Overview of Required APIs

Explore the essential APIs mandated by CMS to promote interoperability and enhance data sharing across the healthcare system.

Patient Access API

Empowers patients with access to their health records, including prior authorizations, to make informed decisions about their care.

  • Patient access to health data
  • Prior authorization details
  • Improves patient engagement
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Provider Access API

Enables providers to access claims and encounter data, helping them coordinate patient care and make informed treatment decisions.

  • Access to claims and encounters
  • Supports care coordination
  • Data-sharing with providers
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Payer-to-Payer API

Allows payers to transfer patient data when they change plans, ensuring continuity of care and access to accurate health records.

  • Data continuity between payers
  • Supports seamless transitions
  • Opt-in for patient privacy
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Prior Authorization API

Automates prior authorization requests, offering status updates and reducing administrative burdens for providers and payers.

  • Streamlined authorization process
  • Status tracking for providers
  • Reduces admin workload
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