Most health plans have CMS-0057 efforts underway. But the broader CMS roadmap is already expanding — from CMS-0053 and CMS-0062-P to Provider Directory / Plan Finder modernization. OnyxOS helps turn compliance from a series of projects into infrastructure that is automated, auditable, and built to evolve.
OnyxOS embeds compliance into payer infrastructure through a FHIR-native automation platform — not a compliance layer sitting beside your systems. CMS-0057 APIs, provider directory readiness, documentation exchange, monitoring, and reporting are built to work together and evolve as CMS requirements change. Onyx helped shape these standards. We know what “done” looks like — and what it takes to stay ready.
FHIR APIs for Patient Access, Provider Access, and Payer-to-Payer exchange — supporting the CMS-9115 foundation and the expanded CMS-0057 roadmap
FHIR-native prior authorization workflows for CRD, DTR, and PAS — helping health plans meet CMS-0057 requirements while moving from manual authorization processes to connected, standards-based exchange.
Plan-Net and provider directory API readiness to support public-facing accuracy, resource completeness, data currency, pagination, API behavior, and referential integrity.
Support for the data foundation health plans need to exchange, validate, and operationalize clinical documentation and claims attachments more reliably as CMS-0053 requirements move forward.
Continuous monitoring across API endpoints, workflows, performance patterns, exceptions, and audit evidence — with readiness support as new requirements such as CMS-0062-P continue to evolve.
Machine-readable drug formulary and plan coverage data exposed through FHIR — helping members, providers, and authorized applications access accurate benefit and coverage information.
— Infrastructure that evolves with CMS requirements as they change.
— real-time monitoring means documentation and evidence are always ready, not assembled under deadline.
— Onyx's pre-built modules and standards expertise compress time-to-compliance significantly.
— integrated infrastructure replaces fragmented point solutions and the ongoing cost of stitching them together.
Onyx architected CMS Blue Button 2.0 — the largest FHIR implementation in the world. Our team has authored 20+ HL7 FHIR and C-CDA standards. OnyxOS is built on that foundation, and it's available to health plans that need to be ready for January 2027 and everything after.
A provider organization with 20+ locations faced a 30% PA denial rate and mounting administrative burden, with CMS-0057 requiring electronic prior authorization by January 2027. Disconnected EMRs and payer portals were blocking real-time data exchange. Onyx implemented a full FHIR-based ePA solution — automating PA triggers at clinical decision points within existing EMR workflows.
Read the full case studyOnyx offers a complimentary, expert-led Readiness Check that gives you a structured view of where you stand — in one week.
