Streamline Prior Authorization with CMS-0057F Compliant SMART on FHIR application

Starting January 1, 2027, the CMS-0057F rule requires payers to provide real-time prior authorization (PA) data requests through certified EHR systems, eliminating phone calls and faxes for PA status or clinical data.

Payer Data Right in Your Workflow

Smart Forms & Pre-Filled Documentation

Simple Clinical Data Exchange

Complete PA Lifecycle Support

Payer Data Right in Your Workflow

Clinical Data & Claims Overview

View outstanding authorizations, approvals, and clinical summaries without leaving the patient chart.

Instant PA Status Updates

Know in seconds whether a request is pending, approved, or needs more information—no more guessing or delays.

Gaps in care

Missed guideline-based services hurt quality and costs; payers use data-driven alerts, outreach, and incentives to close gaps.

Smart Forms & Pre-Filled Documentation

Auto-Populate from the EHR

Pull in patient demographics, diagnoses, and procedure codes automatically.

Built-In Clinical Logic

Underlying rules steer you through specialty-specific requirements—no more hunting down PDFs or clinical guidelines.

Intuitive Questionnaires

Guided prompts help staff complete forms correctly the first time.

Simple Clinical Data Exchange

Direct FHIR Attachments

Send images, reports, and structured data straight to the payer’s PA portal.

Task-Based or Query-Based Sharing

Choose automated batch transfers or on-demand lookups to fit your workflow.

Maintain Audit Trails

Every document you share is tracked for compliance and quality reporting.

Complete PA Lifecycle Support

One-Click Submission

Send your FHIR-based PA request instantly—no manual coding or attachments.

Live Status Tracking

Follow the request through payer review, additional info requests, and final decision.

Fallback for Legacy Workflows

Where X12-278 is still in use, we bridge the gap so nothing falls through the cracks.

Ready for the Real-World

Works with Your Systems—No Rip-and-Replace

EHR Marketplace Ready

Plug-in via to your EHR using your EHR’s third party app marketplace.

Any SMART on FHIR-Enabled EHR

Integrates smoothly with Cerner, Allscripts, athenahealth, and more.

Standards-Based & Future-Proof

Built on HL7® FHIR® R4, Da Vinci Implementation Guides, and OAuth 2.0 security.

Get Started Today

Don't let CMS-0057F compliance become a crisis.

Our team of healthcare interoperability experts is ready to fast-track your compliance journey. With HIKE HEALTH's SMART on FHIR solution, you can focus on what matters most – serving your members and providers – while we handle the technical complexity.

Contact HIKE HEALTH and make regulations your competitive edge.

HIKE HEALTH is a healthcare interoperability business associate that helps U.S. payers adopt advanced technology. Our SMART on FHIR platform delivers the fastest route to CMS-0057F compliance while laying the groundwork for future innovation.

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