APIs for Developers

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The Interoperability and Patient Access rule (CMS-0115-F) defines requirements for free and secure data flow that allows patients access to their health information.  Working with our partners, Contra Costa Health has created service endpoints to meet these requirements through the Patient Access API and Provider Directory API described below.

 Data Type
 FIHR Base URL   API Documentation
Clinical Data, Medical Claims https://icproxy.mycclink.org/proxy-FHIR/api/FHIR/R4/metadata https://fhir.epic.com/ 
(ExplanationOfBenefits.Search & ExplanationOfBenefits.Read)

 

Patient Access API

The Patient Access API is an HL7 FHIR-based API.  To begin developing applications that leverage this API start by reviewing the CMS standards used to make the data available.

Contra Costa Health allows patients to access their clinical and claims data via industry standard FHIR APIs. A step by step guide to connecting with Contra Costa Health's Epic system via API is available here. open.epic :: Developer Resources  

Provider Directory API

The Provider Directory API is publicly available and does not require application registration or authentication.

Machine Readable Files – Transparency in Coverage

Contra Costa Health Plan members may visit our Transparency in Coverage page to access publicly available machine-readable files as required by the Transparency in Coverage Final Rule.

Contra Costa Health Plan - Prior Authorization Metrics for Medical Items and Services (Excluding Drugs)

Reporting Period: Calendar Year 2025

Line of Business: Medicare Advantage (CCHP MA Contract Level)

Run Date: End of Day 02/09/2026

Standard (Non-Urgent) Prior Authorization Requests

 Measure  How Many Times This Happened  Out of Total Requests  Percentage
 Request Approved  55,024  62,216  88.44%
 Request Denied  7,192  62,216  11.56%
 Request Approved After Appeal*  120  62,216  0.19%
 Timeframe Extended & Approved  2,110  79,061  2.67%

 

* Subset of total standard requests appealed.

** Per CMS extension rules under 42 CFR 422.568(b)(2). 

Expedited (Urgent) Prior Authorization Requests (Response Due Within 72 Hours)

Measure How Many Times This Happened  Out of Total Requests  Percentage
 Request Approved  14,738  16,845  87.49%
 Request Denied  2,107  16,845  12.51%

 

Time Between Receiving a Prior Authorization Request and Sending a Decision

 Request Type  Mean (Average) Time (Hours)  Median (Middle) Time (Hours)
 Standard (Non-Urgent)  94.550149  47.738194
 Expedited (Urgent)  114.788525  53.332222

 

Footnote — Urgent Prior Authorization Turnaround Time (2025)

Contra Costa Health Plan (CCHP) has identified a configuration issue that affected calculations for urgent prior authorization turnaround times for calendar year 2025. The defect resulted in an overstated urgent TAT average.

 CCHP is implementing a systems fix in 2026 to correct the calculation and validate affected records in order to publish corrected metric. This note applies only to the Urgent TAT metric for 2025.