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Strength in Numbers: Partnership Strategies

Strength in Numbers: Partnership Strategies

With all of the changes that have taken place in pharmacy, it is increasingly important for QS/1 to continue looking for services that add value and strength to your business. In addition to services developed and supported by QS/1, we also partner with various third-party service providers that offer programs to assist with everything from pricing and rebate programs to adherence and business-intelligence solutions. The goal is to provide our customers access to resources that improve patient care, workflow and also strengthen their bottom line.

QS/1 currently partners with most drug wholesalers for internet ordering of both prescription medications as well as front-end merchandise. Orders can be placed and confirmed electronically. The electronic confirmation automatically adds the merchandise received to on-hand quantities in the QS/1 system, which include Class II items. These partnerships also allow the ability to process price catalogue files, which load actual acquisition prices into the pharmacy management system. Other programs, such as automatic drug ordering, drug pricing and business-intelligence resources, are also available through partners like AmerisourceBergen® and Cardinal Health.

Along with ordering and pricing, managing inventory is a very important part of your business. QS/1’s Pharmacy Management Systems allow the ability to set up perpetual inventory using minimum and maximum quantity settings. Inventory management programs, such as Cardinal Health Inventory Manager and SureCost,® can help determine how much inventory to keep on hand, integrate supply chains and handle expired inventory more efficiently. QS/1 also partners with Smith Drug and other wholesalers for automatic price updates.

To assist with clinical checking for drug/drug and drug/food interactions, QS/1 partners with First Databank. This partnership also provides access to drug images and descriptions that help with quality assurance and patient education monographs to assist with counseling patients on their medications.

Adherence programs are becoming more important than ever, especially with the introduction of the Centers for Medicare & Medicaid Services (CMS) Five-Star Quality Ratings System. Adherence programs assist pharmacists and patients in managing their medication regimes in order to achieve better health outcomes. Health-Minder® is a program included in QS/1’s Pharmacy Management Systems that allows patients to automatically refill prescriptions when needed. If the pharmacy utilizes the QS/1 Interactive Voice Response (IVR) system, patients can be notified when their refills are ready for pickup through the call-out feature. If a patient prefers receiving notification via email or text, QS/1 has partnered with PDR Network®, formerly LDMGroup, to provide this option as well. Another adherence tool offered by PDR is CarePoints®. These are direct-to-patient messaging programs that provide targeted health education messages based on past transactions and behavior. MedsOnCue offers on-demand prescription-specific videos that give patients information on how to take their medication as prescribed. Other adherence-focused programs offered through QS/1 are Mirixa® and PrescribeWellness.

For pharmacies that fill Medicare Part B prescriptions, QS/1 offers the HME Documentation module, which is included in the NRx and PrimeCare Pharmacy Management Systems. This module helps ensure that all required Medicare Part B documentation is compiled and maintained in case of an audit. The documentation includes Medicare Supplier Standards, Assignment of Benefits, Proof of Delivery and the item-specific Physicians Orders. Once you have all of the required signatures, we have partnered with Emdeon® to handle billing. Pharmacies that participate in 340B programs can also take advantage of QS/1 partnerships. American Health Care, Sentry™ 340B, MacroHelix, Pharmacy Data Management, Inc. (PDMI), Pharmaceutical Strategies Group (PSG), RxStrategies™, Inc. and SunRx provide assistance with 340B compliance, inventory management, procurement, drug-pricing management and also offer robust reporting.

Not getting the proper payments for the prescriptions you fill can wreak havoc on your bottom line. There are several programs that can assist with reducing the cost of rejected claims, under paid claims and unpaid claims. Pre- and post-edit programs offered by QS/1, Cardinal Health, Emdeon and RelayHealth provide editing services that evaluate prescription claims prior to adjudication, which reduces third-party rejections and maximizes reimbursements. Prior authorizations (PAs) through CoverMyMeds® assist pharmacies with the process of requesting PAs from physicians, which reduces prescription abandonment, eliminates administrative waste and provides faster determinations from physicians. QS/1 also partners with a large number of reconciliation services that help manage what has or has not been paid to your pharmacy. These services examine unpaid and under-paid prescriptions. They provide reports and assist with recouping the money owed to you. These vendors also provide files that can be loaded directly into the pharmacy system to run reports, from the transaction level, to review payment information.

To ensure your patients have the correct third-party information to submit claims, we offer the CardFinder™ program through Emdeon. With this program, you are able to check a patient’s third-party coverage for Medicare Part D and most commercial insurance plans. This is a real-time service that can help reduce rejected claims due to incomplete or inaccurate third-party information. Medicare patients in the process of choosing the proper coverage often depend on pharmacists to guide them toward the best plan. Although you can only show them the options, iMedicare is a service that can quickly search and compare all available plans. Once the comparison is complete, patients can make more informed decisions about the plans that best fit their needs.

When it comes to legal and regulatory items, QS/1 is constantly updating our software to help keep you compliant with state and federal regulations. One of the changes that most states have already implemented for pharmacy is the Prescription Monitoring Program (PMP) for controlled substances. If you prefer not to track and report this yourself, we offer a service that can do it for you. This service provides pharmacies with the comfort of knowing claims are being reported as required by law and removes the initial manual submission from the pharmacy staff. Federally mandated medication guides can be printed through PDR’s MedGuide™ program. For states that require pseudoephedrine tracking, the QS/1 Point-of-Sale (POS) system records sales and can report to state agencies for customers using MethCheck®. On a local level, some healthcare systems are looking for medication history to provide better care for patients. ESI Rx History™ and Surescripts® medication history services provide a complete and accurate history of a patient’s medications for physicians and caregivers. This helps pharmacies improve patient safety and prescription quality by managing the risk of adverse drug effects, along with enabling more informed treatment decisions across care transitions.

If you are interested in rebates, along with a FamilyCare Pharmacy Network option, QS/1 partners with a number of vendors that offer monetary reimbursements in exchange for data. With your consent, QS/1 collects the data through PowerLine™ and passes it along to one or more of its rebate partners. The data that is forwarded on your behalf does not include any personal health information. In most cases, your rebate will come in the form of a PowerLine credit.

QS/1 offers many programs that can help you achieve success and in many cases, there is no cost from QS/1 for these services. For more information on these or other services and programs available, please call 800.845.7558, ext. 1424, email databaseservices@qs1.com or refer to the QS/1 Services Directory at qs1.com/qs1servicesdirectory.

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