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
Electronic prior authorization from order to a simulated determination, with synthetic data — a demonstration, not a certified or production system
Also available: the SMART questionnaire walkthrough (a questionnaire pre-filled after a SMART launch against Redix’s test simulator; PAS step simulated).
Choose a procedure to walk through the prior authorization workflow
Da Vinci PAS — submit ($submit) and check the status of ($inquire) prior authorization requests. Decisions in this demonstration are simulated.
CMS-required Patient Access API — claims, coverage, and explanation of benefits
Provider Directory and patient data access endpoints
Health plan data exchange — consent management and bulk data export
CDS Hooks-based real-time coverage requirements checking at the point of order entry
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).
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.