Improve Care Coordination with Medicare Claims Data
Beneficiary Claims Data Application Programming Interface (BCDA) gives eligible model entities access to their attributed enrollees’ Medicare Parts A, B, and D claims data, including data from any care received outside their organization.
Eligible model entities
BCDA supports organizations participating in the following Alternative Payment Models:
BCDA Use Cases
Get claims data in days, not weeks
BCDA claims data is available 2-14 days after submission. This means enrollees can receive time-sensitive care when it matters most. See a timeline of the claims data process.
Real-time monitoring and reporting
Track performance, utilization, and shared cost savings with timely insights into your enrollee populations.
Fill the gaps in your claims data
Supplement data from EMRs, ADT feeds, and other sources to get a holistic overview of your enrollees' health histories and provide high-quality care.
Receive standardized FHIR claims data
Get interoperable claims data that follows the HL7 Healthcare Interoperability Standard required by Centers for Medicare & Medicaid Services (CMS).
Using the data
BCDA is an Application Programming Interface (API) that updates enrollee claims data at least once a week. Data is provided in NDJSON format and includes:
- Medicare enrollee identifiers
- diagnosis codes
- dates and times of service
Featured
Get claims data sooner with partially adjudicated claims
Through BCDA, health care organizations can access claims 2 to 4 days after they’re submitted instead of 14 or more. These “partially adjudicated” claims have valuable data but haven’t been fully processed and paid by Medicare systems.
Announcements
Open call for BCDA v3 pilot program
BCDA is inviting existing users to join the Version 3 (v3) pilot.
This is a chance to get started with v3 before its rollout, and give feedback to help shape the API. Participants will be given five brief test scenarios and share their experience.
v3 includes improvements ranging from more timely data to new resources and parameters.
