Pharmacy Benefit Management, v. 1.0

The standards in the URAC Pharmacy Benefit Management (v. 1.0) are divided into the modules that follow. Click on the hyperlink for each module to get to the standard-by-standard coverage of the module.

Standards all employees need to know (Pharm Core 1-3, 12, 23, 24, 26)

Human Resources (Pharm Core 4-11)

Information Technology (Pharm Core 13)

Quality Management (Pharm Core 30-37)

Complaints & Appeals (Pharm Core 22, 25, 27-29)

Consumer Communication Practices (Pharm Core 21, CSCD 1-3, 9-12)

Customer Service (CSCD 6-8)

Contracting and Regulatory (Pharm Core 14, 19-20, CSCD 4-5, PTFD 6)

Pharmacy Services (Pharm DC 1-4, 13)

Retail Pharmacy Network (Pharm DC 5-12)

Drug Utilization Management, Pre-Appeal (DrUM 1-11, 14-19)

Drug Utilization Management, Appeals (DrUM 20-28)

Drug Utilization Management, Exceptions/Exclusions (DrUM 12-13)

P&T/Formulary (PTFD 1-12)

Delegation (Pharm Core 15-18)

Miscellaneous Issues for Members of the URAC Accreditation Team

»