BIC Beneficiary Eligibility Query (BEQ) API

[Derek Wolf]

Does anyone have experience implementing the BEQ API?

• https://developer.bic.cms.gov/swagger-ui/?spec=beq.json
• https://developer.bic.cms.gov/home

"The service is initially intended for use by the Medicare Advantage and Part D (MAPD) Plans, Organizations providing business process support to MAPD plans and other CMS systems such as the Drug Data Processing System (DDPS) that need to evaluate a beneficiary's eligibility." 

We provide an enrollment platform for MA & MAPD plans hence we are looking to integrate the beneficiary eligibility checks provided via the BEQ API.

Is the BIC/BEQ API service available to orgs that are not Plans (carrier) sponsors? Does anyone have a point of contact at CMS that could address my question(s)? 

TIA,

Derek


 

[Shynihan Muhammed]

We are also looking for the same. Appreciate any help. Thank you.

Regards,
Shynihan

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[Kirsten Hansen]

Hi Derek & Shynihan,

Thanks for reaching out to us. Please email this address: BEQ_Distro @cms.hhs.gov for help with the BIC Beneficiary Eligibility Query (BEQ) API. 

Have a great Thanksgiving holiday.

Kirsten Hansen

Product Manager

The Blue Button 2.0 API Team

[Andrew Zinman]

I have sent a few emails to BEQ_Distro, and I'm unable to get a reply. We are trying to get API access to real time BIC-BEQ for the use case submitted in my email. 

Best,

Andrew

Medicare CX

[Developer Group for CMS Blue Button API]

Hi Andrew, 

Apologies that you are not getting a response. We will try to ping them internally and pass your info along. 

- The Blue Button 2.0 Team

[Andrew Zinman]

Thanks, the emails were sent from andrew @medicarecx.com or you can use this policy cx email. 

[Shynihan Muhammed]

I also haven't received a response despite sending multiple emails. I did resend the email today. Thank you for your assistance.

Regards,
Shynihan

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[Andrew Zinman]

Can you try pinging them internally again please. Andrew Zinman, Medicare CX

[Developer Group for CMS Blue Button API]

Hi Andrew, 

We have reached out to the team responsible for this inbox to let them know there are several people awaiting a response. 

The Blue Button 2.0 Team

[Joe Wahl]

Hello, 

We are also looking for access to the BEQ API. I just sent an email to the above address, can anyone assist?

Joe 

[Joe Wahl]

My understanding is that the BEQ API is down right now due to a company, ‘Medizues’, overloading it with requests. They seem to have somehow been sponsored by Humana, who’s own eligibility tool that is dependent on the BEQ API is also down as a result. Seems to be a tough road to getting anything outside of Marx, which I already have access to.

 

Thanks,

 

Joe

 

From: Derek Wolf
Sent: Monday, June 10, 2024 11:15 AM
To: Joe Wahl; and...@policycx.com; shyn...@gmail.com
Cc: Developer Group for CMS Blue Button API
Subject: Re: BIC Beneficiary Eligibility Query (BEQ) API

 

Here is an update:

 

1. BEQ API is only available to Carriers

    It is unlikely that you will be able to find a Plan Sponsor that will help facilitate direct access to the BEQ API. My organization, along with a few other partner organizations, have attempted to gain approval for the BEQ but we have never been successful. 

2. Some carriers may offer an enrollment or eligibility API that acts as a wrapper around the BEQ API.

   Depending upon your existing carrier relationships, this probably represents the most viable path to run BEQ requests.

 

3. One other option that might be available to agents (& call centers) for one-off use-case(s) would be to gain access to the MARX system. This would also require carrier approval. 

 

 

I would not recommend spending a significant amount of time trying to gain access via the BEQ_Distro email. I have spent a lot of time going down this path but it is a dead end! 

 

 

 

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[Derek Wolf]

Here is an update:

1. BEQ API is only available to Carriers

    It is unlikely that you will be able to find a Plan Sponsor that will help facilitate direct access to the BEQ API. My organization, along with a few other partner organizations, have attempted to gain approval for the BEQ but we have never been successful. 

2. Some carriers may offer an enrollment or eligibility API that acts as a wrapper around the BEQ API.

   Depending upon your existing carrier relationships, this probably represents the most viable path to run BEQ requests.

3. One other option that might be available to agents (& call centers) for one-off use-case(s) would be to gain access to the MARX system. This would also require carrier approval. 

I would not recommend spending a significant amount of time trying to gain access via the BEQ_Distro email. I have spent a lot of time going down this path but it is a dead end! 

On Tue, Jun 4, 2024 at 2:20 PM Joe Wahl <yankee...@gmail.com> wrote:

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[Tom Toggas]

Derek,

Then how do you think  Sunfire has it?  

[Andrew Zinman]

From what I understand, BIC BEQ is only available to carriers and a sponsor providing access is considered non-compliant. I don't believe Sunfire has anything similar to this.