PAS (Prior Authorization Support) FHIR API Specification

Service Overview

InterSystems PAS (Prior Authorization Support) REST-based FHIR APIs are designed in compliance with the CMS-0057-F regulationsOpens in a new tab. PAS facilitates efficient and accurate prior authorization processes, benefiting both payers and providers.

Refer to the Getting Started section for information on connectivity, authentication and how to get help.

To use the REST-based FHIR APIs, you will need to know the base URL of the FHIR server you will be connecting to. You can also retrieve the PAS capability statement for the service.

PAS Capability Statement

You can retrieve the Capability Statement for PAS services with a call to the metadata endpoint. Authorization is not required when calling this endpoint.

Your call should be of the form:

<BaseURL>/csp/healthshare/<namespace-identifier>/pas-v<IG version>/metadata

where <BaseURL> and <namespace-identifier> have been provided to you by the payer organization you are connecting with, and <IG version> is the version number of the PAS Implementation Guide you are working with. For example, this could be version 2.0.1 or version 2.1.0.

Available APIs

The APIs available with the PAS service are:

• $submit

• $inquire

• Subscription

Implementation Guides

The PAS service conforms to the following implementation guide(s):

• Da Vinci Documentation Prior Authorization SupportOpens in a new tab implementation guide, version 2.0.1.