs
Deliver information from Epic Payer Platform into live workflows and back
Targeted routing delivers needed data to claims, care management, UM, quality, analytics, and member systems and sends back those insights, reducing manual intake and overhead.
Monitor, audit, and trust data flows
Central dashboards, message tracing, audit logs, and SLAs ensure transparency and create operational confidence.
Simplify change management
Uses versioned mappings and staged promotions to isolate changes and deploy safely, reducing break/fix and rollback risk.
Integration aligned with enterprise security and deployment models
On-premises or managed service deployment options and integration with enterprise SSO and existing gateways/queues.
Real-World Value Use Cases
- New application onboarding: Stand up a new system and connect it with your enterprise through a single integration hub, more quickly and easily than with bespoke links.
- Notifications for care and utilization management: Deliver notices of events of interest to operational systems with consistent routing and error handling.
- Clinical documentation for quality measures and claims: Standardize pipelines deliver documentation where it’s needed for measurement or payment determinations.
- Roster activation across applications: Reuse the same connectivity pattern to synchronize member context consistently.
- Analytics & AI readiness: Produce well-governed, normalized data to strengthen analytics and future AI initiatives.
InterSystems Payer Connector replaces integration sprawl with an integration engine pre-configured for health plans to connect Epic Payer Platform with internal applications. Connect once to the centralized hub and scale confidently. Standardized patterns, strong governance, and operational visibility reduce rework, accelerate time-to-value, and build a durable foundation for new use cases.
Why InterSystems
InterSystems brings decades of healthcare and healthcare data expertise, powering mission-critical systems with unmatched performance, flexibility, and reliability. Our proven technology supports seamless interoperability, while our unique, multi-model architecture enables tailored solutions that evolve with your needs. With industry-leading customer support and low-code tools, we help organizations solve complex challenges faster and smarter.