Health Care Attachments to Support Claims, Referrals and Authorizations

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The American Medical Association appreciates the opportunity to comment. This section includes acknowledgments, however, acknowledgments typically does not support claims, referrals, or authorizations. We believe acknowledgments is misplaced in this section. We understand the reasoning could be because they are lumped together on the regulatory agenda, however the 999 does not seem related. Acknowledgments intersects with multiple transactions, therefore we believe it should have its own section. The guidance claims that two payers have successfully implemented attachments after piloting in 2004. This is inaccurate as the standard that is currently under consideration was not created until 2016. 

NCPDP Comment

  1. Emerging Transaction(s) within NCPDP SCRIPT Standard:
    1. Patient Care Service Referral (ServiceReferral)
    2. Patient Care Service Documentation (ServiceDocumentation)
    3. Response to Request for Patient Care Service Referral (ResponseToReferralRequest)
    4. Request for Patient Care Service Referral (RequestForReferral)
    5. Response to Patient Care Service Referral (ServiceReferralResponse)