Centralize your in-network provider data in a CMS-compliant, FHIR®-native directory.
Benefits
Keeping provider data accurate and compliant is hard. 1up Provider Directory centralizes provider information into a standards-based, FHIR®-native directory that stays current and supports public, CMS-compliant discovery.
With CMS-4208-F2 raising the stakes beyond CMS-9115-F — adding Medicare Plan Finder submission requirements and annual executive attestation — health plans need a solution they can trust. Built on HL7® FHIR® R4 and live since 2021, 1up Provider Directory gives health plans the accurate, standardized data they need to confidently meet both rules.
Ensures provider information stays consistent and up to date across all networks with automated updates.
Avoids Medicare Plan Finder suppression with a solution designed to meet CMS-4208-F2 requirements before the October 2026 deadline.
Gives executives a reliable foundation to sign off on the accuracy of the provider directory with confidence.
Makes it easier for members and providers to find in-network options, supporting referrals, care coordination, and informed enrollment decisions.
Compliance
Meet CMS-9115-F and CMS-4208-F2 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 R4 resources per the Da Vinci Plan Net Implementation Guide.
1up publishes a public, CMS-compliant Provider Directory API for easy discovery and reuse.
Member-facing tools, provider systems, CMS, and third-party applications use the directory to find 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-4208-F2 requires Medicare Advantage plans to submit provider directory data to Medicare.gov’s Plan Finder by October 1, 2026, via a public FHIR® API or machine-readable file.
Plans must support a centralized patient search experience and CMS-operated provider lookup tools, maintain traceable relationships from MA plan to network to providers and facilities using contract-plan-segment IDs, and complete an annual executive attestation for provider directory accuracy. Non-compliance risks suppression in the Medicare Plan Finder during open enrollment.
1up Provider Directory provides accurate, standardized provider data that health plans need to meet CMS-4208-F2 requirements, support Medicare Plan Finder submissions, and give executives a reliable foundation for annual attestation.
Meet CMS-9115-F and CMS-4208-F2 requirements, protect enrollment, and make it easier for members to find in-network care with 1up Provider Directory.
