Prior-authorization testing is open using synthetic data. Start testing

Cut Paperwork, Not Care.

Prior authorization should not mean repeated phone calls, missing documents and patients left waiting.

Smart Health Network connects health plans, providers and people so requests, information and answers can move across the systems they already use. We are putting shared infrastructure to work for prior authorization, with a network designed for healthcare far beyond it.

Less chasing. Clearer answers. More time for care.

See how it works →Connect your organization →
In the news
LIFERS with Christina Farr episode — Paul Meyer, Dr. Neil Hockstein, and Aretha Rochester
LIFERS with Christina Farr (video) · July 14, 2026
Healthcare sends 9 billion faxes a year. Delaware has a better idea →
Delaware DHSS announcement image
State of Delaware · July 6, 2026
Newly launched initiative strengthens Delaware’s health information technology infrastructure →
Illustration of a stethoscope with a green checkmark seal at the end of it (Axios)
Axios · July 6, 2026
Exclusive: Rural health funds to fix prior authorization →

All news →

You can track a pizza. You should be able to follow a request for care.

Was the request received? Is something missing? Who needs to act next?

SHN can bring those answers together across the provider and health plan, so the person waiting for care does not have to piece them together by phone.

Prior authorization · synthetic example
  1. Request submitted · delivered
    Delivery confirmed by the network
  2. Received by the plan
    Source: the plan’s system · Updated 10:42 AM · Next: plan review
  3. Decision reported
    Synthetic source decision, reported by the plan
A request can also branch to More information needed, with the responsible party shown.

Illustrative Member experience, not a live patient tracker. Member-service availability will be announced separately.

See the patient experience →

When a missing document becomes a delay in care

From a recorded Delaware prior-authorization call, May 15, 2026:

Dr. Hockstein: “Well, you had my note. You did have my note.”
Reviewer: “We did not have your note.”
Dr. Hockstein: “You have no clinical information on this patient?”
Reviewer: “I have nothing attached to this patient’s request. That is why we said we could not approve it.”
Dr. Hockstein: “So it was denied without asking for additional information?”

— Neil Hockstein, MD · Delaware Surgeon General · Health Care Commission Chair · practicing head & neck surgeon

Fix the connection, not just the fax.

A provider and a health plan can each have modern software and still depend on phone calls, separate portals and repeated paperwork to finish a request.

SHN provides a common network for that work. Organizations can reuse connections, trusted information about who they are working with, and common rules instead of rebuilding the same arrangements for each relationship.

Connect once. Reach everyone. Across organizations and use cases.

N × N — separate connections

Repeat onboarding, credentials, configuration and testing across each payer-provider relationship.

N × 1 — a shared way to connect
TheHub

Establish the common connection and testing work, then reuse it as more organizations participate.

Before: separate arrangements, repeated work. Repeated onboarding, credentials, configuration and testing across payer-provider relationships (N x N).

After: one shared network, reusable connections. Establish the common connection and testing work once, then reuse it as more organizations participate (N x 1).

Reach participating organizations through supported transactions. Each organization keeps its systems, data and decisions.

Does the second connection become easier than the first? Does the fifth? That is the test.

Delaware is putting the network to work.

Delaware is investing $50 million over five years through its Rural Health Transformation Program in shared healthcare transaction infrastructure. The work brings together Medicaid, health plans, providers and technology partners, starting with prior authorization.

Other states and participants can use the same network and build on the implementation experience rather than start over.

Readiness: testing uses synthetic data and can begin before a production agreement. Limited production for accepted medical prior-authorization workflows begins December 1; January 1 is the production milestone. October 14 Virtual Connectathon held (recap) · next: the October 26 Action Forum.
Explore Delaware’s implementation →Bring your state into the shared effort →

What this means for you

Providers →
Spend less time chasing authorizations and rebuilding payer connections.
Health plans →
Help providers use the APIs you are already building.
States →
Make modernization investments work together across the market.
Patients and care teams →
See what is happening and what comes next.
HIEs and technology partners →
Extend the value of your existing services through a shared network.

Common exchange without transaction tolls.

SHN charges no fees to join or connect, and no transaction fees for designated Open Access transactions, including the designated CMS interoperability transactions.

Organizations can choose additional help operating a connection, managing their network relationships or producing authorized analysis. Those services are optional. Participants still cover their own integration and operating costs. What is included and what is optional →

October 8, 2026: Version 1.0 of the Network Rules and Participation Agreement is published. Rules & Participation →

A network competitors can trust.

SHN is a neutral public-benefit utility for organizations and people across healthcare. Its Public Benefit Corporation structure, common rules and independent Governance Council protect that purpose. An independent Data Rights Trust safeguards defined patient data rights, and a Participant Advisory Council gives users a voice in how the network evolves.

How neutrality and patient rights are protected →

Start with prior authorization. Build for the rest of care.

The same practice that requests an authorization also makes referrals, exchanges clinical information and coordinates follow-up after a hospital stay. Those jobs have different requirements, but they should not need a new underlying network every time.

SHN is common infrastructure for those interactions. Prior authorization is the first major implementation, not the limit of the network.

Cut administrative waste. Reuse the work of connecting and reduce manual handoffs, so more resources can go toward care.

Make coordinated care practical. Value-based care depends on health plans, providers and people working together across organizational boundaries.

Give AI a better foundation. Better software should not have to work around the same disconnected portals and faxes. Shared connections and clear responsibilities make useful automation easier to put to work.

See the full transaction catalog →

Common infrastructure can work across jurisdictions while institutions retain local authority over their systems and data.

For public jurisdictions and international partners →

The Team

Built by people who have done this before.

The team behind Smart Health Network has built and operated real-time health infrastructure at national scale — across providers, payers, and the standards bodies that govern how health information moves. Meet the people →

Engage

Put the network to work.

Bring a prior-authorization workflow, an existing implementation or the organizations in your market. Start with the systems you already have and identify the work that can be shared.

Connect your organization →Start testing →

Bring one workflow, one implementation challenge or the organizations in your market. Start testing, join an Action Forum or talk with the team about how to participate.

Please do not include patient information, passwords or production credentials. See our Website Privacy Policy for how inquiry information is handled.

State agencies considering an RHTP planstates@smarthealthnetwork.org
Providers and health systems ready to connect across the participating marketproviders@smarthealthnetwork.org
Payers ready to participate on shared, neutral infrastructurepayers@smarthealthnetwork.org
Council and Trust inquiriesgovernance@smarthealthnetwork.org
Press and mediapress@smarthealthnetwork.org
Developersdevelopers@smarthealthnetwork.org
Privacyprivacy@smarthealthnetwork.org
Partnership and institutional inquiriespartners@smarthealthnetwork.org

Smart Health Network PBC · A mission-locked Delaware Public Benefit Corporation