1up Provider Access | Real-Time Data for Better Member Care

1up Provider Access

Deliver timely clinical and claims data to your provider partners using FHIR®-based APIs.

Benefits

Effortless Provider Access

Sharing member data with your provider partners is often slow, manual, and hard to manage. 1up Provider Access replaces that complexity with secure, FHIR-based data sharing at scale, while enabling you to maintain control of attribution, consent, and access.

Providers receive data through the tools they already use, including EHRs and existing portals, or a lightweight 1up-hosted interface. Built-in reporting and granular controls give you clear visibility into – and power over – what is shared and with whom.

Better Clinical Decisions

Gives providers a more complete patient history directly at the point of care.

Lower Operational Burden

Eliminates flat files, custom extracts, and ad-hoc requests with standardized APIs and managed provider onboarding.

Improved Member Care

Supports timely, appropriate member care by reducing delays, gaps, and unnecessary services.

Stronger Provider Relationships

Builds trust and strengthens value-based care relationships by giving providers the data needed to improve quality performance.

If I were hypothetically in the market for a vendor to help with CMS interoperability rules, I would 100% go with 1upHealth. They are the best. I like that they are ahead of the game when it comes to knowing and understanding what the rules are, the timeline of those rules, and the implementation of those rules.

— VP/Other Executive, January 2025, collected by KLAS Research

Compliance

CMS Compliance Made Easy

Everything you need to meet CMS-0057-F Provider Access requirements.

Provider Access FHIR APIs

FHIR-based APIs with secure OAuth2 authorization, allowing providers to securely access attributed member health data.

Attribution Ingestion

Secure SFTP ingestion for managing member-provider relationships with attribution visibility in the 1up Console.

Consent Management

Flexible opt-out management with payer-managed ingestion or a 1up-hosted UI, including CMS-aligned member education and auditability.

Features

Value Driven Beyond Compliance

1up Provider Access is more than an API. It’s a scalable healthcare data-sharing experience that drives adoption and measurable value.

How It Works

A simple, end-to-end workflow built for Provider Access.

Provider Attribution

Payers share member-provider relationships to define authorized data access.

Member Consent

Payers share member opt-out preferences, or 1upHealth collects them on the payer’s behalf.

Provider Registration

Providers register once on the 1up Platform and receive read-only API access.

Secure Data Requests

Providers make FHIR API calls to retrieve attributed member data.

Data Controls

Data sharing rules and filtering are enforced automatically.

Reporting & Oversight

Payers monitor activity, usage, and compliance in the 1up Console.

Demo

See 1up Provider Access in Action

Explore interactive product tours showing how payers stay in control of attribution and data pipelines while providers get instant access to member data through their systems.

FAQs

Is 1upHealth’s provider onboarding process payer-agnostic?

Yes. Providers register once through our developer portal, where their organization and credentials are verified. Once approved, providers can access data only for members they are actively attributed to.

How are providers validated before they’re allowed to access data?

1upHealth verifies provider organizations, roles, and credentials through a structured vetting process. Access is always limited to attributed members, with optional payer-supplied National Provider Identifiers (NPIs) to accelerate approval.

How is provider attribution managed and kept up to date?

Payers manage attribution and update it as care relationships change. Access automatically reflects the latest attribution lists, ensuring providers only see data for their current patients.

What data can providers access through the 1up Provider Access API?

Providers can access claims, clinical, encounter, and prior authorization data for attributed members, excluding remittances and cost-sharing by default, through secure FHIR-based APIs.

How are members informed about their opt-out rights?

Members are opted in to provider data sharing by default but can opt out at any time, as required by CMS. 1upHealth provides payers with plain-language education materials to support member communications. If a payer uses 1up’s configurable opt-out UI, the workflow includes clear education on benefits and member choice.

How is access handled for large provider groups or multiple NPIs?

1up Provider Access supports both individual providers and multi-NPI organizations. Provider groups can access data across multiple NPIs under a single, validated organization, while individual providers are limited to their own NPI – ensuring flexibility without compromising access controls.

Additional Resources

Turn Provider Access into a Strategic Advantage

Strengthen care coordination. Improve value-based care. Increase provider satisfaction. Meet CMS-0057-F seamlessly with 1up Provider Access.