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.

TA.DC.4

Pharmacy Checklist (MMIS Module)

CSF PH1: Point of Sale (POS) systems interfaces are maintained in order to appropriately process, adjudicate and report on claims according to state and federal rules.

TA.DC.4

Checklist Item Guidance

For R1, evidence could include acquisition documents, a ConOps that explains how real-time access and adjudication will be implemented, or other planning documents that demonstrate plans to incorporate this capability. For R2 and R3, evidence should include an architecture diagram providing an overview of how claims are accepted into the PBM. R2 and R3 evidence could also include screenshots and test reports showing successful integration with POS, switches, and Internet-based systems as well as acceptance of X12N NCPDP claims. For R2 (if not a desk review) and R3, the state should be prepared to give a demonstration of this capability, and for R3, evidence should show this capability active as of go-live.

Checklist Item Source

SMM, HIPAA, CFR

Checklist Item Criteria

The system performs online real-time capture and adjudication of pharmacy claims submitted by providers via POS devices, a switch, or through the Internet. Accepts ASC X12N NCPDP claims required by 45 CFR Part 162.

Certification with ReadyCert

ReadyCert saves time and effort when producing the required evidence and reports for compliance with TA.DC.4. Does your company's solution or medicaid enterprise system comply with ... "The system performs online real-time capture and adjudication of pharmacy claims submitted by providers via POS devices, a switch, or through the Internet. Accepts ASC X12N NCPDP claims required by 45 CFR Part 162." ... 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.

Compliance is
no longer about
Checklists
Maintaining
the Status Quo
means
maturing your
Security
And proving
beyond a
shadow of a
doubt
that you're
Ready
for
Certification

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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