How it works
One connection. A hub that cannot read what it carries. The person kept in view.
Smart Health Network connects the systems health plans, providers and their partners already use. Each participant connects through a Gateway at the edge of its own systems. The Hub routes encrypted messages between Gateways and does not hold the keys to read them. Plans keep their APIs, coverage policies and decisions. Providers keep their EHRs, workflows and vendors.
A prior authorization, step by step
- A provider starts the request in its own system.
- The provider’s Gateway checks and encrypts it.
- The Hub routes the encrypted message to the plan’s Gateway. It cannot read it.
- The plan’s Gateway checks and decrypts it, then delivers it to the plan’s API.
- The plan decides and responds the same way. Status updates follow the same path until the case is closed.
At every step the decision stays with the plan. The Network carries the request, the required documentation, the response and the status.
Why a shared path matters
If every plan connects separately to every provider, electronic prior authorization can reproduce the burden it was meant to remove. A common connection makes registration, identity, security and testing work reusable, so the next connection does not start from zero. Does the second connection become easier than the first? Does the fifth? That is the test.
How information is protected
Clinical content is encrypted at the sending Gateway and decrypted only at the receiving one. The Hub processes the information needed to authorize, route and prove the exchange. Network audit records are distinct from clinical content. Participants maintain their clinical records and authoritative workflow status. Security teams can review the actual architecture and documentation; the detailed materials are available through the review process.
What is included, and what you can buy
Designated Open Access exchange — Prior Authorization, Provider Access, Patient Access, Payer-to-Payer, Directed Treatment Exchange and Authorized Public Health Reporting, each within its defined scope — carries no SHN participation, network-access, transaction or required Gateway-software-license fee. Optional services such as Managed Gateway, Connection Management and Network Intelligence are separate purchases and never a condition of included exchange. What’s included →
Starting with prior authorization
Medical prior authorization is the first production focus, aligned to the requirements generally beginning January 1, 2027. Testing uses synthetic data and is open now. Other use cases activate as they pass their checks, with their own stated scope and fee treatment; new use cases require their own designation under the Network’s governance. Start testing →
Who runs your Gateway
Your own team, a qualified independent operator, or SHN through its optional Managed Gateway service. The choice does not change your Network access or rights. How governance works →