Directories
2 min
This section explains how directories are used for electronic prior authorization (ePA) message routing. For more detailed information, refer to the Surescripts Directory Implementation Guide.
Provider Vendor Directory Usage
Provider vendors are not required to use the Surescripts Directory to identify PBM/payers that support ePA.
However, the Directory may be used when:
- An Eligibility Response (271) does not indicate active coverage, and
- The provider still wants to initiate a prior authorization with a specific PBM/payer
In these cases:
- ePA messages are still sent to EPAINI
- The PayerID in the PAInitiationRequest is populated using the value obtained from the directory
Provider vendors must also ensure that directory service levels are properly configured for prescribers who use ePA.
PBM/Payer Directory Usage
PBM/payers do not use the Directory for routing or message lookup in standard ePA workflows.
- ePA workflows begin with a PAInitiationRequest sent to EPAINI
- Responses are sent directly back to the initiating provider vendor
- No directory lookup is required for message routing
Exception:
- Unsolicited PAInitiationResponse workflows may differ, but standard ePA message exchange does not require PBM/payer directory access