IQware Applications for the Pharmaceutical Industry

Curing what ails your data


IQware is a patented (US #7,322,028, others pending) data mining, content management & delivery software solution for pharmacies and the pharmaceutical markets. In addition to this premium functionality, IQware handles Medication Therapy Management (MTM) and the additional reporting requirements created by Medicare Part D.

IQware delivers the needed FDA regulatory compliance, secure audit trail, and comprehensive reports for reimbursement by the PDPs.

IQware is your comprehensive MTM solution.




In response to the general dissatisfaction with existing pharmacy IT systems, IQware and IQware Marketing, LLC have formed a partnership to provide leading-edge technologies to address the most critical concerns facing the pharmacy industry today, including:


  • Timely and appropriate reimbursement for services provided
  • "Dual-eligibles," patients eligible for both Medicare and Medicaid and for whom reimbursements are often delayed or denied
  • Prevention of serious drug interactions
  • Prevention of dosage errors
  • Patient drug use compliance and the optimization of drug therapies
  • Prevention of fraud, waste or abuse among patients
  • HIPAA-compliance
  • Compliance with regulatory and governmental agencies and Prescription Drug Plan Sponsors' requirements for payment

IQware also produces a full-function Medication Therapy Management (MTM) system that lets pharmacists to do what they do best: care for patients. First authorized by Medicare Part D (January 2006), MTM features the following:


  • Pharmacists can bill the PDPs for professional MTM services provided to patients
  • Reimbursement levels are expected to be $1 - $3 per minute for professional MTM services
  • Each MTM transaction is tracked and "taxed" by the IQware MTM System, creating revenue for the pharmacist each time an MTM encounter is completed.





Medication Therapy Management



Pursuant to the Medicare Modernization Act (MMA), sponsors of Medicare Part D are required to include Medication Therapy Management (MTM) systems designed to optimize therapeutic outcomes for targeted beneficiaries.



What is the Opportunity for Pharmacists and Pharmacies?


  • Pharmacists can bill PDPs for professional MTM services provided to patients
  • Reimbursement levels are expected to be $1 - $3 per minute for professional MTM services

The intended use of these plans is to improve medication use and reduce adverse drug events, including adverse drug interactions. The MTM encounters are fee-for-service encounters, a cost that prescription drug providers are required by law to reimburse. To be provided primarily by pharmacists, an already over-burdened professional population, the services must be adequately tracked, regulated and reported. In an effort to ease the administrative burden on pharmacists while concomitantly increasing their ability to provide - and charge for - MTM patient services, the team at IQware/IQware Markting, LLC has developed the first comprehensive, HIPAA-compliant health information delivery system for Medication Therapy Management (MTM) Plans.

 

 

 

What are the Operational Requirements of MTM?


  • Pharmacists are statutorily recognized, compensated and regulated for MTM.
  • Medicare 'Part D' drugs are targeted for verification of optimal usage.
  • Prescription Drug Plan (PDP) sponsors must cooperate with licensed pharmacists & physicians through compliance assistance and compensation for services.
  • Patients with chronic disease(s), certain levels of monthly drug expenditures, and those with other risk factors are targeted for MTM services.
  • Eligibility cost threshold is $4,000 per patient per year.
  • Flexibility in plan development and execution is encouraged by CMS (Center for Medicare and Medicaid Services).
  • Innovation is encouraged by CMS
  • Identification of patients who might benefit from MTM services is encouraged by the CMS.
  • Plan evolution and "best practices" development are encouraged by CMS.
  • Time and resource tracking required.
  • Reporting is required.
  • Audit trail is required due to the overlap of HIPAA and definition of electronic medical records.

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IQware MTM System Benefits:

  • Eases administrative and reporting burdens to provide pharmacists more time with patients and increased revenue opportunities (more MTM patients = more MTM revenue for the pharmacist)
  • Each MTM transaction is tracked and "taxed", creating revenue for the pharmacist each time an MTM encounter is logged into the system
  • Tracks adverse drug effect(s) and interaction(s) to specifically target and maximize positive patient outcomes, thereby reducing negative consequences of drug interactions
  • Integrates seamlessly with all existing pharmacy systems
  • Installs without cooperation with or intervention from current vendors
  • HIPAA compliant
  • Virus immune and hacker-proof and 100% secure
  • Identifies and alerts the pharmacist to "dual eligibles", keeping the pharmacist abreast to lapsed or late payments by PDPs
  • Installs simply and is easy to use
  • Interacts and complies with all Prescription Drug Plan (PDP) and governmental filing requirements
  • Offers complete audit trail of all transactions for governmental and PDP reporting and compliance

The Barrier without the IQware MTM System:

  • Implementation is very costly and error-prone.
  • Administrative burden outweighs any increase in revenue.
  • Manual billing is prone to errors, including oversight and missed opportunities for re-billing rejected claims.
  • Training is costly and time-consuming.
  • Pharmacy is unable to easily and effectively identify patients who may benefit from MTM services, currently or in the future. This creates a losing situation for both patients and pharmacists!

The IQware MTM system automates MTM activities to:

  • Easily document and verify all activities covered under Medicare Part D
  • Easily prove HIPAA compliance
  • Easily prove compliance to PDPs to ensure timely payment
  • Easily provide an audit trail
  • Easily integrate to existing pharmacy systems (without outside help or new tech work)
  • Easily identify those patients within the current population who could benefit from MTM services.
  • Easily identify those patients within the current population who could benefit from future MTM services.
  • Easily manage the MTM workload. With automatic updates and patient alerts, the IQware MTM System administers the program, allowing the pharmacist to maximize time with patients and maximize revenue from MTM services.

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