Deliver timely clinical and claims data to your provider partners using FHIR®-based APIs.
Benefits
Sharing member data with your provider partners is often slow, manual, and hard to manage. 1up Provider Access replaces that complexity with secure, FHIR-based data sharing at scale, while enabling you to maintain control of attribution, consent, and access.
Providers receive data through the tools they already use, including EHRs and existing portals, or a lightweight 1up-hosted interface. Built-in reporting and granular controls give you clear visibility into – and power over – what is shared and with whom.
Gives providers a more complete patient history directly at the point of care.
Eliminates flat files, custom extracts, and ad-hoc requests with standardized APIs and managed provider onboarding.
Supports timely, appropriate member care by reducing delays, gaps, and unnecessary services.
Builds trust and strengthens value-based care relationships by giving providers the data needed to improve quality performance.
See how 1upHealth turns CMS-0057-F compliance into measurable value-based care outcomes. Watch a demo of provider attribution, data access, and reporting in the 1up Console.
Compliance
Everything you need to meet CMS-0057-F Provider Access requirements.
FHIR-based APIs with secure OAuth2 authorization, allowing providers to securely access attributed member health data.
Secure SFTP ingestion for managing member-provider relationships with attribution visibility in the 1up Console.
Flexible opt-out management with payer-managed ingestion or a 1up-hosted UI, including CMS-aligned member education and auditability.
Compliance
1up Provider Access is more than an API. It’s a scalable healthcare data-sharing experience that drives adoption and measurable value.
Higher provider adoption
Integrated Provider Experience
Integrated Provider Experience
Delivers data access to providers through EHRs, existing portals, or a lightweight 1up-hosted interface.
Simplified provider setup
Provider Registration & Onboarding
Provider Registration & Onboarding
Enables providers to onboard and obtain OAuth2 credentials via a secure, self-service portal.
Reduced compliance risk
Data Access Controls
Data Access Controls
Allows payers to define and enforce provider-level data access, including cost and sensitive data filtering.
Cleaner Cross-State Routing
BCBSA Interoperability Hub Connectivity
BCBSA Interoperability Hub Connectivity
Routes requests for Blues plans to the Association when home-and-host plans differ.
Operational transparency
Provider Access Usage Reporting
Provider Access Usage Reporting
Provides pre-built reports that track provider access activity, attribution relationships, registration status, and API usage.
A simple, end-to-end workflow built for Provider Access.
Payers share member-provider relationships to define authorized data access.
Payers share member opt-out preferences, or 1upHealth collects them on the payer’s behalf.
Providers register once on the 1up Platform and receive read-only API access.
Providers make FHIR API calls to retrieve attributed member data.
Data sharing rules and filtering are enforced automatically.
Payers monitor activity, usage, and compliance in the 1up Console.
Yes. Providers register once through our developer portal, where their organization and credentials are verified. Once approved, providers can access data only for members they are actively attributed to.
Payers retain full visibility and control through the 1up Console. Real-time reporting shows which providers accessed data, when, and how often.
1upHealth verifies provider organizations, roles, and credentials through a structured vetting process. Access is always limited to attributed members, with optional payer-supplied National Provider Identifiers (NPIs) to accelerate approval.
Payers manage attribution and update it as care relationships change. Access automatically reflects the latest attribution lists, ensuring providers only see data for their current patients.
Providers can access claims, clinical, encounter, and prior authorization data for attributed members, excluding remittances and cost-sharing by default, through secure FHIR-based APIs.
Members are opted in to provider data sharing by default but can opt out at any time, as required by CMS.
1upHealth provides payers with plain-language education materials to support member communications. If a payer uses 1up’s configurable opt-out UI, the workflow includes clear education on benefits and member choice.
1up Provider Access supports both individual providers and multi-NPI organizations. Provider groups can access data across multiple NPIs under a single, validated organization, while individual providers are limited to their own NPI – ensuring flexibility without compromising access controls.
Strengthen care coordination. Improve value-based care. Increase provider satisfaction. Meet CMS-0057-F seamlessly with 1up Provider Access.
