1up Provider Access API

Easily and cost-effectively share member data with your trusted provider partners.

The current challenges of sharing member data

Your value-based care partners need a holistic view of their patients to improve the quality of care, reduce waste, and decrease costs. Giving providers access to your rich member data, including claims history, is essential to their success.

Unfortunately, today, sharing member data with your in-network providers is time-consuming, inefficient, and costly—often relying on manual processes that do not scale and impede data exchange, like sharing flat files. These processes can potentially result in a five-month lag between the data shared and when the provider can take action on that data.

Efficiently & automatically share member data with in-network providers

Designed to meet CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) requirements and leveraging industry standards, the 1up Provider Access API eliminates these manual processes, making it easy and cost-effective for you to share data with providers.

Our FHIR®-based API enables authorized healthcare providers to securely access your member clinical, claims, encounter, and prior authorization data. This automated process ensures providers get timely information, thus improving their quality measure performance and ultimately saving you money.

With the 1up Provider Access API, you can:

Meet Regulatory Requirements

Adhere to CMS-0057-F compliance requirements for Patient Access API data sharing and usage metrics reporting

Streamline Processes

Eliminate manual processes and reduce administrative burden related to sharing data with providers

Realize Cost Savings

Reduce unnecessary tests and procedures

Provide Better Member Care

Streamline care coordination with in-network providers

Be a Better Risk-based Partner

Empower your provider partners to improve quality measure performance with timely data

How 1up Provider Access Works

Why 1up Provider Access

Secure

Accessible only to authorized users with valid access tokens and proper scope of permissions.

Standardized

Adheres to the FHIR R4 standard for Bulk Export and individual FHIR resource APIs.

Configurable

Excludes cost sharing and remittance dollar amounts based on the provider relationship.

FHIR APIs have the potential to support participation in value-based care programs, as these initiatives are critical to reducing the costs of health care delivery while maximizing quality for patients.
Centers for Medicare & Medicaid Services
Interoperability and Prior Authorization final rule

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