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Conduct transactions, as necessary.


CONTROL ID
14378
CONTROL TYPE
Business Processes
CLASSIFICATION
Preventive

SUPPORTING AND SUPPORTED CONTROLS




This Control directly supports the implied Control(s):
  • Perform automated processes according to business requirements., CC ID: 14325

This Control has the following implementation support Control(s):
  • Implement data content requirements and data condition requirements for all transactions., CC ID: 14410
  • Keep code sets open until resolved., CC ID: 14409
  • Refrain from using incentives to conduct transactions., CC ID: 14408
  • Refrain from charging fees to conduct transactions., CC ID: 14415
  • Refrain from rejecting standard transactions., CC ID: 14406
  • Translate standard transactions, as necessary., CC ID: 14405
  • Translate nonstandard transactions, as necessary., CC ID: 14404
  • Process transactions, as necessary., CC ID: 14403


SELECTED AUTHORITY DOCUMENTS COMPLIED WITH




  • General rule. Except as otherwise provided in this part, if a covered entity conducts, with another covered entity that is required to comply with a transaction standard adopted under this part (or within the same covered entity), using electronic media, a transaction for which the Secretary has ado… (§ 162.923(a), 45 CFR Part 162 - Administrative Requirements)
  • If an entity requests a health plan to conduct a transaction as a standard transaction, the health plan must do so. (§ 162.925(a)(1), 45 CFR Part 162 - Administrative Requirements)
  • Change prescriptions (RXCHG, CHGRES). (§ 170.315 (b) (3) (i) (A) (2), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Refill prescriptions (REFREQ, REFRES). (§ 170.315 (b) (3) (i) (A) (4), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Cancel prescriptions (CANRX, CANRES). (§ 170.315 (b) (3) (i) (A) (3), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Request and receive medication history information (RXHREQ, RXHRES). (§ 170.315 (b) (3) (i) (A) (6), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Receive fill status notifications (RxFill). (§ 170.315 (b) (3) (ii) (A) (5), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Relay acceptance of a transaction back to the sender (Status). (§ 170.315 (b) (3) (ii) (A) (7), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Request and respond to transfer one or more prescriptions between pharmacies (RxTransferRequest, RxTransferResponse) (§ 170.315 (b) (3) (ii) (C) (2) (ii), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Create and respond to new prescriptions (NewRxRequest, NewRxResponseDenied). (§ 170.315 (b) (3) (ii) (B) (1), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Electronic prior authorization transactions (PAInitiationRequest, PAInitiationResponse, PARequest, PAResponse, PAAppealRequest, PAAppealResponse, PACancelRequest, and PACancelResponse). (§ 170.315 (b) (3) (ii) (B) (9), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Request and respond to cancel prescriptions (CancelRx, CancelRxResponse). (§ 170.315 (b) (3) (ii) (A) (3), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Request and respond to renew prescriptions (RxRenewalRequest, RxRenewalResponse). (§ 170.315 (b) (3) (ii) (A) (4), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Receive fill status notifications (RXFILL). (§ 170.315 (b) (3) (i) (A) (5), 45 CFR Part 170 Health Information Technology Standards, Implementation Specifications, and Certification Criteria and Certification Programs for Health Information Technology, current as of January 2024)
  • Change prescriptions (RXCHG, CHGRES). (§ 170.315 (b) (3) (i) (A) (2), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Refill prescriptions (REFREQ, REFRES). (§ 170.315 (b) (3) (i) (A) (4), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Cancel prescriptions (CANRX, CANRES). (§ 170.315 (b) (3) (i) (A) (3), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Request and receive medication history information (RXHREQ, RXHRES). (§ 170.315 (b) (3) (i) (A) (6), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Receive fill status notifications (RxFill). (§ 170.315 (b) (3) (ii) (A) (5), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Relay acceptance of a transaction back to the sender (Status). (§ 170.315 (b) (3) (ii) (A) (7), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Request and respond to transfer one or more prescriptions between pharmacies (RxTransferRequest, RxTransferResponse) (§ 170.315 (b) (3) (ii) (C) (2) (ii), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Create and respond to new prescriptions (NewRxRequest, NewRxResponseDenied). (§ 170.315 (b) (3) (ii) (B) (1), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Electronic prior authorization transactions (PAInitiationRequest, PAInitiationResponse, PARequest, PAResponse, PAAppealRequest, PAAppealResponse, PACancelRequest, and PACancelResponse). (§ 170.315 (b) (3) (ii) (B) (9), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Request and respond to cancel prescriptions (CancelRx, CancelRxResponse). (§ 170.315 (b) (3) (ii) (A) (3), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Request and respond to renew prescriptions (RxRenewalRequest, RxRenewalResponse). (§ 170.315 (b) (3) (ii) (A) (4), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)
  • Receive fill status notifications (RXFILL). (§ 170.315 (b) (3) (i) (A) (5), 45 CFR Part 170, Health Information Technology: Initial Set of Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, current as of July 14, 2020)