The technical standard healthcare systems use to exchange data electronically, including the data structures required for electronic prior authorization under federal rules.
What it means
FHIR gives providers, payers, and health IT vendors a common data language, replacing the patchwork of proprietary formats that made healthcare interoperability difficult for years. For prior authorization specifically, FHIR defines how clinical documentation, coverage rules, and submission statuses get structured so that systems from different vendors can actually talk to each other. It's the foundation underneath ePA, and it's what HTI-4 certification criteria are built around.
