2024 Self-Audit Series #4: Transferred Prescriptions
Making sure your transferred prescriptions are complete can be one of the easiest audit recoupments to prevent.
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Each state’s Board of Pharmacy outlines in their laws what is required to be included on a transferred prescription, and auditors love to identify missing information and marking the claim discrepant. Pharmacies should educate themselves on the individual requirements to avoid big recoupments during audit.
Transferred prescriptions can easily be targeted for audit based on the origin code billed on the claim. High dollar claims with an Origin Code of 5 have an increased likelihood for audit. Consider utilizing this information to self-audit your transferred prescriptions on a regular basis.
PAAS Tips:
- Do not assume faxes you receive from other pharmacies are complete, missing requirements only affect your claims during an audit
- Refresh your staff’s knowledge with your state’s current prescription transfer laws
- Consider creating or utilizing transfer prescription blanks that include all required elements for your state
- When using software transfer fields, consult with your PMS vendor to ensure all information is included and be sure to include this “screen shot” during audit
- Run internal reports on a regular basis to review your transferred prescriptions
- Be sure written dates are entered correctly to avoid filling past expiration
- Always double check that quantities and refills are entered accurately to avoid billing over what is remaining on the prescription.
- See June 2022 Newsline, Best Practice for Entering Transfers with Partial Refills Remaining.
- Origin code “5” should be billed for all transferred prescriptions.
- See February 2023 Newsline, Why Does Billing the Correct Origin Code Matter?
- Contact PAAS National®® analysts with questions or concerns on your transferred prescription, info@paasnational.com or (608) 873-1342.
Analyst at PAAS National®
As a Certified Pharmacy Technician at PAAS, I am here to assist and provide you with pre- and post-audit advice. I can also provide product and billing information.
I attended Madison College in nearby Madison, WI (PAAS headquarters are in the Madison suburb of Stoughton). Prior to coming to work at PAAS, I worked as a Certified Pharmacy Technician in a retail setting for 25+ years. Pharmacy has been my life’s work.
Helping our members have a successful audit experience is very rewarding. Celebrating with them, when PAAS often helps generate positive post-audit results, is the best part of my work.
I attended Madison College in nearby Madison, WI (PAAS headquarters are in the Madison suburb of Stoughton). Prior to coming to work at PAAS, I worked as a Certified Pharmacy Technician in a retail setting for 25+ years. Pharmacy has been my life’s work.
Helping our members have a successful audit experience is very rewarding. Celebrating with them, when PAAS often helps generate positive post-audit results, is the best part of my work.
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