CMS Certification with ReadyCert

ReadyCert was built to drive Certification projects at lightning speed. ReadyCert treats your project RTM like a Certification checklist, and treats your Certification checklist like a project RTM. Using the familiar process of requirements fulfillment, ReadyCert empowers your Enterprise to recycle the work of Certification by transforming checklist items and solution requirements into relate-able data elements. When loaded in ReadyCert your system review criteria, fulfillment responses, evaluations and artifacts are quantified and tracked across projects and enterprises to provide deep intelligence and insight into your Compliance narrative.

CM.PH3.1

Pharmacy Checklist (MMIS Module)

CSF PH3: Authorization for services that require prior approval in order to manage costs or ensure patient safety is confirmed.

CM.PH3.1

Checklist Item Guidance

For R1, evidence could include acquisition documents, requirements, a ConOps that explains how this will be implemented, or other planning documents that demonstrate plans to incorporate this capability. For R2 and R3, evidence could include test reports and a screenshot of an edited transaction on prior authorization (e.g., "NCPDP-75: PA required"). For R3, the evidence should date to the time frame when the module went live. For R2 (if not a desk review) and R3, the state should be prepared to give a demonstration of this capability.

Checklist Item Source

IBP

Checklist Item Criteria

SMA ensures that edits are performed on a prior authorization when required.

Certification with ReadyCert

ReadyCert saves time and effort when producing the required evidence and reports for compliance with CM.PH3.1. Does your company's solution or medicaid enterprise system comply with ... "SMA ensures that edits are performed on a prior authorization when required." ... Prove it meaningfully with ReadyCert. Provide clear and concise linkage from the RFP, to the Test Case, to the utilization reports and a secure and convenient application specially engineered to make compliance work quick and easy.

ReadyCert is the Software as a Service (SaaS) answer to Compliance! Take the tour with one of our subject matter experts with you or your entire team. You'll learn how ReadyCert will save your team time and effort when performing compliance work by automating mundane tasks and streamlines reporting across projects, enterprises and frameworks. Our team will show you how ReadyCert improves consistency and eliminates duplicate work scenarios, how it tracks vendor information and how controls are mapped to your enterprise's business areas.

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