Member Consent Service

Secure, efficient, and compliant member
consent management.

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Member Consent Service is part of Cotiviti’s Interoperability solution suite.

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96%

of surveyed Payment Integrity VPs, Directors and Managers at payer organizations are likely to recommend Cotiviti.*

Real-time access to clinical data is increasingly in demand. At the same time, data privacy and enhanced control over what is shared, with whom, and for what purpose is a focal point of regulation like CMS-9115-F, CMS-0057-F, 42 CFR part 2, and the Telephone Consumer Protection Act (TCPA).

Unfortunately, for many health plans, member consent is managed through a series of manual workflows and paperwork that involves multiple plan personnel and is not suitable for enterprise-wide deployment.


Learn more about Member Consent Service

Take control of consent.

Member Consent Service (MCS) is a single, centralized platform that allows health plans to securely and efficiently capture, store, and manage consents for members and related persons. With our solution, health plans can more easily manage access to member health data and quickly respond to changes in members’ data-sharing preferences while remaining compliant with regulatory requirements.

Manage more securely and compliantly.

By integrating MCS APIs across their ecosystems, health plans can manage consent creation once and enforce it consistently every time protected health information (PHI) is disclosed through Patient Access API calls, the member portal, or any other communication channel. The result is continuous compliance with CMS-0057-F, 42 CFR Part 2, HIPAA, and state privacy mandates, significantly reduced audit exposure, and a scalable foundation that adapts to future regulatory changes without the need for system-by-system updates.

Member Consent Service can be deployed as a standalone solution or seamlessly integrated with any data exchange infrastructure, including Cotiviti FHIR Gateway, Patient Access API, Provider Access API, and Payer-to-Payer (P2P) API.

Member Consent solution benefits

  • Support compliance with CMS-0057-F, 42 CFR Part 2 and all state-based data sharing requirements with opt-in/opt-out member consent.
  • Capture member communication preferences by channel and enforce a configurable Do Not Call list to support compliance with FCC TCPA regulations.
  • Eliminate manual processes with fully electronic capture, storage, and management of member consent preferences.
  • Deliver better service with an intuitive web-based interface for Privacy Officers, Customer Service Representatives, and other users.
  • Streamline data access and sharing with a platform that supports multiple personal/authorized representatives and filtering options for member medical information.
  • Improve the member experience with a web-based portal that allows members to easily manage their own consents.

To learn how Member Consent Service can help your organization, you can reach out to your primary representative, provide your contact information below, or submit your questions to answers@cotiviti.com

Ready to learn more? Talk to one of our sales representatives—fill out the form below to schedule a call.