From a request for care to a clear next step.
Prior authorization brings a provider, a health plan and a person waiting for care into the same process. SHN helps the work move between their systems without making them start over with every new connection.
A prior authorization, across organizations
The provider sends the request. A supported workflow sends the request and the information required for that interaction.
The plan receives and responds. The request reaches the responsible plan service. The response can confirm receipt, ask for more information or communicate a decision.
The response reaches the people responsible for the next step. The connected workflow distinguishes what has happened from what still needs to happen.
The person can be included. An authorized Member experience can make progress understandable across organizations, rather than leave the patient calling each one for an answer. Current availability is described on the patients page.
The health plan makes coverage decisions. Clinicians make care decisions. SHN provides the common infrastructure for the exchange.
A digital front door is only the first step.
APIs are digital front doors to services. Reaching one also requires an address, a connection and permission to enter. Common standards help systems exchange information, but organizations still need a dependable way to find one another, establish trusted access and complete the work.
SHN supplies that common framework. Its Gateway connects an organization’s systems to the network and applies the required checks. The Hub carries encrypted messages between Gateways without reading their contents or holding the keys to decrypt them. Other qualified paths can support agreed interactions where appropriate.
One connection, more useful work.
Connections and trust arrangements can be reused across participating organizations and supported transactions. The next use may need configuration, permissions and testing, but it does not require rebuilding the entire foundation.
Keep your existing EHR, payer systems and vendors. Operate the Gateway yourself, appoint a qualified operator, or purchase SHN’s managed service. Your operator choice does not purchase different network rights.
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 through the developer resources and the security-review process.
Included transactions. Optional services.
Designated Open Access transactions carry no SHN participation, network-access, transaction or required Gateway-software-license fee. Optional services are separate purchases and never a condition of included transactions. The full catalog, with scope and availability, is on Open Access.