PayerNetwork

Free self-assessment

Where does your CMS-0057-F program actually stand?

A short survey, not a sales call. Ten minutes of questions covering all four mandated APIs plus the prior-authorization process requirements, so you know which gaps to scope first.

Most CMS-0057-F conversations start with a vendor demo before anyone's actually mapped what's already built, what's half-built, and what hasn't started. That's how a scoped six-month project turns into an open-ended one.

This survey exists to skip that step. It's the same set of questions we'd ask in a discovery call, just without the call: where each API stands today, what your current claims and UM systems already expose, and where the prior-authorization turnaround-time and reporting requirements are likely to bite first.

What it covers

Six sections, same order as the rule itself

Patient Access API

Whether prior-auth status and denial-reason data are already flowing through an existing Patient Access API, or still need to be added.

Provider Access API

In-network attribution, opt-out handling, and whether backend-services SMART App Launch is already in place for provider authentication.

Payer-to-Payer API

Consent and opt-in workflow maturity, and whether a $member-match and bulk-data export approach exists yet.

Prior Authorization API (CRD/DTR/PAS)

CQL rule authoring, DTR questionnaire tooling, and PAS submission handling, plus who owns rule maintenance today.

Process & turnaround-time compliance

How close current UM workflows are to the 72-hour/7-day decision windows and the mandatory denial-reason requirement.

Public reporting & audit

Whether the public prior-auth metrics report can be generated today, and how defensible the audit trail behind it actually is.

Take the survey

Ten minutes, no sales call attached. Answers stay with you; we don't see them unless you choose to share your results with us.

Start the readiness survey →