Centralize your in-network provider data in a CMS-compliant, FHIR®-native directory.
Benefits
Keeping in-network provider data accurate and compliant is difficult. 1up Provider Directory replaces fragmented files and manual updates with a centralized, standards-based directory.
The solution delivers a public, CMS-compliant API that makes it easy for members to find in-network providers across systems and specialties.
Ensures provider information stays consistent and up to date across all networks with automated updates.
Reduces manual reconciliation, provider outreach, and directory maintenance by automating provider data ingestion and publishing.
Helps members and providers quickly find in-network options, supporting referrals, care coordination, and better plan decisions.
Compliance
Meet CMS-9115-F Provider Directory requirements with a fully managed solution, without taking on the complexity yourself.
Public-facing FHIR R4 API that requires no authorization and makes in-network providers easy to discover by other providers, members, and third-party applications.
Pre-built dashboards that show how your public API is being used, including request volume, access patterns, and resource activity.
A simple workflow for publishing and maintaining accurate in-network provider data.
Provider data is ingested from source systems, validated, and mapped into clean, standards-based FHIR resources per the Da Vinci Plan Net Implementation Guide.
1up publishes a public, CMS-9115-F-compliant Provider Directory API for easy discovery and reuse.
CMS, Medicare.gov, member-facing tools, provider systems, and third-party applications use the directory to identify in-network doctors and facilities.
Ongoing synchronization ensures provider changes are reflected within required timeframes and remain accessible to all.
All CMS-regulated payers must include the provider name, network status, address, phone number, and specialty for in-network providers.
All Medicare Advantage prescription drug plans (MA-PD) must include pharmacy name, address, phone number, network count, and pharmacy type for in-network pharmacies.
Provider data is updated within CMS-required timeframes after changes are received (within 30 days).
Yes. The standardized FHIR format allows developers to build apps that help members find and compare providers.
CMS has proposed that Medicare Advantage plans submit provider directory data to Medicare.gov’s Plan Finder starting October 1, 2026, using a public FHIR API or machine-readable file with updates within 30 days.
1up Provider Directory’s public, standards-based FHIR API supports timely updates and is designed to conform with the final CMS guidance released in February 2026.
Publish accurate covered provider information, meet CMS-9115-F requirements, and improve access to care with 1up Provider Directory.
