Make your prior-authorization investment useful to providers.
Your plan is investing in APIs, workflows and implementation teams. SHN helps turn those capabilities into working exchanges with the providers and partners who need them, without rebuilding the same connection work relationship by relationship.
Keep your systems and decisions.
Your APIs, utilization-management systems, coverage policies and decisions remain yours. SHN helps others connect to them. It does not become your benefit-design or authorization decision engine.
Reduce repeated implementation work.
Reuse common onboarding, valid trust evidence and applicable test results. Keep the checks that genuinely depend on your plan’s requirements. Bring an existing test plan and identify what shared testing can replace, not simply add another exercise.
Make the return path work too.
A request is only part of the exchange. Acknowledgments, requests for more information and decisions must reach the provider’s supported workflow. Authorized Member services can extend that visibility to the person waiting for care.
Pay for additional operating value, not permission to exchange.
Designated Open Access transactions carry no SHN transaction fee. Optional services can help operate a Gateway, manage plan-specific connection requirements and exceptions, or produce additional authorized analysis. Required transaction status and records remain included.
Measure adoption, not just published APIs.
Start with a supported prior-authorization workflow and the providers who need to use it. Track completed exchanges, recurring exceptions and the work still falling back to phone calls and portals.
Review the framework. Test in parallel.
The Version 1.0 participation package is published. The Network Rules, the Network Participation Agreement (with the incorporated BAA and Government Program Addendum) and the Health Plan Leader Memo are available for review on request, so legal, security and implementation teams can work in parallel. Review is separate from execution and production activation. Review the Rules & Participation page →
SHN has completed a SOC 2 Type II examination. The report is available for participant security review under standard security-review terms. Request security materials →
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.