1upHealth makes it easy for health plans to acquire, manage, and use healthcare data.​
You rely on accurate, timely, and secure data to run your business, but manual workflows, lagging information, poor data quality, and data silos are holding you back. It’s time to modernize your health data exchange strategy. That’s where 1upHealth comes in.
We simplify health data exchange so you can move faster, operate with confidence, and gain a competitive advantage. Whether you’re looking to simply meet government regulations or reimagine your interoperability strategy from end to end, we’ve got you covered.
THE 1UP PLATFORM
1upHealth offers the most advanced, FHIR-first data platform built for the realities of healthcare. Powered by our lakehouse architecture, we connect and activate health data across your ecosystem – securely, reliably, and at scale – so interoperability works for your health plan, not against it.
The results: reduced operational costs, better member experiences, and stronger provider relationships.Â
Automate prior authorization to deliver faster decisions and better experiences.
Unlock historical member data to improve onboarding and close care gaps.
Enable providers with timely patient data for better care decisions.
Give members easy, secure access to their health information.
Publish accurate provider directories that make in-network care easy to find.
Deliver transparent drug coverage details to members and providers.
CMS-0057 deadlines are fast approaching. Download our new Interoperability Guide to learn what CMS requires, how to avoid costly vendor mistakes, and how to generate value beyond compliance.
1upHealth is built to handle large-scale data exchange, supporting health plans as membership, data volume, and data exchange across the ecosystem increase.
Simplifies interoperability by managing CMS-9115-F and CMS-0057-F compliance now and as regulations evolve.
Takes on the complex work of API development, validation, and system connectivity – so payers can focus resources on building and differentiating on top of the platform.
Offers solutions that operate independently or integrate end to end. Built to fit your existing workflows, systems, and infrastructure.
Provides you with a one-to-many network of payers, providers, and third-party apps that grows stronger with each connection.
Lends regulatory expertise, strategic guidance, and 24/7 support through a dedicated, 100% U.S.-based team.
Turns compliance investments into business impact by standardizing and activating real-time clinical and financial data.
From integrated technologies to interoperability expertise, 1upHealth partners across the healthcare ecosystem to deliver scalable, trusted data exchange.
Whether you’re a small regional plan or a national payer, 1upHealth supports interoperability across every line of business.
Supports Medicare Advantage and Fee-for-Service lines of business with interoperability that keeps pace with evolving CMS requirements.
Helps state agencies and managed Medicaid plans meet compliance while supporting complex member populations.
Partners with local, regional, and national commercial plans to help them unlock value across all lines of business.
Enterprise-grade security and a tech-agnostic architecture ensure data protection and privacy while prioritizing accuracy and governance.
Meet CMS requirements. Reduce operational burden.
Turn health data into a strategic advantage for your health plan.Â
