URAC Compliance for PBMs: Five Ways ProviderTrust Helps


URAC accreditation for pharmacy benefit managers demonstrates a commitment to patient safety and transparency, and is a must for PBMs competing for government-funded business. With more states passing legislation governing PBM licensing and operation, the accreditation and endorsement has become increasingly important. But ensuring ongoing compliance with URAC requirements can be an operational challenge, especially when it comes to pharmacy network oversight.

At ProviderTrust, we are honored to work with URAC-accredited pharmacy benefit managers who are committed to safety, transparency, and fighting fraud in healthcare. Here are five ways our monitoring services help PBMs achieve and demonstrate URAC compliance and improve efficiency. 

Pharmacy Network Monitoring Makes Meeting URAC Requirements Easier

1. Credential Pharmacies Faster

Improve credentialing workflows with verification and screening of eligibility requirements. Integrate ProviderTrust insights with your credentialing software or other data management system for maximum efficiency. 

2. Easily Identify Excluded Pharmacies

Ensure eligibility of every Medicare and Medicaid transaction. Identify non-compliant pharmacies on an ongoing basis with no manual list searching. Prove exclusion monitoring history with our audit-ready reports.

3. Track and Store Insurance Documents

Securely store liability insurance documents alongside pharmacy demographic data. Track expiration dates and get customized alerts when a new insurance document is due.

4. See Primary Source Verification (and Screenshots)

Get automated primary source verification of licenses and DEA registration at your desired frequency. See time-stamped and audit-ready screenshots for every verification. Want insight into pharmacist-in-charge licenses? We can do that, too.

5. Find Missing Pharmacy Licenses

Complete your pharmacy network data by adding and tracking entity or PIC licenses. Upload the data you have and we’ll return current licenses and the most up-to-date status. Get alerts and documentation of expired or inactive licenses.  

Our ongoing pharmacy network monitoring is a powerful and flexible solution that can empower growth within your pharmacy network—without bogging down teams in credentialing, operations, or compliance.

How Dash Helps

Our dashboard allows you to quickly see the overall health of your pharmacy network, including a brief overview of eligibility issues and currently monitored populations.

Review and manage your pharmacy and pharmacist populations with an easily filtered roster to view comprehensive profiles.

All of your issues in one place, our “Alerts” tab allows you to review and filter your eligibility issues so you can make the necessary adjustments to your pharmacy network.

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