Existing Wording: In addition to these core elements needed to populate the 278 message, any "supporting information" resources needed to process the prior authorization request (whether determined by DTR processes or by other means) must also be included in the Bundle. Relevant resources referenced by those "supporting information" resources SHALL also be included (e.g. prescriber Practitioner and Medication for a MedicationRequest).

Comment:

How will the need for additional supporting information be communicated to the provider prior to generating the authorization request? A catalog or menu of supporting information for each service a payer requires a prior auth for should be made available in an electronic format.

Summary:

How will the need for additional supporting information be communicated to the provider prior to generating the authorization request?