generated: '2026-08-14'
method: searched
source: https://1up.health/ + https://docs.1up.health/help-center/Content/en-US/get-started/cms-patient-access/developer-overview.html
  + https://1up.health/products/1up-comply/1up-provider-access-api/
plan_count: 6
name: 1upHealth API Plans and Pricing
description: >
  1upHealth offers enterprise health data interoperability solutions for payers, health plans,
  and healthcare organizations. Pricing is customized based on the specific products selected,
  number of member connections, data volume, and compliance requirements. Contact the 1upHealth
  sales team for a tailored quote. Historical pricing has ranged from approximately $200-$450
  per month per connection depending on scope and read vs. write access requirements.
specificationVersion: '0.1'
url: https://1up.health/
plans:
  - name: Patient Access API
    description: >
      FHIR-based Patient Access API for health plans to meet CMS Interoperability and Patient
      Access Final Rule requirements. Enables patients to connect their health records to
      third-party applications using SMART on FHIR and OAuth 2.0.
    url: https://docs.1up.health/help-center/Content/en-US/get-started/cms-patient-access/developer-overview.html
    pricing: Contact for pricing
    pricingModel: custom
    features:
      - SMART on FHIR OAuth 2.0 authorization
      - Full FHIR R4 patient data access
      - Clinical and claims data
      - HIPAA-compliant infrastructure
      - CMS compliance reporting
  - name: Provider Access API
    description: >
      FHIR Bulk Export API enabling in-network providers to receive member data from health
      plans. Covers USCDI v1 data classes including clinical, claims, encounter, and prior
      authorization data. Required for CMS compliance starting January 2027.
    url: https://1up.health/products/1up-comply/1up-provider-access-api/
    pricing: Contact for pricing
    pricingModel: custom
    features:
      - FHIR Bulk Export (NDJSON)
      - USCDI v1 data classes
      - Claims data from January 1, 2016 onward
      - Prior authorization data
      - Provider attribution verification
  - name: Payer-to-Payer Data Exchange API
    description: >
      FHIR Bulk Export API for payer-to-payer member data transfers during plan transitions.
      Supports CMS Interoperability and Prior Authorization Final Rule requirements for
      continuous member data portability.
    url: https://docs.1up.health/help-center/Content/en-US/api-references/apis.html
    pricing: Contact for pricing
    pricingModel: custom
    features:
      - FHIR Bulk Export for payer transitions
      - Clinical and claims data transfer
      - CMS compliance support
      - OAuth 2.0 client credentials
  - name: Provider Directory API
    description: >
      FHIR-conformant Provider Directory API maintaining accurate network provider information
      aligned with DaVinci PDEX Plan Net Implementation Guide for Medicare Advantage plans
      and Federally-facilitated Exchanges.
    url: https://1up.health/
    pricing: Contact for pricing
    pricingModel: custom
    features:
      - DaVinci PDEX Plan Net compliant
      - Practitioner and organization data
      - Network and location data
      - Real-time directory updates
  - name: Electronic Prior Authorization API
    description: >
      AI-powered electronic prior authorization solution integrating clinical data to
      streamline ePA workflows. Supports CMS Interoperability and Prior Authorization Final
      Rule compliance.
    url: https://1up.health/
    pricing: Contact for pricing
    pricingModel: custom
    features:
      - FHIR-based ePA workflows
      - AI-assisted clinical data integration
      - CMS compliance support
      - Real-time authorization status
  - name: 1up Platform (Enterprise)
    description: >
      Full-platform enterprise license providing access to all 1upHealth products including
      Patient Access, Provider Access, Payer-to-Payer, Provider Directory, Electronic Prior
      Authorization, Formulary, and the core FHIR-first data platform. Includes dedicated
      implementation support, SLA guarantees, and custom integrations.
    url: https://1up.health/
    pricing: Contact for pricing
    pricingModel: custom
    contact: https://1up.health/
    phone: +1 (888)-344-7187
    features:
      - All API products included
      - HIPAA-compliant infrastructure
      - HITRUST r2 and SOC 2 Type II certified
      - Dedicated implementation support
      - Custom SLA agreements
      - FHIR R4 full resource support
      - JSON and XML data formats
      - Bulk data export capability