PARDD
Prior Authorization Requirements, Documentation, and Decision API
PARDD is the CMS-0057-F Prior Authorization API that lets providers query coverage requirements, gather documentation, and submit and track authorization decisions via FHIR.
PARDD stands for Prior Authorization Requirements, Documentation, and Decision — the Prior Authorization API required by CMS-0057-F. It is the most operationally complex of the rule's four APIs because it spans three jobs: telling a provider what a payer requires, helping assemble the needed documentation, and carrying the actual authorization request and decision.
PARDD is built on the HL7 Da Vinci prior-authorization implementation guides — CRD (Coverage Requirements Discovery), DTR (Documentation Templates and Rules), and PAS (Prior Authorization Support) — and it must interoperate with the X12 278 transaction that payers use internally today.
By moving prior authorization onto FHIR, PARDD is intended to cut the phone calls, faxes, and portal re-keying that make prior auth one of the most burdensome administrative workflows in healthcare.
How this relates to Health1st
Health1st's Prior-Authorization Agent runs PARDD end to end: it maps X12 278 ↔ FHIR, drives the Da Vinci CRD/DTR/PAS exchanges, auto-assembles supporting documentation, and handles denial reasons — with human-in-the-loop review at every step.
Related terms
CMS-0057-F requires impacted US payers to stand up four FHIR APIs — Patient Access, Provider Access, Payer-to-Payer, and Prior Authorization (PARDD) — with API compliance generally due January 1, 2027.
A FHIR-based API that automates the prior-authorization workflow — checking requirements, gathering documentation, and exchanging decisions — as required by CMS-0057-F.
Da Vinci is the HL7 accelerator that publishes FHIR implementation guides for payer–provider workflows, including prior authorization, coverage, and data exchange.
X12 278 is the EDI transaction US payers use for prior-authorization and referral requests and responses.
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