What's included — and what you can choose to buy

A shared network should make each new connection easier to use, not create a new charge whenever another organization joins.

SHN includes the common connection software, required checks and testing, exchange, status and records for the use cases below. Additional operating and software services are optional.

Six included use cases

Within their defined scope and operating limits, these use cases carry no SHN participation, network-access, transaction or required Gateway-software-license fee:

• Prior Authorization
• Provider Access
• Patient Access
• Payer-to-Payer
• Directed Treatment Exchange
• Authorized Public Health Reporting

SHN calls this fee treatment Open Access. Each use case has its own supported specifications. The list describes the economics, not a claim that every use case is already live. Delaware’s initial production work starts with prior authorization.

A working service, not just message transport

Network Exchange includes the required identity and connection checks, supported testing, requests and responses, required status, receipts, notices and basic error information. The required Gateway software is included.

The Network Console gives users a usable view of the records they may access, including standard search, filtering and export. Viewing required information across many connections does not turn it into a paid analytical service. SHN’s required support and correction of its own network failures are included too.

Choose additional help where it is useful

Managed Gateway. SHN deploys, maintains, monitors, supports and recovers the agreed Gateway configuration, with hosting where selected. SHN is responsible for the service it sells. You may instead operate the software yourself or use a qualified independent operator.

Connection Management. Additional software and support for your organization’s own connection rules, reviews and follow-up work.

Network Intelligence. Analysis of information your organization is authorized to use, helping it understand repeated work and opportunities to improve.

Managed Gateway has a defined service description and acceptance process; Connection Management and Network Intelligence are in development. Each offer identifies what is included, supported configurations, availability, support and price before purchase. Buying management or analytical services does not require buying SHN Gateway operation.

Where the line falls

Suppose a provider’s required security credential expires. SHN updates its network status and supplies the required notice. That is included.

A plan may also have its own additional approval rules. Connection Management can check which extra reviews are needed and send them to the plan’s team. The plan can do that work itself or buy it elsewhere. The rule check is already part of the purchased service; it does not require a second analytics purchase.

More reach, the same included rights

More participating organizations, recipients or required responses do not themselves create an SHN fee. You may decline every optional service.

No-fee exchange does not remove all implementation costs. Your systems, integration, infrastructure, vendors and selected operator may still have costs. A funded program covers the work it specifies.

A governed commitment, not introductory pricing

Open Access is established through the Network Rules and Fee Schedule. Changes to its designations follow the governing approval, notice and participant-protection procedures, and require Governance Council approval. Existing agreements and the applicable notice, participant and transition protections continue to apply.

Before live use, participants receive the scope, operating limits and responsibilities for their connection. Exceeding a limit does not authorize an unspecified bill. Ending an optional service does not erase included rights or required records; changing the Gateway operator involves an agreed handover.

Claims, pharmacy and other new use cases need their own stated scope and fee treatment. This page does not change an existing agreement or remove a right established under it.