1upHealth · Pricing Plans

1Up Health Plans Pricing

1upHealth offers enterprise health data interoperability solutions for payers, health plans, and healthcare organizations. Pricing is customized based on the specific products selected, number of member connections, data volume, and compliance requirements. Contact the 1upHealth sales team for a tailored quote. Historical pricing has ranged from approximately $200-$450 per month per connection depending on scope and read vs. write access requirements.

1Up Health Plans Pricing is the machine-readable pricing-plan profile for 1upHealth on the APIs.io network, conforming to the API Commons Plans specification.

It defines 6 plans, with named plans including Patient Access API, Provider Access API, Payer-to-Payer Data Exchange API, Provider Directory API, Electronic Prior Authorization API, and 1 more.

Tagged areas include FHIR, Health Data, Interoperability, Patient Access, and HL7.

6 Plans
View Source
FHIRHealth DataInteroperabilityPatient AccessHL7SMART on FHIRHealthcarePayerClaimsElectronic Prior Authorization

Plans

Patient Access API

FHIR-based Patient Access API for health plans to meet CMS Interoperability and Patient Access Final Rule requirements. Enables patients to connect their health records to third-party applications using SMART on FHIR and OAuth 2.0.

Provider Access API

FHIR Bulk Export API enabling in-network providers to receive member data from health plans. Covers USCDI v1 data classes including clinical, claims, encounter, and prior authorization data. Required for CMS compliance starting January 2027.

Payer-to-Payer Data Exchange API

FHIR Bulk Export API for payer-to-payer member data transfers during plan transitions. Supports CMS Interoperability and Prior Authorization Final Rule requirements for continuous member data portability.

Provider Directory API

FHIR-conformant Provider Directory API maintaining accurate network provider information aligned with DaVinci PDEX Plan Net Implementation Guide for Medicare Advantage plans and Federally-facilitated Exchanges.

Electronic Prior Authorization API

AI-powered electronic prior authorization solution integrating clinical data to streamline ePA workflows. Supports CMS Interoperability and Prior Authorization Final Rule compliance.

1up Platform (Enterprise)

Full-platform enterprise license providing access to all 1upHealth products including Patient Access, Provider Access, Payer-to-Payer, Provider Directory, Electronic Prior Authorization, Formulary, and the core FHIR-first data platform. Includes dedicated implementation support, SLA guarantees, and custom integrations.