Document Assessment

After your application and supplemental documentation have been processed, you will receive a Document Assessment. The Document Assessment is a tool provided for self-reporting policies and procedures and other documentation demonstrating compliance with the standards.  The Document Assessment and the referenced policies, procedures and other documentation should be submitted within 120 days of receiving the Assessment. The Assessment requests policies, procedures and other documentation pertaining to:

ORGANIZATIONAL INFRASTRUCTURE
Licensing and Compliance
• Pharmacy, pharmacists, technicians
Management Processes
• Organizational structure Mission statement, delegated processes
• Development and Control of Policies and Procedures
• Scope of specialty pharmacy services
Personnel
• Job descriptions, hiring and credentialing personnel, training documentation, performance and competency assessment
• Collection, evaluation, and documentation of pharmacy workload
Structure for fiscal management
Product Procurement, Receipt, Storage, Preparation, and Distribution
• Inventory control, environmental conditions, hazardous materials,  recalls, mail order, home delivery
Confidentiality of Patient Information
• Access, information destruction, provision of privacy practice, physical layout for patient privacy
Information Systems and Security
• Contingency Plan

ACCESS TO MEDICATIONS
Comprehensive Benefits Investigation, Prior Authorization, and Benefits Coordination
Hub Coordination and Data Reporting
REMs compliance
Provision of Financial Information

CLINICAL AND PATIEN MANAGEMENT SERVICES
Patient Enrollment Process and Materials
Communication with Prescribers, Pharmacists, and Health Care Providers for Coordinated Patient Care
Comprehensive Patient Profile

• Demographics, medication history, DUR processes
• REMs requirements and lab documentation
Patient Consultation and Education
• Patient assessment and DUR processes
• Communication and resources
Case Management Services and Process
• Patient assessment, protocols, documentation, and coordination with health care providers
• Patient customization
Patient Care Interventions and Delays in Therapy

QUALITY IMPROVEMENT
Collection and evaluation of quality related metrics including
• Adherence
• Persistence
• Interventions and cost avoidance
• Call center performance
• Patient and healthcare provider satisfaction, and complaint handling
• Error rates and types of errors
• Outcomes based on quality improvement projects 
• Quality improvement training
• Data reporting accuracy