Coverage Requirements Discovery (CRD)

Real-time coverage requirement discovery at the point of care — exposing payer coverage rules to EHR systems while treatment decisions are made.

Implementation GuideDa Vinci CRD

VersionV 2.2.0-ballot (STU 2.2 Ballot)open_in_new

SecurityCDS Hooks · SMART

Base Path/priorauth/api/v1

policy

Overview

The Coverage Requirements Discovery (CRD) API is a FHIR®-based interoperability API that enables payers to expose coverage requirement information to EHR systems in real time while treatment decisions are being made.

This allows clinicians and administrative staff to determine whether a service is covered, identify if prior authorization is required, and determine what documentation must be submitted. CRD aligns with HL7® FHIR®, Da Vinci IGs, the SMART on FHIR security framework, and CMS interoperability regulations.

fact_check

Capability Statement

Developers can access the Acentra Health FHIR server capabilities for the CRD API using the CapabilityStatement endpoint:

METAhttps://sb.fhir.mhbapp.com/priorauth/api/v1/metadata

View JSON

The CapabilityStatement describes the supported profiles, interactions, and authorization and token endpoints.

API Access Setup

settings_suggestFHIR SMART Configuration

Clients can retrieve SMART configuration details by invoking the SMART configuration endpoint at /.well-known/smart-configuration, appended to the FHIR Base URL.

vpn_key

The FHIR Base URL is provided upon successful App Registration approval.

bolt

CDS Hooks

The CRD API supports the following CDS Hooks services.

HOOKappointment-bookhttps://sb.fhir.mhbapp.com/priorauth/api/v1/cds-services/appointment-book-crd

HOOKencounter-starthttps://sb.fhir.mhbapp.com/priorauth/api/v1/cds-services/encounter-start-crd

HOOKorder-selecthttps://sb.fhir.mhbapp.com/priorauth/api/v1/cds-services/order-select-crd

HOOKorder-signhttps://sb.fhir.mhbapp.com/priorauth/api/v1/cds-services/order-sign-crd

HOOKorder-dispatchhttps://sb.fhir.mhbapp.com/priorauth/api/v1/cds-services/order-dispatch-crd

HOOKencounter-dischargehttps://sb.fhir.mhbapp.com/priorauth/api/v1/cds-services/encounter-discharge-crd

dataset

Profiles

The CRD API supports the following profiles.

datasetCRD Appointment with OrderdatasetCRD Appointment without OrderdatasetCRD Communication RequestdatasetCRD Device RequestdatasetCRD EncounterdatasetCRD Medication RequestdatasetCRD Nutrition OrderdatasetCRD Service RequestdatasetCRD Vision Prescription

http

Request Headers

All requests for CRD API profiles require the following headers:

Header	Value
content-type	application/json
accept	application/json
authorization	Bearer {access_token}

science

Sample Responses & Data

gpp_good

Important Information for EHR Systems

Topic	Reference
Privacy, Security and HIPAA	https://www.healthit.gov/topic/privacy-security-and-hipaa
ONC Model Privacy Notice	https://www.healthit.gov/topic/privacy-security-and-hipaa/model-privacy-notice-mpn