Eligibility provides pharmacists with the electronic delivery of PBM/payer member data in a pharmacy setting. Through the pharmacy management system (PMS), the pharmacist can request patient information such as eligibility and pharmacy benefit coverage information.

The following information applies to Eligibility Requests (270) initiated from a pharmacy:

For an Eligibility Request from a pharmacy, the Surescripts ID S00000000000010 is sent in the ISA08, GS03, and 2100A NM109 fields of the 270.

The Surescripts ID will echo back in the ISA06 and GS02 fields of the Eligibility Response.

Formulary information may not be returned in the Eligibility Response if requested by the PBM/payer. This includes the fields:

ID Load and Response Files

Eligibility for Pharmacy

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DairyComp305 - VAS Dairy Management Software

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The term "Zone" represents different dairy locations. PULSE Zones may be different physical dairy locations (for example, multiple locations across the state or country) or different user-defined locations within a single dairy site (for example, Pens 1-100 are Zone 1, Pens 101-200 are Zone 2, etc.).

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applications that are allowed on a device. A device that has other apps installed is considered out of compliance.

Allowlist apps

applications that are not approved for installation on a device. A device that has any of these apps installed is considered out of compliance.

Blockedlist apps

applications that must be installed on a device. A device that is missing any of these apps is considered out of compliance.

required apps

automated responses to a device that violates rules for managed devices.

compliance actions

a list of mobile apps you have made available for your users. Includes apps that users can download from public app stores and apps you intend to distribute using the device management system (In-house apps).

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an app distributed by the device management service rather than downloaded from a public app store.

Eligibility for Pharmacy

About Eligibility for Pharmacy

Eligibility Identifiers

Eligibility Response