FHIR APIs That Meet CMS Requirements and Scale

CMS mandates require healthcare payers to expose specific FHIR R4 APIs for patient access, provider directory, payer-to-payer exchange, and prior authorization. Implementation is technically complex — requiring deep knowledge of HL7 FHIR specifications, healthcare data standards, and the operational workflows these APIs support. We provide the architecture leadership and technical expertise to get it right.

What We Deliver

• Patient Access API (CMS-9115) — Design and implement FHIR R4 APIs that give members access to their claims, clinical data, and coverage information
• Provider Directory API — Build standards-compliant provider directory APIs that meet CMS requirements for accuracy and accessibility
• Payer-to-Payer Data Exchange — Implement secure, standards-based data exchange between health plans to support member transitions
• Prior Authorization API — Design APIs that support electronic prior authorization workflows, reducing administrative burden and improving turnaround times
• FHIR Architecture Design — Design the underlying architecture — FHIR servers, data mapping layers, authentication, and integration patterns — for performance, security, and maintainability
• Data Mapping & Transformation — Map your existing claims, clinical, and administrative data to FHIR resources with accurate, complete data representation

Related Services

For organizations that need broader regulatory compliance support beyond FHIR APIs, our CMS Compliance Assessment & Resolution service provides end-to-end compliance guidance.

Why The Asior Group

We combine deep healthcare interoperability knowledge with enterprise architecture discipline (TOGAF 9) and cloud architecture expertise (GCP-PCA). Our FHIR implementations are designed not just to meet today's CMS requirements, but to serve as the foundation for your organization's broader data exchange strategy.