Medication History for Claims Data Suppliers Overview

this is early adopter documentation information is subject to change about medication history the surescripts medication history services provide prescribers with the electronic delivery of pbm/payer claim data and/or pharmacy fill data common use cases are below note, this is subject to change and may not be all inclusive the surescripts medication history for ambulatory services are designed to allow authorized health care providers and their authorized agents to electronically access a patient's medication history this includes, but is not limited to, pbm/payer supplied data only in connection and conjunction with the treatment of a specific patient in an ambulatory visit or another specific treatment event the surescripts medication history for reconciliation services are designed to allow authorized health care providers and their authorized agents in the acute care settings to electronically access a patient’s medication history this includes, but is not limited to, pbm/payer supplied data for the purpose of medication reconciliation the surescripts medication history for long term post acute care (ltpac) services are designed to allow authorized health care providers and their authorized agents in the ltpac settings to electronically access a patient’s medication history, including but not limited to, information from pbm/payer supplied data for the purpose of medication reconciliation the surescripts medication history for populations (panel) for providers is designed to assist authorized health systems, hospitals, risk bearing groups, and their authorized agents to electronically access a patient’s medication history, including but not limited to, pbm/payers and retail pharmacies only in connection and conjunction with the treatment of a specific patient and for the purposes of better managing the health of patient populations the surescripts medication history for populations (panel) for health plans is designed to assist health plans in electronically accessing a patient’s medication history, including but not limited to pbm/payer supplied data without a treatment event for activities such as risk stratification, payment operations, care management activities, etc about this document surescripts created this document to provide pbm/payer data suppliers information on medication history, which provides a structured, electronic format for transmitting prescription claim data note the terms "message" and "transaction" are used interchangeably throughout this guide "transaction" is used when referencing language pulled directly from a standards organization document which uses the term "transaction" document references please reference the following documents when reading this documentation surescripts provided materials surescripts connectivity and authentication implementation guide https //docs surescripts com/connectivity authentication/guide surescripts eligibility companion guide https //docs surescripts com/eligibility/guide surescripts error guidance supplement https //docs surescripts com/error guidance/guide surescripts medication history companion guide https //docs surescripts com/medhistory/guide medication history 4 0 translation matrix external materials to be obtained by the customer (available at www ncpdp org) ncpdp script standard 2023011 files note schema files version may change and will not be considered final until published in the generally available guide xml files (schemas) 20230115 ncpdp script implementation guide v2023011 (may 2024 republication) xml standard guide v2022071 note the xml standard only updates when the guide changes the latest version is 2022071 ncpdp does not retroactively update xml versions with each new script/specialized standard this standards matrix shows the xml guide version for each standard v203011 script standard example guide v10 ncpdp script implementation recommendations version (latest version) ncpdp external code list (ecl) v202301 (ncpdp online tool) ncpdp script this guide utilizes the ncpdp (national council for prescription drug programs) messaging standard prescriber/pharmacist interface script version 2023011 as a baseline to become an ncpdp member, please go to https //www ncpdp org/membership aspx https //www ncpdp org/membership aspx the ncpdp script standard 2023011 package contains a complete list of fields and additional requirements customers should read and comprehend the associated standards prior to reading this guide ncpdp is an american national standards institute (ansi) accredited standard development organization the ncpdp “script” standard is a copyrighted document and may be obtained by contacting ncpdp 9240 e raintree drive scottsdale, az 85260 7518 phone (480) 477 1000 fax (480) 767 1042 https //www ncpdp org https //www ncpdp org