PPT-Improving Your Formulary and Denials Management

Zinkeng Asonganyi PharmD Director of Pharmacy ServicesAmbulatory Operations University of Texas Medical Branch Objectives Understand the data and metrics your cancer program or practice must collect and report on to improve revenue cycle management eliminate waste and reduce costs . Clinical Operations Workgroup. Meaningful Use – . Formulary & Benefit. Core Measure. Generate and transmit permissible prescriptions electronically (. eRx. ). Meaningful Use Stage 1:. Core: . . Making sense of government audits. . . Jennifer Ogden. Audit Solutions Manager. Agenda. Recovery Audit Contractors . Auditor Overview. Audit Process. Data Analysis. Upcoming changes. Why is it important to you?. What is a PBM?. An organization that helps:. Manage the purchasing, reimbursement and dispensing of prescription drugs for employers, plan sponsors or health plans. Create and maintain pharmacy networks . Presenters. 2. - Proprietary and Confidential -. Peter . Angerhofer. Peter . is a principal at Colburn Hill Group; he brings experience in operations, strategy and health policy to both daily operations as well as long-term vision.. and. Dominic Goodwin, Project Co-ordinator, WA Drug Evaluation Panel. The WA SMF - Vision. To . deliver optimal patient outcomes in an equitable manner through a single list of approved medicines for all WA public hospitals; evaluated, implemented and managed in a . Bureau of Health . Professions Licensure. Department of Public Health. May 17, 2018. Review of March 15. th. meeting. Cost Impact . Presentation. Draft Formulary Regulations. 105 . CMR 720: Drug Formulary . Clinical Operations Workgroup. Meaningful Use – . Formulary & Benefit. Core Measure. Generate and transmit permissible prescriptions electronically (. eRx. ). Meaningful Use Stage 1:. Core: . Bureau of Health Care Safety and Quality. Department of Public Health. December 15, 2016. Draft Formulary (105 CMR 720). Schedule. Amendments. Comments. Guidance. Interchangeable Abuse Deterrent Drug Products Evaluation. Background. A formulary is a continually updated list of medications and related information, representing the clinical judgement of physicians, pharmacists and other experts in the diagnosis, prophylaxis or treatment of disease and promotion of health. . Unit I. DP-206. (Dr.). Anupriya. . Kapoor. Assistant Professor. School of Pharmaceutical sciences, . CSJMU, Kanpur. Definition. Formulary is a continually revised compilation of pharmaceuticals and some important ancillary information that reflects the current clinical judgement of medical staff. . Yousef Ahmed . Alomi. , Sultan Mohammed Al-. Jarallah. , . Rasha. . Abdelsalam. . Elshenawy. , . Faiz. A . Bahadig. . Rph. ABSTRACT: . Objective: . Formulary management is an integrated patient care process which enables physicians, pharmacists and other healthcare professionals to work together to promote clinically sound cost-effective medication therapy and positive therapeutic outcomes. Effective use of healthcare resources can minimize overall medical costs, improve patient access to more affordable care and provide an improved quality of life. A formulary not only includes a list of medications and medication-associated products but also includes medication-use policies, important ancillary drug information, decision support tools and organizational guidelines. Therefore, in this study, we aimed to provide the guiding principles for the Formulary Management System at Ministry of Health (MOH) hospitals in Saudi Arabia. . Background. A formulary is a continually updated list of medications and related information, representing the clinical judgement of physicians, pharmacists and other experts in the diagnosis, prophylaxis or treatment of disease and promotion of health. . Compiled by . Coral . F. Fernandez, RN CCDS CCS. August, 2017 – September 2018. 1. INTRODUCTION. Coral F. Fernandez, RN CCDS CCS. 27 years with Baptist. 2. years as a file clerk in HIM (prior to EMR). Dr. Haider Raheem. Formulary Systems . Background. A formulary is a continually updated list of medications and related information, representing the clinical judgement of physicians, pharmacists and other experts in the diagnosis, prophylaxis or treatment of disease and promotion of health. A formulary includes, but is not limited to, a list of medications and medication-associated products or devices, medication-use policies, important ancillary drug information, decision-support tools, and organizational guidelines..