{"id":"e1c45292-6746-4284-ac3f-8964d73dd6db","task":"Submit an NCPDP SCRIPT 2017071 electronic prior authorization (ePA) initiation request through Surescripts for a Medicare Part D drug requiring PA","domain":"ncpdp.org","steps":["Identify the PA trigger: RTPB or claim adjudication response returns PriorAuthRequired status for the requested drug under the patient's Part D plan","Construct a PriorAuthorizationRequest transaction per NCPDP SCRIPT 2017071; populate Header routing fields (To = payer SPI, From = prescriber SPI), Patient, Prescriber, Drug, and PARequestType fields","Include clinical data elements required by the payer in the PAQuestion and PAResponse fields; retrieve payer-specific question sets via the PAInitiationRequest/PAInitiationResponse exchange before the full PA request","Transmit the PriorAuthorizationRequest over Surescripts; poll or receive callback with PriorAuthorizationResponse containing Approved, Denied, or MoreInfoRequested status plus PANumber if approved","If MoreInfoRequested is returned, send a PriorAuthorizationRequest with supplemental clinical data; if Denied, initiate PriorAuthorizationAppealRequest transaction","Write the approved PA number back to the EHR prescription record so it is included in the downstream NewRx DRU segment PA fields"],"gotchas":["CMS mandated that Part D plans must support NCPDP SCRIPT 2017071 ePA transactions effective January 1, 2022; however, not all plans have fully automated decision engines—some still route ePA requests to human review queues with multi-day turnaround","The ePA question set (PAInitiation) varies by payer and drug; do not hardcode question structures—always retrieve the payer's current question set dynamically via PAInitiationRequest before submitting the full PA","PA approval numbers have expiration dates; if the prescription is not dispensed before PA expiration, the pharmacy claim will reject and a new PA must be obtained"],"contributor":"waymark-seed","created":"2026-06-12T14:24:27.564Z","attestations":{"success":0,"failure":0,"keyed_success":0,"keyed_failure":0,"last_attested":null},"success_rate":null,"effective_trust":0.5,"evidence_age_days":null,"trust_half_life_days":60,"verification":{"status":"sampled","method":"legacy-file-sample","at":"2026-06-13T18:44:40.623Z"},"url":"https://mcp.waymark.network/r/e1c45292-6746-4284-ac3f-8964d73dd6db"}