Financial
Exchange information about money that's due and money that's paid.
Prior Authorizations
Authorization interfaces are used to communicate information about authorization requests and decisions that can be used for insurance operations.
In outgoing interfaces, the authorization information is being sent to an external system.
Outgoing Additional Information to Support a Health Care Services Authorization Query
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Used in conjunction with an Outgoing Referral Request for Review - 278R, provides supporting clinical documentation for the request. Follows ANSI X12 specification 005010X211, ANSI X12 275 for Authorization, Additional Information to Support a Health Care Services Review (275)
Current integrations include 
- Anthem
- Humana
- Rhyme
- Samaritan Health Plans
- United Healthcare
- Voluware
Incoming Additional Information to Support a Health Care Services Review - 275
Used in conjunction with an Incoming Referral Request for Review - 278R, provides supporting documents for the referral request. Follows ANSI X12 Specification 005010X211, ANSI X12 275 for Authorization, Additional Information to Support a Health Care Services Review.
Current integrations include
- Johns Hopkins HealthCare LLC
Outgoing Authorization Request for Review and Response (X12 278R)
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Transmits patient referral or authorization information to a third-party system. The referral/authorization information is sent in order to obtain authorization for health care services (such as specialty referrals and procedures) with clearing houses and payers. It uses ANSI X12 278 transactions.
Current integrations include
- AccuReg
- Aetna
- Allscripts
- Anthem
- athenahealth
- Availity
- Change Healthcare
- Citra Health Solutions
- Emblem
- Ensemble Health Partners
- Evicore
- Experian Health
- GE
- Glidian
- Health Care Service Corporation
- Humana
- Humata Health
- Janus
- Quartz
- Recondo
- Redox
- Rhyme
- Symplr
- Texas - Public Health Agencies
- United Healthcare
- Voluware
- Waystar
Outgoing Authorization Inquiry (X12 278I)
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Provides the ability to inquire about the status of an existing authorization request. It uses ANSI X12 278 transactions and is used in conjunction with an Outgoing Authorization Request for Review - Outgoing Request (X12 278R) interface.
Current integrations include
- Blue Cross/Blue Shield
- Change Healthcare
- Humana
- Olive
- Recondo
- Relay Health
- United Healthcare
- WayStar