Solutions
The Interoperability and Prior Authorization final rule includes four APIs and multiple payer deadlines. 1upHealth covers all of them.
Benefits
Most healthcare interoperability vendors talk about how the APIs work. 1upHealth can explain what they mean for your health plan — and how to drive value beyond compliance.
That expertise is backed by a fully managed, modular platform that integrates with your existing systems and keeps pace with evolving CMS interoperability requirements.
The deadline is just the beginning. The same foundation that gets you to January 2027 delivers additional value — powering risk adjustment, quality measurement, care gap closure, and whatever comes next for payers.
1upHealth takes on the complexity of CMS-0057-F, from API development to ongoing maintenance, with a dedicated platform and experienced team handling it all.
More CMS FHIR API implementations than any other vendor means a proven path to production and a team that has seen every curveball.
1upHealth manages the connectivity with other payers, providers, third-party apps, and external vendors on your behalf, eliminating point-to-point integration costs and reducing internal IT lift.
Plans that build point solutions for today's mandates will spend again when the next regulation arrives. The 1up Platform is a flexible investment that compounds over time.
Capabilities
Meet the Mandate
One platform covering Electronic Prior Authorization, Payer-to-Payer Data Exchange, Provider Access, and Patient Access.
Pre-built dashboards and audit trails give leadership clear, defensible visibility into compliance activity across all APIs.
Flexible workflows capture, track, and audit member consent without adding operational burden.
Customizable controls define exactly what data is shared and with whom for specific use cases.
Go Further
ONE CONNECTION. EVERY PARTNER
One-to-Many Network
One-to-Many Network
A single connection to the industry's largest payer, provider, and third-party app network.
ADOPT NOW. EXPAND LATER
Modular By Design
Modular By Design
Start with what you need today and layer in additional capabilities over time.
COMPLIANCE DATA, PUT TO WORK
Real-Time Data Activation
Real-Time Data Activation
Compliance data flows directly into risk, quality, care management, and member engagement workflows.
NO LOCK-INS. NO CONSTRAINTS
Open Integrations
Open Integrations
Connects with your existing EHRs, UM systems, and analytics platforms.
SECURITY YOU CAN STAND BEHIND
Enterprise-Grade Infrastructure
Enterprise-Grade Infrastructure
HIPAA-compliant, HITRUST-r2-certified, and SOC 2-Type II-audited infrastructure protects sensitive data at every point of exchange.
BUILT-IN COMMAND CENTER
Most interoperability platforms give you APIs. 1upHealth gives you a command center. The 1up Console provides visibility and control over how data moves across your ecosystem. You can view and manage:
For CMS-0057-F specifically, that means one place to monitor compliance activity across all four APIs, generate the reports your leadership and regulators need, and answer confidently when someone asks if your health plan is compliant.
CMS-0057 deadlines are fast approaching for payers. Download our new Interoperability Guide to learn what CMS requires, how to avoid costly vendor mistakes, and how to generate value beyond compliance.
THE 1UP PLATFORM
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.
WHY 1UPHEALTH
Deep regulatory expertise, a proven track record, and a team that stays with you long after go-live.
Join the nation’s leading health plans trusting 1upHealth to handle CMS-0057-F compliance.
Leave the complexity to us.
