The Pharmacy to Health Plan Authorization Request and Response Transaction provides a mechanism for a pharmacy to request approval from a health plan to authorize certain healthcare products and services, as required by the patient’s health plan contract. The health plan responds to the pharmacy’s request for the approval of products and/or services. The information exchanged includes, but is not limited to, approval status for coverage of the products and/or services that are included in the patient’s health plan benefits and/or authorization limitations. View the most current version as HTML here