Get paid faster, with less paperwork.
One standardized network path across participating payers — without replacing your EHR.
Prior authorization isn’t the product. It’s the first transaction. The product is shared administrative rails.
The connection.
One connection replaces per-payer portals, faxes, and bilateral integrations: prior authorization from your production activation — with eligibility following on the same connection as it is enabled — claims and remittance as they go live in your market, and each new catalog category after them — all on the same connection.
Three ways to connect — without replacing your EHR
The richest data path — and it reduces dependence on the EHR vendor’s native timeline.
The workflow stays entirely in the EHR, where your clinicians already work.
From the EHR marketplace — the broadest interim path for certified-EHR providers, subject to supported SMART capabilities and marketplace policies.
All three paths terminate at the same standard gateway interface — whichever operating model runs your Gateway.
And one operating-model decision
Run the Gateway in your own environment — your infrastructure, your keys. Your IT vendor or systems integrator running it on your behalf is still you operating it.
A Certified Network Partner — your HIE, EHR vendor, or integrator — operates the Gateway on your behalf. Being tested with Delaware’s state HIE.
Where available, an approved managed operating model runs the Gateway for you as an Optional Service — under your authority and the applicable key-custody controls.
Same network, same conformance requirements, same participant rights, same network participation rates.
A small practice without an integration team can have a Certified Network Partner — or an approved managed operating model where available — run its Gateway, and begin in the cloud sandbox — most providers and EHR teams start there; no production deployment is required to begin, and most deployments require outbound connectivity only. Start testing → · Get Connected →
Providers never pay SHN for prior authorization.
Prior authorization can remain free permanently. Providers that elect the broader EXPAND utility can add claims, remittance, and other network services on the same connection.
The price.
CONNECT is $0. Providers never pay SHN for prior authorization. The EXPAND economic flow — for providers that elect the broader utility — is $0 through 2028, 0.025% in 2029, and the published 0.05% Standard, on aggregate routed paid-claim volume, metered at your own gateway (no individual claim carries a charge). “Free” refers to SHN network fees; EHR-vendor, integrator, and internal costs remain the participant’s. Full pricing →
What it replaces.
The lines your CFO already budgets: eligibility-verification labor, prior-authorization staffing and follow-up (roughly 13 hours per physician-week of combined physician and staff time — AMA), status-check calls, remittance posting and reconciliation, clearinghouse fees and RCM modules, and the rework that follows front-end denials. Billing-and-insurance work has been measured at up to 14.5% of primary-care revenue (JAMA); the network fee is five one-hundredths of one percent of routed claim volume — and nothing at all through 2028 for Launch Participants. Your monthly statement shows the computed fee next to the cost it displaces, from the first month.
Launch Participant terms (EXPAND).
Commit to prior authorization by January 2027 and claims routing at your market’s claims release — no later than January 1, 2028. Pay nothing through 2028, a 0.025% transition rate in 2029, and the published 0.05% from January 1, 2030 — with a monthly statement throughout showing the computed fee alongside the cost it displaces. The window closes December 31, 2026.
Your EHR stays. Keep the systems you have. Connect them to the shared rails.
Getting connected.
Your EHR and the systems you already run stay; you connect through the standard gateway interface — operated by you, by a Certified Network Partner on your behalf, or under an approved managed operating model where available — with certified partners handling the onboarding and integration work. Onboarding and baseline conformance testing are part of ACCESS — always free — and in rural-health states, transformation funding can pay for the onboarding work. Start in the sandbox today; prove conformance at a Connectathon. The green conformance result is technical readiness evidence — not production approval by itself. Production activation also requires executed agreements, production credentials, and completed launch checks. Local Test Kit — create a free developer account and see the workflow run on synthetic data in minutes; a reference implementation for testing, not the deployment path. See it work →
This is not an IT project for your practice — certified partners and state funding do the connection work. Your state’s health information exchange, your EHR vendor, and revenue-cycle firms do it using the systems you already run, and states are funding provider onboarding. Eligible providers in participating state programs pay nothing to connect, and Launch Participants pay no SHN fee through 2028. Say yes to the invitation; the network does the rest. Connect directly, or through a certified partner — same network, same network participation rates. →
Per-transaction benchmarks are published third-party figures (CAQH Index; AMA survey data). Results vary by organization, starting cost, route migration, participation levels, and decommissioning timing; whether the network clears your fee is computed from your numbers in a working session, and each participant sees its own computed fee alongside displaced cost on its monthly network statement.