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Healhcare Information Technology Standards Panel

HealthCare Information Technology Standards Panel

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HITSP operates under contract to the U.S. Department of Health and Human Services (HHS).

Transaction

T 79 - Pharmacy to Health Plan Authorization Request and Response Transaction

The Pharmacy to Health Plan Authorization Request and Response Transaction provides a mechanism for a pharmacy to request approval from a health plan to authorize certain healthcare products and services, as required by the patient’s health plan contract. The health plan responds to the pharmacy’s request for the approval of products and/or services. The information exchanged includes, but is not limited to, approval status for coverage of the products and/or services that are included in the patient’s health plan benefits and/or authorization limitations. View the most current version as HTML here.

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Construct	Title / Version	Referenced by	Status	Document Access
T 79	Pharmacy to Health Plan Authorization Request and Response Transaction Version:1.1	IS 9 V:1.0 IS 77 V:1.0	Released (Panel Approved)	DOWNLOAD
NOTE: View as HTML here.
T 79	Pharmacy to Health Plan Authorization Request and Response Transaction Version:1.2		Released (Panel Approved)	DOWNLOAD

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Reference Documents

Acronyms
AHIC Use Cases
Conventions (naming and numbering)
Glossary
Harmonization Framework
Interoperability Specifications Overview