Zyntrigues, Volume 1, Issue 3 - March 2008
Volume 1, Issue 3, - March 2008 |
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In this Issue
Musingsby Bob Pinkerton, COO THE LURE OF TECHNOLOGYIt would not take a violation of the Geneva Convention to get me to admit I’m a gadget hound. And nothing gets me more fired up at this time of year than the new technologies introduced at the major consumer electronics and IT shows. So, we were standing around the water cooler and discussing trends in Web 2.0/3.0 technology and what that means for our solution set (that’s the kind of thing technical geeks do, you know). The Zynchros.com platform is really a delivery mechanism for Pharmacy Quality Management applications. It seems to me it engenders all of the capabilities required to create a new breed of solutions – the kind where you loosely connect a number of services and deliver a compelling user-experience without investing in hundreds of thousands of lines of code. As we talked more about what we might do and how it would add value to our customers’ view of pharmacy, we came up with the idea to look at some off-the-shelf services and how we might assemble those into a compelling solution for automating Pharmacy and Therapeutics (P & T) activities. Instead of flying the entire P & T committee to a regional hub and spending 3 days at the Marriott, what if you could invite them to an online meeting room (think WebEx or LiveMeeting) and, once they arrived, there were key information resources available to them including drug dossiers for their review and consideration, all of your agenda items and presentations and some compelling technology to track voting and gather opinions. I’m sure there are a host of other capabilities that could be delivered to the “P&T room” and, while it’s clear that face-to-face meetings aren’t going away anytime soon, the cost for an online P &T session would be a fraction of the traditional quarterly gathering. Whether that enables P & T to meet more often or you simply replace one or two of the quarterlies with a digital meeting, we think the benefits are substantial. Like most ideas, this one seems compelling to me. Experience has taught me that saying these things out loud often results in reactions you weren’t expecting. I’m curious if this kind of capability appeals to your firm and, if so, what additional elements you’d like to see. Drop me a line at robert.pinkerton@zynchros.com. I’d love to hear from you and understand whether that time at the water cooler was time well spent or simple star-gazing. Bob P.S. I just wanted to take the opportunity to wish everyone all the best with the CMS 2009 submission window. We’re thinking of you and stand ready to help in any way we can. |
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Keeping up with CMSby David Smith, VP, Product Management This is one of the busiest times of year for our development team here at Zynchros.com as we prepare for the Part D 2009 submission window. One of our greatest challenges is keeping track of all the new requirements and updates from CMS as the information about the Part D program trickles out. From our past experience, we’ve learned that merely monitoring the “official” documents from CMS (such as the Call Letter and HPMS Technical Manual) isn’t enough – sometimes critical information is relayed through memos, answers to questions in user calls, and other unwritten forums. We scrutinized the recent CMS Formulary Training video (http://www.cms.hhs.gov/apps/events/event.asp?id=356) with great interest, and it included a few surprises. For example, we had to make a last-minute adjustment when we learned that for NDCs with a Prior Authorization Type of “Part D vs Part B only” that no Prior Authorization Group Description is allowed. Thanks to our Agile development methodology, we were able to quickly update the application to ensure that no PA Group Description is included in the HPMS formulary file in that case. We’re now looking forward to the CMS User Call on April 2, which will be dedicated to questions arising from the video (we have several on our list, especially clarifications on the use of the “applies to new starts only” Step Therapy Type and Prior Authorization Type within the six classes of clinical concern). The final HPMS Technical Manual (published on March 17) also contained a couple of surprises compared to the draft information published back in December and January. Fortunately there were no last-minute changes to the HPMS Formulary File format, but there have been some significant changes to the Prior Authorization File compared to the draft published in January. (If you need help coping with these changes or creating the PA file, check in with Frank Janda for information about our PA File Generation service.) There were also a few new details about the submission calendar: it seems that the HPMS tools will be available on March 28 (three days earlier than originally announced), and the supplementary files can be uploaded beginning June 3 (with a deadline of June 9). By contrast, we didn’t find many changes of note (with respect to formulary management, at least) in the final Call Letter also published on the 17th. I know all of our Part D customers are waiting with great anticipation, as we are, for the release of the 2009 Formulary Reference File (FRF) which as of this writing is still not available. Unfortunately, the deadline has now passed for us to be able to provide new Part D 2009 functionality (which depends on the FRF) in our planned March 21 release. As a result, the new Part D 2009 functionality for creating and editing Part D 2009 formularies will be available 72 hours after CMS does release the 2009 FRF. This 72-hour window gives us time to:
Functionality for validating Part D 2009 formularies, creating reports, and exporting the HPMS formulary file will be available in our subsequent release planned for March 31. Keeping track of CMS is demanding and necessary in order for us to continue to deliver the high quality, comprehensive Zynchros.com service you’ve come to expect and rely upon. The bottom line for us is your success in the submission process. We’ll know this challenge has paid off when the preparation and submission of your Part D 2009 formulary files goes smoothly and you are free from worrying the details. Please contact me at your convenience to let me know how we’re doing at david.smith@zynchros.com. -- |
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Zynchros Prior Authorization Reporting ServiceDo you need help generating the new prior authorization (PA) supplementary file, required during the Part D 2009 submission window, April 1 – 21, 2008?
For each of your formularies, our professional services group will:
The supplementary file will include each PA group in the formulary, the list of drugs within each PA group on formulary, and the text fields you provided, all in the required tab-delimited flat file format and meeting the field size limits CMS mandates. Avoid the uncertainties and time-consuming details of this new CMS requirement. For more information and to get started, please contact Frank Janda, Zynchros Professional Services Sales at 206.792.4134 or via e-mail to frank.janda@zynchros.com. |
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Join us for the Part D 2009 Webcast, Wednesday, March 26th at 8:30am Pacific/11:30am EasternJoin Zynchros as we discuss the CMS changes to the Part D 2009 program, outlined in their PBP Software and Formulary Submission paperwork reduction act filing, and the draft 2009 Call Letter. Get the information you need to make the changes critical to your submission process. Attend the web cast to learn:
Details of Member Formulary Reporting & notification and Prior Authorization Supplementary file requirements will also be discussed.
Would you like more information regarding the web cast or have any questions you'd like to have answered during the web cast? Feel free to contact us, we'd be happy to help you. |
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Enhanced Member Formulary ServiceProducing member formulary reports that meet your marketing requirements and CMS marketing guidelines can be an expensive and time-consuming task.
To reduce the cost and effort of producing CMS-compliant member formulary reports please call one of our CMS experts at 1.866.ZYNCHROS (1.866.996.2476) option #1 or e-mail us at member.formulary@zynchros.com. |
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Tips and Tricks: Get a Head Start on 2009 SubmissionsBy Scott Pillsbury, Director, Customer Service and IT You can start working on your 2009 Part D formularies even before CMS has published the latest Formulary Reference File (FRF). Simply make a copy of your current 2008 Part D formulary by navigating to the “Manage Your Formularies” screen and click on the “Copy” symbol ( When the copy process is complete, you will see your new formulary with a formulary type of “2008 Part D”. Don’t panic, this is correct. You may now start editing the formulary for your 2009 benefit year. Once Zynchros receives the updated FRF and specifications from CMS you can anticipate a notification that the system is ready-for-use within 72 hours of our receipt of the FRF. An important component of the update will be the process to convert a 2008 Part D formulary to the new 2009 Part D specifications. The conversion process will
The balance of the steps will be provided in detail as part of our software update on March 31. Of course, Zynchros Customer Service is standing by ready to assist you in any way possible. As always, we may be reached via email at service@zynchros.com, or you can call our help desk at 866-996-2576 option 2. If you have any requests for future installments of “Zynchros Tips and Tricks” please send them to scott.pillsbury@zynchros.com. I look forward to hearing from you. |
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) of the 2008 Part D formulary you wish to use as your starting point for your 2009 Part D formulary. Enter a “name” and “abbreviation” for the new formulary and click the “Copy Formulary” button to complete.