Coverage Requirements Discovery (CRD) API
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 understand whether a service is covered, identify if prior authorization is required, determine what documentation must be submitted. The CRD API aligns with HL7® FHIR®, Da Vinci implementation guides, the SMART on FHIR security framework, and CMS interoperability regulations, enabling real-time, standards-based coverage requirement discovery at the point of care.
Capability Statement
Developers can access the Acentra Health FHIR server capabilities for Coverage Requirements Discovery (CRD) API using the CapabilityStatement endpoint:
The capability statement describes the set of capabilities (behaviors) implemented by the FHIR Server to enable the Coverage Requirements Discovery (CRD) API. For example, it describes the enabled profiles, interactions, and provides information about the authorization and token endpoints.
API Access Setup
FHIR 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.
The FHIR Base URL will be provided upon successful App Registration approval.
Getting Access Token
| Section | Key | Value |
|---|---|---|
| HTTP Method | POST | https://sb.fhir.mhbapp.com/sof/oauth2/token |
| HTTP Headers | content-type | application/json |
| accept | application/json | |
| authorization | Basic base 64({client_id}:{client_secret}) | |
| HTTP Body | code | {oauth code} |
| grant_type | authorization_code | |
| redirect_uri | {your_redirect_uri} |
Hooks
Acentra Health Interoperability Solution’s Coverage Requirements Discovery (CRD) API supports the following hooks
| Hook | Endpoint |
|---|---|
| Appointment Book | https://sb.fhir.mhbapp.com/priorauth/cds-services/appointment-book-crd |
| Encounter Start | https://sb.fhir.mhbapp.com/priorauth/cds-services/encounter-start-crd |
| Order Select | https://sb.fhir.mhbapp.com/priorauth/cds-services/order-select-crd |
| Order Sign | https://sb.fhir.mhbapp.com/priorauth/cds-services/order-sign-crd |
| Order Dispatch | https://sb.fhir.mhbapp.com/priorauth/cds-services/order-dispatch-crd |
| Encounter Discharge | https://sb.fhir.mhbapp.com/priorauth/cds-services/encounter-discharge-crd |
Profiles
Acentra Health Interoperability Solution’s Coverage Requirements Discovery (CRD) API supports the following profiles
| Profile |
|---|
| CRD Appointment with Order |
| CRD Appointment without Order |
| CRD Communication Request |
| CRD Device Request |
| CRD Encounter |
| CRD Medication Request |
| CRD Nutrition Order |
| CRD Service Request |
| CRD Vision Prescription |
Request Headers
All requests for Coverage Requirements Discovery (CRD) API profiles require the following headers
| Header | Value |
|---|---|
| content-type | application/json |
| accept | application/json |
| authorization | Bearer |
Sandbox Test Data Catalog
Acentra Health Interoperability Solution’s Sandbox environment provides synthetic yet reliable test data to facilitate testing Coverage Requirements Discovery (CRD) API. The dataset is representative of real-world scenarios and ensures consistency across related resources. The identifiers provided can be used to construct API requests for testing different workflow interactions.
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 |