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VA Technical Reference Model v 24.3

ASC X12N Health Care Services Review: Request for Review and Response (278)
ASC X12N Health Care Services Review: Request for Review and Response (278) Standard or Specification

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Technologies must be operated and maintained in accordance with Federal and Department security and privacy policies and guidelines. More information on the proper use of the TRM can be found on the TRM Proper Use Tab/Section.

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Description: The ASC X12N 278 Health Care Services Review: Request for Review and Response transaction is recognized by the United States Federal Government as the standard for the electronic exchange of health plan prior authorization information in accordance with the Health Insurance Portability and Accountability Act (HIPAA). This standard excludes the area of outpatient pharmacy, which is covered under the National Council for Prescription Drug Programs (NCPDP) Retail pharmacy transactions.
Technology/Standard Usage Requirements: Users must ensure their use of this technology/standard is consistent with VA policies and standards, including, but not limited to, VA Handbooks 6102 and 6500; VA Directives 6004, 6513, and 6517; and National Institute of Standards and Technology (NIST) standards, including Federal Information Processing Standards (FIPS). Users must ensure sensitive data is properly protected in compliance with all VA regulations. Prior to use of this technology, users should check with their supervisor, Information Security Officer (ISO), Facility Chief Information Officer (CIO), or local Office of Information and Technology (OI&T) representative to ensure that all actions are consistent with current VA policies and procedures prior to implementation.
Section 508 Information:
Decision: View Decisions

Decision Source: TRM Mgmt Group
Decision Process: One-VA TRM v19.4
Decision Date: 04/07/2019 at 21:07:52 UTC
Introduced By:
Standards Body: ASCX12
- The information contained on this page is accurate as of the Decision Date (04/07/2019 at 21:07:52 UTC).