Make your January investment reach the market.
Your plan is building APIs, refining workflows and preparing teams for electronic prior authorization. The next challenge is making those capabilities work with the providers and partners who need them.
Smart Health Network provides a shared connection and testing approach so that work can reach further without being repeated relationship by relationship.
Keep what you are building
Your APIs, utilization-management systems, medical policies, decisions and systems of record stay in place. The network helps others connect to those capabilities; it does not replace your implementation.
Replace repeated tests, not useful work
Bring a bilateral test already on your implementation plan. Identify which parts a common test program can cover and which still need a plan-specific check.
Where the same result meets the same requirement, reuse it. The objective is to reduce the work around implementation, not add another test to an overloaded calendar.
Reach providers through the tools they use
Work with EHR, HIE and workflow partners to establish a usable provider-to-plan connection. Resolve the source and return path together, including requests for more information and the updates that otherwise lead to repeated calls.
As more organizations participate, reuse the connection and testing work that remains applicable.
Make progress visible
Your system supplies the request’s status and decision. The shared exchange helps return that information to the relevant provider, person or care-team experience with the right permissions.
Required status is included. The plan retains its coverage decisions and responsibilities.
Know what is included
Supported prior-authorization exchange carries no SHN participation, network-access, transaction or required Gateway-software-license fee. The same connection does not become chargeable because you reach more participants.
Run the Gateway yourself, choose a qualified operator or consider SHN’s optional Managed Gateway. Additional management and analytical services are being developed with separate scope and pricing. They are not required for the included exchange.
Bring your team into the shared effort
Name an implementation lead and the owner of your PA API. Choose one synthetic workflow. Join a readiness discussion with the people responsible for provider integration and operations.
Testing can begin while production diligence continues. Before live use, the parties agree their responsibilities and complete the necessary checks. Participation is non-exclusive and does not replace a plan’s regulatory obligations.
SHN has completed a SOC 2 Type II examination. The report is available for participant security review under NDA. Request security materials →
Participant-review materials are being released during the week of September 14, with the conformed package available for review by September 21. Review is separate from execution and production activation.
Do the work once where possible. Make it useful across more connections.