Provider access API

API overview

Utah Medicaid's Provider Access API is an enterprise API that implements the HL7 FHIR standard. This allows providers to securely request a patient’s clinical data from the payer when there is an active treatment relationship. Typical patient data includes claims, clinical records, medications, and encounter details, helping improve care coordination and decision-making.

Information for patients about the benefits of API data exchange by impacted payers must be in plain language and include how a patient can opt out.

The Provider Access API follows the SMART Backend Services security model.

Capability statement

Developers, for the capability statement please reference https://fp.medicaid.utah.gov/ProviderClient/metadata .

The capability statement outlines versions, authorizations, resources, profiles, interactions, search parameters, and end points.

Getting started

In order to access the API, Providers will need to register by completing the form found on the Provider Registration page.

Authorize URL format:

https://sso.mylogin.utah.gov:443/am/oauth2/authorize?client_id={your_client_id}&redirect_uri={your_redirect_url}&response_type=code

Getting access token:

HTTP method: POST

URL: https://sso.mylogin.utah.gov:443/am/oauth2/access_token

HTTP headers:

Header name	Value
content-type	application/json
accept	application/json
authorization	Basic base 64({client_id}:{client_secret})

HTTP body:

Field name	Value
code	{oauth code}
grant_type	authorization_code
redirect_url	{your_redirect_uri}

Explore API

API documentation:

https://fp.medicaid.utah.gov/VendorService/developerapi?resource=developer_patient_api

Resources

The API supports the following resources:

Resource	URL
Coverage	https://fp.medicaid.utah.gov/ProviderClient/Coverage
Endpoint	https://fp.medicaid.utah.gov/ProviderClient/Endpoint
ExplanationOfBenefit	https://fp.medicaid.utah.gov/ProviderClient/ExplanationOfBenefit
HealthcareService	https://fp.medicaid.utah.gov/ProviderClient/HealthcareService
InsurancePlan	https://fp.medicaid.utah.gov/ProviderClient/InsurancePlan
Location	https://fp.medicaid.utah.gov/ProviderClient/Location
Metadata	https://fp.medicaid.utah.gov/ProviderClient/metadata
OperationDefinition	https://fp.medicaid.utah.gov/ProviderClient/OperationDefinition
Organization	https://fp.medicaid.utah.gov/ProviderClient/Organization
OrganizationAffiliation	https://fp.medicaid.utah.gov/ProviderClient/OrganizationAffiliation
Patient	https://fp.medicaid.utah.gov/ProviderClient/Patient
Practitioner	https://fp.medicaid.utah.gov/ProviderClient/Practitioner
PractitionerRole	https://fp.medicaid.utah.gov/ProviderClient/PractitionerRole
RelatedPerson	https://fp.medicaid.utah.gov/ProviderClient/RelatedPerson
StructureDefinition	https://fp.medicaid.utah.gov/ProviderClient/StructureDefinition

Request header:

All API resource requests require the following headers:

Header name	Value
content-type	application/json
accept	application/json
authorization	Bearer {ACCESS_TOKEN}

Regulatory information

Resource
CARIN Alliance Code of Conduct , opens in a new tab
CMS Best Practices for Payers and App Developers , opens in a new tab
CMS Regulations and Guidelines , opens in a new tab
Privacy, Security, and HIPAA , opens in a new tab
ONC Model Privacy Notice , opens in a new tab