UM Operations
UM Delegation
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
Delegation fragments the authorization record: a member's PAs may live across several delegates' systems, which becomes a visible problem under CMS-0057-F when the Patient Access, Provider Access, and Payer-to-Payer APIs must present unified prior-auth data. Delegation oversight now includes API data-supply obligations.