Architecture Overview

At 1upHealth, we’ve built the architecture of our technology to meet CMS requirements. 1up provides connectivity and data ingestion for both providers and patients.

CMS Requirements

1upHealth enables Health Plans to meet the following CMS requirements.

Patient Access API

Requires claims, encounter, clinical, and formulary data to be accessible through HL7 FHIR® R4 API endpoints for patients to share through a third-party application of their choice.

Diagram of the 1up Patient Access API

Provider Directory API

Health Plans must make available a FHIR® API-based list of providers that are in network.

Diagram of the 1up Provider Access API

Product Overview

The 1upHealth product suite enables Health Plans to choose one module or a fully integrated solution to meet all CMS requirements.

Diagram of the 1upHealth Payer Solutions

Architectural Overview

1upHealth converts healthcare data from CCDA and HL7v2 to FHIR® by extracting the patient's health history from the source data file into a highly organized RESTful API.

The 1up payer platform provides an API Gateway that enables connectivity to Health Plan member applications, third-party applications, and other data management tools.

Diagram of the 1upHealth Payer Platform architecture