# 1up Provider Directory Centralize your in-network provider data in a CMS-compliant, FHIR®-first directory. ## Benefits ### Provider Data You Can Rely On Keeping provider data accurate and compliant is hard. 1up Provider Directory centralizes provider information into a standards-based, FHIR® directory that stays current and supports public, CMS-compliant discovery. With CMS-4208-F2 raising the stakes beyond CMS-9115-F — adding Medicare Plan Finder submission requirements and annual executive attestation — health plans need a solution they can trust. Built on HL7® FHIR® R4 and live since 2021, 1up Provider Directory gives health plans the accurate, standardized data they need to confidently meet both rules. #### Accurate Provider Information Ensures provider information stays consistent and up to date across all networks with automated updates. ### Reduce Enrollment Risk Avoids Medicare Plan Finder suppression with a solution designed to meet CMS-4208-F2 requirements before the October 2026 deadline. ### Attest With Confidence Gives executives a reliable foundation to sign off on the accuracy of the provider directory with confidence. ### Better Access to Care Makes it easier for members and providers to find in-network options, supporting referrals, care coordination, and informed enrollment decisions. 1upHealth has done well with their service and attention to detail. I have a team of people from the vendor that I talk to regularly, and they are just open books. VP/Other Executive, January 2025, collected by KLAS Research ## Compliance ### CMS Compliance Made Easy Meet CMS-9115-F and CMS-4208-F2 Provider Directory requirements with a fully managed solution, without taking on the complexity yourself. ### Provider Directory FHIR API Public-facing FHIR R4 API that requires no authorization and makes in-network providers easy to discover by other providers, members, and third-party applications. ### Provider Directory Usage Reporting Pre-built dashboards that show how your public API is being used, including request volume, access patterns, and resource activity. ## How It Works A simple workflow for publishing and maintaining accurate in-network provider data. ### Provider Data Ingestion Provider data is ingested from source systems, validated, and mapped into clean, standards-based FHIR R4 resources per the Da Vinci Plan Net Implementation Guide. ### API Publication 1up publishes a public, CMS-compliant Provider Directory API for easy discovery and reuse. ### In-Network Provider Discovery Member-facing tools, provider systems, CMS, and third-party applications use the directory to find in-network doctors and facilities. ### Continuous Updates Ongoing synchronization ensures provider changes are reflected within required timeframes and remain accessible to all. ## FAQs **What data must be included?** All CMS-regulated payers must include the provider name, network status, address, phone number, and specialty for in-network providers. All Medicare Advantage prescription drug plans (MA-PD) must include pharmacy name, address, phone number, network count, and pharmacy type for in-network pharmacies. **How often is provider data updated?** Provider data is updated within CMS-required timeframes after changes are received (within 30 days). **Does the 1up Provider Directory support third-party applications?** Yes. The standardized FHIR format allows developers to build apps that help members find and compare providers. **How does CMS-4208-F2 Medicare Plan Finder impact Provider Directory?** CMS-4208-F2 requires Medicare Advantage plans to submit provider directory data to Medicare.gov’s Plan Finder by October 1, 2026, via a public FHIR® API or machine-readable file. Plans must support a centralized patient search experience and CMS-operated provider lookup tools, maintain traceable relationships from MA plan to network to providers and facilities using contract-plan-segment IDs, and complete an annual executive attestation for provider directory accuracy. Non-compliance risks suppression in the Medicare Plan Finder during open enrollment. 1up Provider Directory provides accurate, standardized provider data that health plans need to meet CMS-4208-F2 requirements, support Medicare Plan Finder submissions, and give executives a reliable foundation for annual attestation. ## Additional Resources Blog - CMS-4208-F2 Provider Directory Requirements for Medicare Advantage Plans (2026): What Plans Need to Know CommercialMedicaid - 1up Partner Program CommercialMedicaid - What Sets 1upHealth Apart from Other Vendors CommercialMedicaid - 1up Provider Directory ## Ready to Simplify In-Network Provider Data? Meet CMS-9115-F and CMS-4208-F2 requirements, protect enrollment, and make it easier for members to find in-network care with 1up Provider Directory.