--- title: Application Certification Requirements slug: epa-accelerator/guide/application-certification-requirements docTags: createdAt: 2026-08-12T18:21:51.770Z --- :::hint{type="info"} For customers using Electronic Prior Authorization Accelerator, the items marked with \* are certified by Surescripts on your behalf. ::: # Provider Vendor Requirements **PA.200:** The application shall make available for display the ResponseStatus and each occurrence of a PANote from all response transactions. :::hint{type="info"} Multiple responses of the same type may be received.\* ::: **PA.201:** When the PBM/payer provides a question set in the PAInitiationResponse, the application shall display\*: - QuestionSetContactCommunicationNumber - DeadlineForReply - AttachmentNotes (when attachment required) **PA.202: **The application shall require all specified questions to be answered (not blank) and an order, prior to sending the PARequest. \* **PA.203:** In the event that a PA has been canceled by the initiator or closed by the PBM, and the prior authorization is still desired, a new PAInitiationRequest shall be sent. \* **PA.204:** When the prescriber and main prior authorization contact vary, the application shall utilize the Provider composite to supply the prior authorization contact name and PrimaryTelephone. **PA.205:** Provider vendors shall not send a PAAppealRequest if the value of the IsEAppealSupported field is "false" in the PAResponse.\* **PA.206:** Prescribing vendors who are utilizing the Surescripts Eligibility 270/271 messages shall populate the first BenefitsCoordination element with the associated information returned in a Surescripts 271 message. If more than one active coverage is returned, only the single coverage information utilized to write the prescription is sent. The 271 message's ISA13 control number shall be populated in the BenefitsCoordination/InterchangeControlNumber field in all instances including scenarios where there is no active coverage. **PA.207:** Either MedicationPrescribed/DaysSuppy or MedicationPrescribed/PADaysSupplyDosesPerDay shall be populated in the PAInitiationRequest when available. **PA.208:** If the PAInitiationRequest includes a PAPriorityIndicator flag, the priority must be displayed to the end user. The value of "S" (Standard Priority) should be the default if the data element is sent in the transaction. **PA.209:** The application shall make available for display the ExpirationDate to the prescriber for a Prior Authorization renewal request (unsolicited PAInitiationResponse).\* **PA.210:** If a PBM/payer requires an attachment in an answered question, the application shall not allow a request to be sent without the attachment composite being populated.\* **PA.211:** When both a brand and generic NDC exist for a medication, in the PAInitiationRequest provider vendors shall submit the drug description and NDC of the form of the medication they want to prescribe for the patient. **PA.214:** The application shall support the ePA question set conditional logic as outlined in the NCPDP ePA standard.\* **PA.219:** The drug name shall be an item that is currently available for dispensing. If there are active NDCs available, an inactive/obsolete NDC shall not be used. Customers are expected to work with their drug compendia vendor to satisfy this requirement. **S.203:** Sender demographic information, when included in the message, shall match what was registered by the customer in the Surescripts Directory. When a prescribing system utilizes the Surescripts Learning Directory service, this requirement is satisfied for learned locations. **S.208:** Codified values within a message shall not conflict with the related textual concept. **Example 1:** | Field Name | Proper Use | Improper Use | | --------------------------------------------- | -------------------------- | ------------ | | DrugDescription | Primariea 10mg/10ml liquid |   | | DrugCoded/Strength/StrengthValue | 10 | \ | | DrugCoded/Strength/StrengthUnitOfMeasure/Code | C42576 (mg/ml) |   | | DrugCoded/Strength/StrengthForm/Code | C42953 |   | **Example 2:** | Field Name | Proper Use | Improper Use | | --------------------------------------------- | ------------------------------- | ------------------- | | DrugDescription | Amoxicillin 500 mg oral capsule |   | | DrugCoded/Strength/StrengthValue | 500 | 250 | | DrugCoded/Strength/StrengthUnitOfMeasure/Code | C28253 (Milligram) | C28254 (Milliliter) | | DrugCoded/Strength/StrengthForm/Code | C25158 (Capsule) | C42998 (Tablet) | # Provider Vendor and PBM/Payer Requirements **PA.212:** Payer and submitter systems shall be able to send and receive PDF attachments at a minimum.\* **PA.213:** Participant applications shall not allow users/systems to respond multiple times to a message the application has already sent. The only exceptions are: the INProcess PAResponse followed by an Approved/Denied PAResponse message; and PARequest/PAResponses when additional information is requested. **PA.220: **Customers shall support the scenarios detailed in the Message Flow section of this guide. **S.200:** Customers shall be able to receive syntactically valid maximum and minimum populated messages. Optional data elements (and values therein) shall not cause message failure. **S.201:** Customers shall ensure all messages are syntactically correct before transmission to Surescripts. **S.205:** The sender shall ensure the combination of the From and MessageID elements, for all messages including Error, is unique for at least 18 months. Surescripts recommends an unformatted Globally Unique Identifier (GUID). **S.206:** System shall support user entry and display of up to three digits to the right of the decimal place, without the system rounding or truncating. The decimal point is represented by a period and shall be used as follows: - Only when there are significant digits to the right of the decimal - When there is a digit before and after the decimal point - Not with whole numbers For example, consider the following possible values: | **Correct Format Examples** | **Incorrect Format Examples** | | --------------------------- | ----------------------------- | | 2.5 | .27 | | 0.15 | 3.00 | | 21 | 14. | **S.209: **The customer shall implement and maintain a Surescripts approved drug compendia that is updated at least monthly. # PBM/Payer Requirements **PA.215:** If the PBM/health plan receives a PAInitiationRequest or PARequest that contains a PAPriorityIndicator of "X" (expedited), the PBM/health plan shall process the request and respond in an expedited manner. If the PAInitiationRequest or PARequest needs to be manually reviewed for priority, then the PBM/health plans shall make the priority indicator available for display. **PA.216:** If the provider vendor populates the Provider composite, the PBM system shall make the Provider composite contents available to be viewed by the user. **PA.217:** The PBM/payer system shall make available for display the QuestionSetComment from the PARequest and the PAAppealRequest if the prior authorization request would otherwise be denied or approved with modifications. **PA.218:** The PBM/payer system shall only send one PAResponse with a status of 'InProcess' and include the ExpectedResponseDate and/or PANote. This PAResponse is to be followed by a subsequent PAResponse with the final determination or request for additional information.