Clarification on Data Availability in the New DPC Production Environment

[Gokulraj]

Hello DPC Support Team,

I have a quick clarification regarding the new/upcoming DPC production environment.

When an organization connects to the production environment for the first time, will existing historical or active data for Patients, Practitioners, ExplanationOfBenefit (EOB), and Coverage already be available for the organization's attributed beneficiaries?

Or are organizations expected to create, seed, or import any of these records themselves before retrieving data through DPC?

Thank you.

[Data at the Point of Care (DPC) Community]

Hello,

Thanks for your question. We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission

[Data at the Point of Care (DPC) Community]

Hello,

Thank you for your question!

Once you create your Patients and Practitioners and add them to your attribution roster (Group), you can run a bulk export against that roster.

DPC will then return the data for those beneficiaries — including their Patient, EOB, and Coverage resources. If you only need one beneficiary, you can scope the export to that patient using the Patient/$everything endpoint.

So you do create the Patient and Practitioner records to establish the roster, but the claims data itself is served back to you — you don't seed or import that.

Let us know if you have more questions!

Best,

The DPC API team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Harley Dickey]

Hi  DPC API team,
When exactly will production reopen and what is the timeline for this?  I cannot seem to find a definitive answer since we last connected in 2023.

We have been interested in this for quite some time & would love to express our continued interest in getting access or even a heads-up when production opens, and confirm what AledadePBC will need to submit to gain access.
We have all of our Type 2 NPIs, a list of provider NPIs to enroll, & our patient MBIs - when could we test this out in real-time?
Thanks kindly,

Harley Dickey | they/them ⓘ

Tech Product Manager

| aledade.com

[Data at the Point of Care (DPC) Community]

Hi Harley,

Thank you so much for your question about the status of DPC onboarding. We're still pausing requests for production access while we build and test a new digital onboarding experience.

We don't have a specific date for when onboarding will resume yet, but we're getting closer, and we'll post an announcement in the Google Group and on the updates page of our website as soon as we have more information.

You’ll also receive an email with a request to share details about the requesting organization(s), so we can follow up directly when onboarding resumes.

Again, thank you for reaching out. If you have any additional questions, feel free to contact us directly at any time.

Best,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Ray Vuono]

Thank you for the questions and the responses.  

Ray

[Tom Johnson]

When you say "the claims data itself is served back to you", will this include the patient's full claim history or only claims related to the clinic asking? I have tried 276/277 and the requesting supplier limitation is the showstopper for that being an effective route.  My particular use case is to embed a programmatic check for DME Same or Similar without clinic staff having to manually go through the MAC portal separately. 

Thanks,

Tom

[Data at the Point of Care (DPC) Community]

Hello,

DPC returns each attributed beneficiary's full adjudicated Medicare claim history, not only the claims your organization submitted. Because access is authorized by your treatment relationship with the beneficiary rather than by who billed the claim, the export includes claims from other providers and suppliers.

For more detail, please see:

• The data page for what data DPC provides
• The Terms of Service for information on permitted data use

Please let us know if you have any further questions.

Best,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Ray Vuono]

I am sorry,  do we have access to this now?

Ray

[Data at the Point of Care (DPC) Community]

Hi Ray,

Just to make sure I answer the right question — are you asking about access to production data specifically?

If yes, please see our earlier response in this thread for the latest on the timeline, instructions on joining the waitlist, and where updates will be posted when onboarding resumes.

Please let us know if you have any other questions.

Best,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.