Questions about the shared network
What is SHN?
SHN is a neutral public-benefit network that helps health plans, providers and people work together across existing systems. Prior authorization is the first major implementation of infrastructure designed for many healthcare transactions.
Is SHN just a prior-authorization service?
No. Prior authorization is an immediate way to put the network to work. The common connection, trust and participation framework can support additional transactions, each with its own requirements and availability.
Does SHN decide whether care is approved?
No. Health plans retain coverage decisions and clinicians retain care decisions. SHN connects the requests, information and responses between responsible parties.
Do we have to replace our EHR or payer system?
No. Start with the systems and partners you already use. Your implementation may still need configuration, integration and testing for the supported workflow.
Does connect once mean every organization is immediately reachable?
No. It means the underlying connection and applicable trust work can be reused. The other organization must participate in the relevant supported interaction, and the required permissions and operating conditions still apply.
What does SHN charge for?
Common participation and designated Open Access transactions have no SHN fees. Optional services cover additional operating, management, analytical or coordination work. Your own integration and vendor costs may still apply. The published Rules & Participation package contains the complete fee structure, and the Open Access page lists the seventeen Transaction Types in the published Catalog.
Can a small practice participate without running infrastructure?
A practice can use an appropriate EHR or workflow partner, qualified operator or supported managed arrangement. The implementation review identifies the practical route and its costs.
Can patients use a tracker today?
The public Member-service launch will be announced separately. Current illustrations show the intended experience, not a live view of an individual’s authorization. For a current request, contact the provider or plan.
Do individual rights depend on becoming a Member?
No. Defined protections under the Network Rules also apply to people who never create an SHN account. The privacy contact can direct access, correction and complaint requests into an appropriate secure process.
Does the Hub read patient information?
The Hub routes encrypted messages without holding the keys to read their contents. Authorized systems and services outside the Hub handle the information needed for their respective work. The Hub’s records are not a universal clinical record.
Can a state pay for provider adoption or additional program services?
Yes, within its applicable authority and approved scope. A state can define eligible provider-adoption work and separately commission optional operating or analytical services. Funding does not create new information rights or substitute for required approvals.
How do we start?
Bring one supported workflow and the relevant implementation lead. Explore the connection, test with synthetic data and complete the arrangements needed before live use.
Does every interaction use the Hub?
The Hub is the common road between participants’ Gateways — the path the Network makes easiest, most tested and most valuable. The Network can also recognize other qualified paths where an interaction, existing infrastructure or a jurisdiction requires them. Those alternatives preserve flexibility without changing the common trust framework.
Can Open Access change without our knowledge?
More connections do not create a charge. Open Access is established through the Network Rules and Fee Schedule; changes require Governance Council approval and the applicable notice and participant protections. An included step cannot become paid just because it is renamed.
Does using Smart Health Network change who is responsible for the underlying healthcare transaction?
No. Network participation does not reallocate responsibility between plans, providers or other participants. Each remains responsible for its own acts, decisions and obligations under applicable law and its existing relationships. SHN is responsible for the Network and any services it actually undertakes.
Does testing commit us to production?
No. Test-environment terms apply, but a synthetic test is not a production purchase or approval. Before carrying live traffic, the parties complete the agreements and technical, security and operating checks for the actual connection.
Does participation establish regulatory compliance?
No. It supports implementation and produces evidence about the functions tested. Plans retain their regulatory responsibilities; SHN testing is not CMS certification. Detailed regulatory context is on Ready for January.
How is information protected?
The routing Hub is designed to carry encrypted healthcare messages without the keys to read them. Authorized systems handle the information needed for the work. Rules and service terms limit access, retention and use. Hosting or participation does not permit independent resale, unrelated model training or disclosure of a participant’s identifiable performance to competitors. SHN has completed a SOC 2 Type II examination; the report is available for participant security review under standard security-review terms.
What happens if a service fails or we stop using it?
The production terms specify support, incident communication, recovery and transition. SHN is responsible for its own service obligations. Ending an optional purchase does not erase included rights or required records. Changing Gateway operators needs a handover plan for unfinished requests and later updates, not just an export of old records.
Last updated: October 2026