Recent Changes and Updates to the Reimbursement Landscape
Despite the fact that the pharmacy retains the very significant financial responsibility for drug spend and concentrates on trying to limit this in a number of ways, in comparison, pharmacy spends very little time or effort or has very little involvement in ensuring payment for those very expensive high investment drugs or even in designing and implementing payment strategy. The CDM is at the core of this, but unfortunately, often is bloated, cumbersome, outdated and missing critical elements. Additionally, the session provides suggestions and tools for assessing current practice and making needed changes. It’s not only about money but about assuring data accuracy. The series will cover the entire reimbursement cycle including inpatient as well as retail and outpatient reimbursement rules and best practices.
Pharmacist Learning Objectives:
- Describe the required responsibilities and necessary engagement of different stakeholder for effective Pharmacy Revenue Cycle management
- Identify future changes and external factors that will impact pharmacy revenue
Pharmacy Tech Learning Objectives
- Describe strategies to mitigate the risks of pharmacy denials associated with the prior authorization process and ensuring accurate data submission
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Identification, Mitigation, and Disclosure of Relevant Financial Relationships
As an accredited provider of continuing education, Vizient, Inc. is dedicated to ensuring this activity presents learners with only accurate, balanced, scientifically justified recommendations, and is free from promotion, marketing, and commercial bias. In accordance with The Standards for Integrity and Independence in Accredited Continuing Education, all planners, faculty, and others in control of the educational content have disclosed the absence or existence of all financial relationships (of any dollar amount) with ineligible companies within the past 24 months.
It is Vizient’s policy that owners and employees of ineligible companies, and any individuals who refuse to disclose the absence or existence of financial relationships with any ineligible companies are disqualified from participating as planners or faculty.
Absence of Relevant Financial Relationships
Vizient, Inc., Jointly Accredited for Interprofessional Continuing Education, defines companies to be ineligible as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
An individual is considered to have a relevant financial relationship if the educational content an individual can control is related to the business lines or products of the ineligible company.
No one in a position to control the content of this educational activity have relevant financial relationships with ineligible companies.
Mike Culligan, Rph, FABC
Spencer Martin, PharmD, MBA, BCPS
Melissa Fahnle, BS
Senior Project Manager
In support of improving patient care, Vizient, Inc. is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare
Vizient, Inc. designates this activity for a maximum of 1.50 ACPE credit hours.
Universal Activity Number: JA0006103-0000-22-121-L04-P
Universal Activity Number: JA0006103-0000-22-121-L04-T
- 1.50 ACPE Pharmacist
- 1.50 ACPE Pharmacy Technician