the interactions are currently organized more coarse grain that is suitable to certification program that would lead to requiring likely HIT to support than necessary.  Suggest to recognize the following actors that are HIT neutral and enable to establish clear sender/client/requester vs. receiver/server/responder responsibilities they have to support when implemented through separate HIT modules/solutions.  The following provides a starting point to indicate the level of granularity needed:

• PA Initiator - user/system starting the ePA workflow - can be EHR, Scheduling, Practice Management, Consumer, etc.
• Coverage Requirements Requester - system that actually interacts with the payer to request coverage requirements
• Coverage Requirement Responder - system that provides the coverage requirements response - the payer, or intermediaries acting on behalf of the payer.
• Documentation/Template Requirements Requester
• Documentation/Template Requirements Responder
• Supporting Information Requester
• Supporting Information Source
• PA Request Submitter
• PA Request Status Requester
• PA Request Responder

This should for DTR also clarify scenarios where the source of the supporting information (e.g., EHR, HIM, clinical data repository) is not part of the system initiating the request, e.g., Scheduling, Registration, Practice Management, Consumer.