DEMO: Do NOT upload PHI or real patient data. Contact Redix for production licensing.

Prior Authorization Workflow and API Sandbox

Electronic prior authorization from order to a simulated determination, with synthetic data — a demonstration, not a certified or production system

Live APIs PAS CRD DTR Patient Access Provider Access Payer-to-Payer
PAS
Patient
Provider
Payer
CRD
DTR
Choose how to explore
Explore the workflow →
Sign in to a test EHR, request prior authorization for a synthetic patient, complete the documentation, submit it and follow its status and history.
Real SMART sign-in to a public test EHR (user launch, not SMART Backend Services) · synthetic patient · Redix workflow API, not Da Vinci PAS transport · payer review shown in guided walkthroughs · not connected to QNXT or a live payer
Explore the APIs ↓
Step through CRD, DTR and PAS with Redix demonstration endpoints, or call each API in the explorer below.
Synthetic data · decisions simulated automatically · public demo key · not a compliance certification

Also available: the SMART questionnaire walkthrough (a questionnaire pre-filled after a SMART launch against Redix’s test simulator; PAS step simulated).

Select Clinical Scenario

Choose a procedure to walk through the prior authorization workflow

Total Knee Replacement
CPT 27447
MRI Brain w/ Contrast
CPT 70553

Prior Authorization Support (PAS)

Da Vinci PAS — submit ($submit) and check the status of ($inquire) prior authorization requests. Decisions in this demonstration are simulated.

GET /api/pas/metadata
POST /api/pas/Claim/$submit
POST /api/pas/Claim/$inquire
POST /api/pas/Claim/$cancel Redix demo shortcut; in the PAS guide, cancellations are sent through $submit

Patient Access API

CMS-required Patient Access API — claims, coverage, and explanation of benefits

GET /api/patient/Claim
GET /api/patient/ClaimResponse
GET /api/patient/Coverage
GET /api/patient/ExplanationOfBenefit

Provider Access API

Provider Directory and patient data access endpoints

GET /api/provider/Patient
GET /api/provider/Practitioner
GET /api/provider/Organization

Payer-to-Payer API

Health plan data exchange — consent management and bulk data export

POST /api/payer/Consent
GET /api/payer/Consent
POST /api/payer/Group/$export
GET /api/payer/Claim
GET /api/payer/Coverage

Coverage Requirements Discovery (CRD)

CDS Hooks-based real-time coverage requirements checking at the point of order entry

GET /cds-services
POST /cds-services/order-sign-crd
POST /cds-services/order-select-crd
GET /crd/rules

Documentation Templates and Rules (DTR)

SMART-on-FHIR questionnaires and clinical decision support libraries

To see a questionnaire started by a SMART on FHIR launch, try the SMART DTR walkthrough (public test environment; simulated authorization decision).

GET /fhir/Questionnaire
GET /fhir/Library
GET /smart/.well-known/smart-configuration

About CMS-0057-F Compliance

CMS-0057-F requires impacted payers to provide FHIR-based Patient Access, Provider Access, Payer-to-Payer and Prior Authorization APIs, with API requirements generally beginning January 1, 2027. CMS recommends the HL7 Da Vinci CRD, DTR and PAS guides for prior authorization. This sandbox lets you explore Redix demonstration endpoints for those areas with synthetic data and simulated decisions. Using it does not establish compliance.