About 1upHealth Provider Access

As a provider, you can make requests to our Provider Access API and export payer data for members you have an upcoming or active treatment relationship with. To do so, you’ll first need to sign up for Production access in the 1up Dev Portal. Once your organization has been verified, you will be able to generate Client Credentials that allow you to retrieve an authorization token. This token can then be used to make requests to the Provider Access API and export data for your Patients.

While you wait for Production access, you’ll be able to create Sandbox clients if you would like to test out our API and export some mocked FHIR Patient data.

CMS Requirements

As part of the rule CMS-0057-P, finalized in 2024, payers must make their health plan member’s data available to their attributed provider. Additionally, patients need to be able to opt out of this data sharing if desired. Click here to learn more about this requirement.

1up’s Provider Access Architecture

Payers are able to attribute health plan members to their respective providers through the use of organization level NPIs. The Payer’s attribution data is ingested into our 1up FHIR Platform and is leveraged by our data access policies to return the proper Patient data on a Provider Access Bulk FHIR Export request.

The 1up Provider Access API is a bulk FHIR data API that meets the HL7 FHIR Bulk Data API specification.

In order to make a request to this Provider Access API, an access token must be supplied that identifies the Provider organization. This token is obtained through a OAuth 2.0 client credentials flow, enabled by our 1up Dev Portal.

After making a valid FHIR Bulk Export request, you will receive a URL to track the asynchronous job exporting your Patients’ data. Once complete, you will be given additional URL(s) to download your exported Patient data as .ndjson files. All of these requests will be made with the same authorization token retrieved on behalf of your client.