CMS-0057 & Policy
Provider Access API
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
The attribution problem (which providers may see which members) is the design center: payers must maintain a defensible provider-patient relationship process. For prior auth specifically, giving providers visibility into existing authorizations reduces duplicate requests and status-check phone traffic.