Road to production

Everything you need to go from first introduction to production access — including what to expect at each step and how to build a successful integration along the way.

#Understanding Flexpa

Before diving into implementation, it's worth understanding what Flexpa provides and how healthcare data works. This context will help you make better architectural decisions and build more effective integrations.

Flexpa is a unified API that lets a patient consent to share their health records with your application. Through a single integration, your users authorize access to their data and you receive standardized FHIR resources in return.

#A 3-in-1 patient access network

Flexpa connects to three patient access networks through one integration:

Health insurers (CMS-9115) — Claims and coverage data from payers, returned as FHIR resources. Best for longitudinal health and financial history.
Medical record systems (ONC (g)(10)) — Clinical records from individual providers' EHRs, returned as FHIR resources. Best for targeted facility access.
Nationwide exchanges (TEFCA IAS) — Records discovered across 56,000+ facilities via a single authorization, returned primarily as clinical documents that Flexpa converts to FHIR resources. Best for multi-facility provider data.

See the network documentation for full coverage details and how the networks compare.

#FHIR

Healthcare data on Flexpa is built on FHIR (Fast Healthcare Interoperability Resources), a modern standard for exchanging healthcare information. Our intro to FHIR guide explains the key concepts. That said, you don't need to be a FHIR expert — our ViewDefinition $run endpoint can extract the specific data you need without manual records parsing.

We're FHIR experts. Tell us what data your application needs, and we'll do the heavy lifting to help you get it directly.

#Claims data

If you're interested in claims data from payers, start with our claims data guide. Claims tell the story of a patient's healthcare journey — from doctor visits to prescriptions to hospital stays — and are the richest source of longitudinal financial and clinical information available through Flexpa.

#TEFCA and clinical documents

If you're interested in TEFCA, it's important to understand how clinical documents flow through the network. TEFCA records arrive primarily as C-CDAs (Consolidated Clinical Document Architecture documents), which Flexpa surfaces as FHIR DocumentReference resources and converts into structured FHIR resources on your behalf. See the DocumentReference documentation for details on how these documents are represented and how the conversion works.

Our FAQ covers the questions that come up most frequently during integration.

#How to get started

The path from first introduction to live mode follows four steps. Each one builds on the previous, and most of the integration work happens during sandbox access.

#1. Demo intake

Start at flexpa.com/demo. The intake form collects some basic information about you and what you are building, and gives you the opportunity to experience Flexpa's networks firsthand through our Flexpa Consent flow.

Upon completing the form, a member of the Flexpa team will review your submission and reach out with next steps.

#2. Sandbox access

If Flexpa is a good fit, we will invite you to a dedicated Slack channel and provision access to our sandbox environment.

From there, you can begin building and testing your integration against test mode. Test mode gives you access to a wide set of synthetic patients and test credentials across health insurers, medical record systems, and nationwide exchange — so you can validate your integration against representative data before going live.

#Portal access

Once you have sandbox access, head to portal.flexpa.com to set up your developer account.

From the portal you can retrieve your test mode API keys (both your publishable key for frontend integration and your secret key for backend token exchange), manage your application settings, and monitor usage.

#Start with the quickstart

Our quickstart guide provides a complete working example that demonstrates the full integration flow. Clone the repository, add your API keys, and see the entire consent-to-data-retrieval process in action.

As you build, three references will come up repeatedly:

Flexpa Consent — The patient authorization flow. Built on SMART on FHIR with OAuth 2.0 PKCE, Consent is how your users grant your application access to their records.
Patient linking — How Flexpa represents the same person across multiple sources. Each source keeps its own FHIR Patient resource, and Flexpa links them under a master Patient so you can query a unified view with $everything and $summary.
Flexpa API — The FHIR R4 API reference. Covers every resource available, how to authenticate requests, and how to retrieve records once a patient has consented.

#Explore test mode

Your test mode keys give you access to a sandbox of synthetic data spanning all three networks. We provide test payers, EHR sandboxes, and TEFCA test patients with credentials documented in the test mode reference, so you can validate end-to-end flows against representative response shapes before going live.

#Ask questions

If you have any questions while building in sandbox, drop them in your dedicated Slack channel. A Flexpa team member will jump in to help.

#3. Master Service Agreement

When you are ready to move forward, we will prepare a Master Service Agreement (MSA). The MSA includes policy and compliance language that reflects our commitments as a data exchange participant, as well as the obligations we require of our customers to uphold the same standards.

Before going live, you will need a signed MSA and publicly accessible links to your privacy policy and terms of service.

Organizations that do not yet have a privacy policy or terms of service cannot be promoted to live mode.

#4. Kickoff call

Upon signing the MSA, we will schedule a kickoff call. Your technical team will meet with members of Flexpa's technical and customer success teams to walk through what you are building, your timeline, and your integration plan so you are set up for success in live mode. From there, we will set up a recurring check-in over your first few weeks in live mode to stay close to your rollout and keep things on track.

Your dedicated Slack channel remains the best way to reach us after going live — for support, questions, or anything else.

#Advanced resources

As you build out your integration and need to handle more sophisticated use cases, these guides provide deeper insight into specific aspects of healthcare data.

#Parsing FHIR data

FHIR resources are deeply nested and verbose. Our parsing FHIR guide covers the fastest way to extract actionable data using the ViewDefinition/$run API, and is especially useful when shaping data for agents or other downstream systems.

#Agents

Our agent guide walks through connecting Flexpa to Claude, ChatGPT, and custom agents so patients can ask natural language questions about their health records over their authorized data.

#Explanation of benefits

Explanation of Benefits (EOB) resources contain detailed breakdowns of healthcare services, costs, and insurance processing. The EOB resource documentation provides a comprehensive guide to understanding what an EOB contains and how to extract meaningful information from these complex documents.

#Financial information

Healthcare costs and insurance processing involve complex calculations and relationships between patients, providers, and payers. Our financial guide explains how to interpret cost information, understand insurance processing, and work with the financial aspects of healthcare data.

#Billing

Our pricing is publicly available at flexpa.com/pricing.

#Common questions

#Can I test Flexpa in live mode?

While you cannot use real patient data in test mode, our test mode reference covers test payers, EHR sandboxes, and TEFCA test patients with credentials you can use to validate end-to-end flows before going live.

#Can I use live mode before paying?

You must complete the steps above before receiving live mode access. We do not have a free plan for live mode, but our pricing is publicly available.

#Why do I need a privacy policy and terms of service?

Flexpa operates within a regulated data exchange ecosystem. As a participant, we are required to uphold the CARIN Code of Conduct, which sets standards for how patient data is handled, disclosed, and protected. We extend those same obligations to our customers.

A publicly accessible privacy policy and terms of service demonstrate to patients that you are transparent about how their data is accessed, used, and retained. Without them, we cannot verify that your application meets the baseline requirements to receive live mode access.

If you are starting from scratch, the ONC Model Privacy Notice is a good reference for what to include.