ACCESS API Explorer PROTOTYPE

CMS ACCESS Model FHIR API Demo — Enrollment Workflow

Mock Server: http://localhost:8080 | Swagger Docs | IG v0.9.1 | FHIR R4
1Check Eligibility
2Align Patient
3Pull Claims (BCDA)
4Report OAP Measures
5Submit G-code Claim
6Unalign Patient

Check Eligibility — POST /Patient/$check-eligibility

Request Profile | Response Profile | Result Codes

Align Patient — POST /Patient/$align

Request Profile | Response Profile | Result Codes

Pull Claims — BCDA Sandbox Bulk Export

BCDA User Guide | BCDA Swagger | Data Dictionary
BCDA Sandbox: checking...
Triggers a real BCDA sandbox bulk export. Synthetic Medicare claims data for ~50 beneficiaries (XS sandbox).

Report OAP Measures — POST /Patient/$report-data

Request Profile (Draft) | Response Profile (Draft) | Result Codes
Note: This API is not yet published in the CMS IG (v0.9.1). The structure shown is our best-guess based on the IG async pattern and RFA measure requirements.

Submit G-code Claim — POST /claims/submit

ACCESS Model | RFA pp. 26-27 (Billing & Claims Processing) | 837P / CMS-1500 via MAC
Note: G-code claims use the traditional 837P pathway via MACs, not FHIR APIs. This is a separate data channel from the FHIR operations above. Claims are processed as "zero-paid" by the MAC — actual payment comes quarterly from the IPC. G-codes shown are placeholders; CMS will publish actual codes before July 2026.

Unalign Patient — POST /Patient/$unalign

Request Profile | Response Profile | Result Codes | Reason Codes