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resQ

Pharmacy Data PBMs and Part D Sponsors Need to Remain In Compliance

Gain Pharmacy Credentialing Efficiencies

Remove administrative burden and reduce the financial impact of gathering pharmacy credentials to enroll or validate pharmacies into your network. resQ™ can serve as a direct source for application for participation.

 

Improve Bottom Line

Utilizing resQ™, helps lower the total cost of credentialing/re-credentialing, saves you time and increases your efficiency and operation functionality. Information obtained from resQ™ can add value to other segments of your organization such as the care management system, provider directory or claims processing.

 

Ensure 455 Compliance

Reduce your risk of failed-audits and non-compliance with accurate pharmacy data in a single resource. Easily gather CMS Title 42 CFR 455 requirements for mandatory screenings for all Part D Medicaid participating pharmacies and affiliated parties including pharmacists. 
 

How resQ™ Works for You

Reduce Your Fraud, Waste & Abuse Risk

With the heightened focus on pharmacy data fraud and collection of associated fines it has become critical for you to ensure pharmacies have properly attested to FWA guidelines and follow state-specific and CMS 455 guidelines.  Relying on outdated data and manual processes is no longer an option.  You must have access to accurate and complete data on pharmacies that can automate and minimize as much of the credentialing data collection work as possible.  Additionally, maintaining accurate prescriber data for fraud monitoring and avoidance of inaccurate claims paying is also a necessity. With the right solution and the right data, PBMs can be more prepared to avoid some of the most common pitfalls that increase risk of non-compliance and FWA. Our recent white paper, “The Five Most Common FWA Pitfalls PBMs Make and How to Avoid Them,” shares some of the important lessons learned by our customers that can help your organization reap the same benefits available to those who are getting it right. 

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Real-Time Access to Supporting Documentation and Pharmacy Data

Your resQ™ subscription includes one (1) WebConnect User License to provide real-time access online to the pharmacy information, as well as visibility and accessibility to the required copies of electronic documentation submitted by the pharmacies.  New Document Batch Download feature allows for download of documents for up to 50 pharmacies at one time.



Save Time, Money and Resources Gathering Pharmacy Credentials

Standardized pharmacy credentialing and regulatory compliance requirements in simple ASCII text data files, makes it easier for you to gather the most current, detailed and accurate pharmacy credentialing data.  resQ™ provides a single resource for tens of thousands of individual independent and smaller chain pharmacies’ credentials allowing you to reallocate in-house credentialing resources previously dedicated to manual data entry, screen scraping, phone calling and updating spreadsheets.

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Trusted Source for Pharmacy Data

Leveraging the established NCPDP Pharmacy Profile, an industry consensus committee of independent pharmacies, PBMs, chain pharmacies, and PSAOs, developed a standardized set of professional, industry, pharmacy services, CMS 455 disclosure and ownership requirements to expand the online Pharmacy Profile and create the single resource for pharmacy credentialing data, resQ™.