Integrations
Vendor identities are partly confirmed (AdvanceMD · CrelioHealth · INVOPAD · PayMedics · Novitas JH · BCBS), but every external platform remains NOT CONNECTED. No live connectivity is simulated.
RequiSure does not integrate real EMR, LIS, RCM, or payer systems in this prototype. Knowing a vendor's identity is not the same as a technical connection — each card shows what is Known versus what is still To Be Confirmed.
Vendor-Neutral Integration Architecture
Vendor-neutral adapter interfaces. External systems (AdvanceMD, INVOPAD, PayMedics, Novitas/BCBS) are prospective implementations, not hard-coded assumptions. No live integration is built.
Clinical Source / EMR AdapterNot Connected
RequiSure Core (vendor-neutral)
LIS AdapterNot Connected
RCM AdapterNot Connected
Payer / Outcome AdapterNot Connected
Clinical Source / EMR Adapter
NOT CONNECTEDClinicalSourceAdapter
Current implementation
To Be Confirmed
Current provider / order source not yet confirmed
Prospective / future implementation
AdvanceMD
Potential / future provider system — not currently in use; API/interface capability To Be Confirmed
Neutral contract capabilities
fetch_patient()fetch_encounter()fetch_clinical_notes()push_readiness()
LIS Adapter
NOT CONNECTEDLISAdapter
Current implementation
CrelioHealth
Current LIS · technical/API/interface capability To Be Confirmed
Prospective / future implementation
INVOPAD
Planned / future LIS · specific product/module To Be Confirmed
Neutral contract capabilities
transmit_order()fetch_accession()fetch_results()
RCM Adapter
NOT CONNECTEDRCMAdapter
Current implementation
PayMedics
Billing / RCM partner · technical integration & data-return capability To Be Confirmed
Neutral contract capabilities
fetch_charges()fetch_claim_status()fetch_remittance()
Payer / Outcome Adapter
NOT CONNECTEDPayerPolicySourceAdapter
Prospective / future implementation
Novitas — Jurisdiction H (Texas)
Medicare MAC · exact applicable LCD/Article Requires Validation
BCBS
Commercial payer category · exact entity/plan/product To Be Confirmed
CMS Coverage API
Future policy source · not integrated
Neutral contract capabilities
fetch_policy()fetch_eligibility()fetch_outcome()
Vendor Integration Contracts (identity known · not connected)
AdvanceMD (Potential / Future Provider System)
NOT CONNECTEDVendor / system: AdvanceMD — potential / future provider system (not currently in use)
Known
- • Not currently in use
- • Potential / future provider system only
Unknown · To Be Confirmed
- • Current provider / order source (To Be Confirmed)
- • API / interface capability
- • Read / write capabilities
- • Electronic order routing
- • Fees / approval / certification process
Expected inbound
PatientDemographicsInsuranceEncounterDiagnosesClinical notesMedicationsAllergiesPrior labsProviderLocationOrder details
Expected outbound
Readiness statusMissing itemsTaskAuthorization statusABN statusHold/releaseEvidence Packet summary
Integration questions (To Be Confirmed)
- • What is the current provider / order source?
- • If AdvanceMD is adopted later, is API access available?
- • Clinical-note retrieval method?
- • Writeback capability?
- • Electronic order route?
- • Fees?
- • Certification/partner process?
CrelioHealth (Current / First-Pilot LIS)
NOT CONNECTEDVendor / system: CrelioHealth — confirmed current & first-pilot LIS
Known
- • Confirmed current LIS (CrelioHealth)
- • Confirmed first-pilot LIS (CrelioHealth)
- • INVOPAD is future / planned only
Unknown · To Be Confirmed
- • CrelioHealth API / interface capability
- • CrelioHealth technical contact
- • INVOPAD specific product/module (future)
- • INVOPAD transition timeline (future)
Expected inbound
AccessionAcknowledgementSpecimen statusCancellationModificationPerformed testResults
Expected outbound
Patient identifiersPayerProviderReleased orderDiagnosisSpecimenPriorityAuthorization/ABN metadataEvidence Packet referenceUnique order ID
Integration questions (To Be Confirmed)
- • What CrelioHealth API / interface capability exists?
- • How does an order currently enter CrelioHealth?
- • At what exact point should RequiSure permit an order to enter the LIS?
PayMedics (Billing / RCM)
NOT CONNECTEDVendor / system: PayMedics — confirmed billing / RCM partner
Known
- • Confirmed billing / RCM partner (PayMedics)
- • PayMedics receives billing information from CrelioHealth
Unknown · To Be Confirmed
- • Exact technical method CrelioHealth uses to send information to PayMedics
- • Whether claim-status data can return electronically
- • Whether denial reasons can return electronically
- • Whether payment information can return electronically
- • Appeal status / adjustment data / CARC / RARC return
Expected inbound
Performed testsChargesClaim IDClearinghouse statusPayer responseCARCRARCPaymentAdjustmentDenialAppealPatient responsibility
Integration questions (To Be Confirmed)
- • How does CrelioHealth transmit billing data to PayMedics?
- • Can PayMedics return claim-status / denial / payment data electronically?
- • Which system contains the authoritative claim/payment outcome?
Novitas / Texas Medicare
NOT CONNECTEDVendor / system: Novitas — Jurisdiction H (Texas) — confirmed MAC context
Known
- • Medicare MAC context: Novitas, Jurisdiction H
- • Geography: Texas
Unknown · To Be Confirmed
- • Exact applicable RPP LCD (pending Kevin source)
- • Exact applicable Article (pending Kevin source)
- • Medical-necessity logic (REQUIRES VALIDATION)
Integration questions (To Be Confirmed)
- • Exact controlling Novitas JH LCD/Article for the confirmed RPP panel?
- • Who approves and maintains the coverage rule set?
BCBS (Commercial Payer)
NOT CONNECTEDVendor / system: BCBS — confirmed commercial payer category (entity/plan TBC)
Known
- • Intended commercial payer category: BCBS
Unknown · To Be Confirmed
- • Exact BCBS entity / plan / product
- • Applicable commercial coverage rules
Integration questions (To Be Confirmed)
- • Which exact BCBS entity / plan / product?
- • What commercial coverage rules apply to the RPP panel?
Future Test Areas (backlog only — not built)
RPP remains the sole functional demonstration category in this prototype.
PCR Wound · Future backlog — not builtPCR UTI · Future backlog — not builtToxicology · Future backlog — not builtPGx (Pharmacogenomics) · Future backlog — not builtGenetic · Future backlog — not builtBlood Panels · Future backlog — not built