Regulatory Compliance for Pharmacy Supply Chain Specialists

This activity describes the role of standard-setting, regulatory, and accreditation organizations in the pharmacy supply chain. Regulations relevant to the drug supply chain are reviewed including the federal Controlled Substances Act, Drug Supply Chain Security Act, and 340B Drug Pricing Program.

Risk Evaluation and Mitigations Strategy (REMS)

This module dives into the risk evaluation and mitigation strategy (REMS) program, including it history and how health-system can manage current and emerging medication requirements.

Supply Chain Compliance

This module looks at the current tactics for pharmacy supply chain management, including 340B inventory models, the Drug Supply Chain Security Act, managing drug shortages and drug recalls.

Billing for Clinical Pharmacy Services and Collaborative Practice

This activity analyzes manage key stakeholders and the requirements for establishing a billable pharmacy service to various case settings including physician-based and hospital-based clinics.

Additional Billing Opportunities and Value-Based Care

This activity assesses billing opportunities in a physician practice and pharmacy initiatives related to value-based care.

Denials, Appeals, Edits, and Calculating Reimbursement

This activity delves into handling common denial types, strategies to appeal a denied claim, and payment models related to insurance contracts.

Medicare Billing

This activity reviews managing patient billing within the outpatient and inpatient Medicare reimbursement model.

Medicare Rules and Regulations

This activity dives into the billing information for Medicare and Medicaid programs including eligibility, funding sources, and drug categories.

Overview including Cost and Revenue Cycle

This activity provides an overview of the pharmacy revenue cycle and key CMS policy and payment information.

Revenue Cycle Building Blocks and Formulary Decision Making

This activity describes the roles and responsibilities of key stakeholders and the mechanics of the pharmacy revenue cycle including standards of participation for health systems.