What is CMS-0057-F Prior Authorization?

CMS-0057-F is a federal rule requiring payers to implement a Prior Authorization API using FHIR by January 1, 2027. It mandates electronic processing of X12 278 Prior Authorization requests via FHIR-based APIs compliant with the Da Vinci PAS Implementation Guide.

How does Redix support X12 278 to FHIR conversion?

Redix provides bidirectional conversion between X12 278 Request/Response and FHIR Claim/ClaimResponse resources, supporting both the request and response workflows required for CMS PAS compliance.

What is the Da Vinci PAS Implementation Guide?

The Da Vinci Prior Authorization Support (PAS) Implementation Guide defines the FHIR-based API specification for electronic prior authorization. It maps X12 278 transactions to FHIR resources, enabling real-time prior authorization processing.

CMS PAS 278 Prior Authorization

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X12 278 to FHIR:

FHIR to RMap:

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Only X12 278 Request or 278 Response files (max 50KB)

Paste X12 278 Content: 0 characters (max 51,200 for 50KB limit)

CMS PAS 278 Prior Authorization

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Conversion Complete

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Conversion Summary