Message Linkage

message linkage requirements and best practices are described in the table below four key fields are used to link messages together, as defined below this linkage allows a software system to tie one message to another for example, on a painitiationresponse the pbm/payer system needs to find the painitiationrequest to which the provider vendor is referring this linkage should be done in an automated manner ncpdp refers to message linkage as trace number messageid – the unique number assigned to each message this id initiates the electronic linking of subsequent message types relatestomessageid – the messageid of the most recent and relevant message in the workflow pareferenceid – assigned by the prescribing system on the initial message (or on parequest message for prior authorization renewal requests) and is used by the prescribing system as a tracking identifier on all request and response prior authorization messages the identifier must be unique per prescribing system for at least 18 months pacaseid – pbm/payer assigned identifier for this request and used by the pbm/payer as a tracking identifier on all request and response prior authorization messages painitiationrequest and response fields painitiationrequest painitiationresponse parequest paresponse messageid = 123 messageid = abc messageid = 456 messageid = def relatestomessageid if eligibility is used, relatestomessageid contains the interchange control number (isa13 of eligibility response (271)) if rtpb is used, then relatestomessageid contains the rtpb response messageid if rxchange is used, relatestomessageid contains the rxchangerequest messageid note if multiple products are used, use the latest messageid that was used as a trigger for the pa relatestomessageid = 123 relatestomessageid = abc relatestomessageid = 456 pareferenceid = xyz pareferenceid = xyz pareferenceid = xyz pareferenceid = xyz pacaseid = n/a pacaseid = 999 pacaseid = 999 pacaseid = 999 status status status status messageid = 111 messageid = 222 messageid = 333 messageid = 444 relatestomessageid = 123 relatestomessageid = abc relatestomessageid = 456 relatestomessageid = def pa appeal and cancel request and response pa appeal request pa appeal response pa cancel request pa cancel response messageid = 789 messageid = ghi messageid = 012 messageid = jkl relatestomessageid = def relatestomessageid = 789 relatestomessageid relates to the most recent message received from your trading partner see definition above since pa cancel requests can be sent at any time after receiving case id, this would relate to the most recent message for example, if this was sent after provider sent the parequest (and had not yet received a paresponse from the pbm/payer) the relatesto id would be abc relatestomessageid = 012 pareferenceid = xyz pareferenceid = xyz pareferenceid = xyz pareferenceid = xyz pacaseid = 999 pacaseid = 999 pacaseid = 999 pacaseid = 999 status status status status messageid = 555 messageid = 666 messageid = 777 messageid = 888 relatestomessageid = 789 relatestomessageid = ghi relatestomessageid = 012 relatestomessageid = jkl third party processor message linking when pbm/payers return a co or cp reason code, the message becomes marked as closed for third party processing if surescripts’ third party processor search finds a match, surescripts creates a secondary painitiationrequest based upon the initial painitiationrequest the recipient is updated and a secondary messageid with a prefix of epaini is sent to the third party processor when the third party processor responds, the message has a relatestomessageid that has a prefix of epaini and references the secondary painitiationrequest if the pbm/payer referenced is not connected to surescripts for electronic prior authorization but the third party processor is, surescripts forwards the message to the third party processor as if they were the pbm/payer – no modifications to the messageid are made painitiationrequest and response from third party processor painitiationrequest (to epaini) painitiationresponse (from pbm/payer closed for third party) second painitiationrequest (to third party) second painitiationresponse (from third party) parequest (to third party) paresponse (from third party messageid = 123 messageid = abc messageid = epaini321 messageid = def messageid = 789 messageid = 010 relatestomessageid contains the interchange control number (isa13 of eligibility response (271)) relatestomessageid = 123 relatestomessageid = abc relatestomessageid = epaini321 relatestomessageid = def relatestomessageid = 789 pareferenceid = xyz pareferenceid = xyz pareferenceid = xyz pareferenceid = xyz pareferenceid = xyz pareferenceid = xyz pacaseid = n/a pacaseid = n/a pacaseid = n/a pacaseid = 123456 pacaseid = 123456 pacaseid = 123456 status status status status status status messageid = 111 messageid = 222 messageid = 333 messageid = 444 messageid = 555 messageid = 666 relatestomessageid = 123 relatestomessageid = abc relatestomessageid = epaini321 relatestomessageid = def relatestomessageid = 789 relatestomessageid = 010 if surescripts cannot find a third party processor, surescripts will return a closed painitiationresponse with epaini in the from field and possibly a link to a web based pa forms provider