Credentialing Guidelines and Requirements

1.0

Pharmacology for Technicians

13.75%

1.1

Generic and brand names of pharmaceuticals

1.2

Therapeutic equivalence

1.3

Drug interactions (e.g., drug-disease, drug-drug, drug-dietary supplement, drug-OTC, drug-laboratory, drug-nutrient)

1.4*

Strengths/dose, dosage forms, physical appearance, routes of administration, and duration of drug therapy

1.5

Common and severe side or adverse effects, allergies, and therapeutic contraindications associated with medications

1.6

Dosage and indication of legend, OTC medications, herbal and dietary supplements

2.0

Pharmacy Law and Regulations

12.50%

2.1

Storage, handling, and disposal of hazardous substances and wastes (e.g., MSDS)

2.2

Hazardous substances exposure, prevention and trea®ent (e.g., eyewash, spill kit, MSDS)

2.3

Controlled substance transfer regulations (DEA)

2.4

Controlled substance documentation requirements for receiving, ordering, returning, loss/theft, destruction (DEA)

2.5

Formula to verify the validity of a prescriber’s DEA number (DEA)

2.6

Record keeping, documentation, and record retention (e.g., length of time prescriptions are maintained on file)

2.7

Restricted drug programs and related prescription-processing requirements (e.g., thalidomide, isotretinoin, clozapine

2.8

Professional standards related to data integrity, security, and confidentiality (e.g., HIPAA, backing up and archiving)

2.9

Requirement for consultation (e.g., OBRA'90)

2.10

FDA’s recall classification

2.11

Infection control standards (e.g., laminar air flow, clean room, hand washing, cleaning counting trays, countertop, and equipment) (OSHA, USP 795 and 797)

2.12

Record keeping for repackaged and recalled products and supplies (TJC, BOP)

2.13

Professional standards regarding the roles and responsibilities of pharmacists, pharmacy technicians, and other pharmacy employees (TJC, BOP)

2.14

Reconciliation between state and federal laws and regulations

2.15

Facility, equipment, and supply requirements (e.g., space requirements, prescription file storage, cleanliness, reference materials) (TJC, USP, BOP)

3.0

Sterile and Non-Sterile Compounding

8.75%

3.1

Infection control (e.g., hand washing, PPE)

3.2

Handling and disposal requirements (e.g., receptacles, waste streams)

3.3*

Documentation (e.g., batch preparation, compounding record)

3.4*

Determine product stability (e.g., beyond use dating, signs of incompatibility)

3.5

Selection and use of equipment and supplies

3.6*

Sterile compounding processes

3.7*

Non-sterile compounding processes

4.0

Medication Safety

12.50%

4.1

Error prevention strategies for data entry (e.g., prescription or medication order to correct patient)

4.2

Patient package insert and medication guide requirements (e.g., special directions and precautions)

4.3

Identify issues that require pharmacist intervention (e.g., DUR, ADE, OTC recommendation, therapeutic substitution, misuse, missed dose)

4.4

Look-alike/sound-alike medications

4.5

High-alert/risk medications

4.6

Common safety strategies (e.g., tall man lettering, separating inventory, leading and trailing zeros, limit use of error prone abbreviations)

5.0

Pharmacy Quality Assurance

7.50%

5.1

Quality assurance practices for medication and inventory control systems (e.g., matching National Drug Code (NDC) number, bar code, data entry)

5.2

Infection control procedures and documentation (e.g., personal protective equipment [PPE], needle recapping)

5.3

Risk management guidelines and regulations (e.g., error prevention strategies)

5.4

Communication channels necessary to ensure appropriate follow-up and problem resolution (e.g., product recalls, shortages)

5.5

Productivity, efficiency, and customer satisfaction measures

6.0

Medication Order Entry and Fill Process

17.50%

6.1*

Order entry process

6.2*

Intake, interpretation, and data entry

6.3*

Calculate doses required

6.4

Fill process (e.g., select appropriate product, apply special handling requirements, measure, and prepare product for final check)

6.5

Labeling requirements (e.g., auxiliary and warning labels, expiration date, patient specific information)

6.6*

Packaging requirements (e.g., type of bags, syringes, glass, pvc, child resistant, light resistant)

6.7

Dispensing process (e.g., validation, documentation and distribution)

7.0

Pharmacy Inventory Management

8.75%

7.1

Function and application of NDC, lot numbers and expiration dates

7.2

Formulary or approved/preferred product list

7.3*

Ordering and receiving processes (e.g., maintain par levels, rotate stock)

7.4

Storage requirements (e.g., refrigeration, freezer, warmer)

7.5

Removal (e.g., recalls, returns, outdates, reverse distribution)

8.0

Pharmacy Billing and Reimbursement

8.75%

8.1

Reimbursement policies and plans (e.g., HMOs, PPO, CMS, private plans)

8.2*

Third party resolution (e.g., prior authorization, rejected claims, plan limitations)

8.3

Third-party reimbursement systems (e.g., PBM, medication assistance programs, coupons, and self-pay)

8.4

Healthcare reimbursement systems (e.g., home health, long-term care, home infusion)

8.5

Coordination of benefits

9.0

Pharmacy Information System Usage and Application

10.00%

9.1

Pharmacy-related computer applications for documenting the dispensing of prescriptions or medication orders (e.g., maintaining the electronic medical record, patient adherence, risk factors, alcohol drug use, drug allergies, side effects)