LTC Is Different … Do Auditors Agree?
PAAS National® analysts frequently assist pharmacies that service LTC facilities. Three audit flags PAAS analysts frequently see for LTC pharmacies
Entries by Dana Westberg, CPhT
Update to PAAS’ Onsite Credentialing Guidelines
PAAS National® has created an Onsite Credentialing Guidelines, an extensive checklist to assist PAAS members with scheduled and/or unexpected visits from PBM auditors. Unannounced visits can catch pharmacy staff off guard when the Pharmacist-in-Charge (PIC) is not present.
Start of New Year = Opioid Plan Rejects
PAAS National® analysts receive numerous calls at the start of the new year looking for guidance on opioid plan rejects.
Prescriber Statement Requirements Needed for Prescription Discrepancies
Appealing audit discrepancies can be confusing and time consuming. PAAS National® analysts have over 50 years of dedicated audit assistance experience, and review nearly 10,000 audits a year.
Missing DUR and SCC Documentation Can Lead to Recoupment!
Many pharmacy teams are overwhelmed with the increasing daily workload. This can result in data entry staff creating shortcuts, like entering override codes to get claims processed.
“Unauthorized Refills” Audit Discrepancies; How Does This Happen?
Audit results flagging “unauthorized refills” or “overbilled quantity,” can lead to big recoupments.
Flu Shot Season Is Here – What Is Needed for Audit?
COVID-19 has forced a significant increase in the number of vaccinations pharmacies do daily. With this increase also comes additional audits.
Could You Be Giving Vaginal Creams Away for Free?
PAAS National® analysts continue to see claims for Premarin® and Estrace® creams being audited and recouped. Are you in jeopardy?
Is Your Pharmacy Ready for an Unannounced Audit?
Pharmacies are often startled with the limited amount of time a PBM offers prior to an onsite audit. However, PBM auditors, DEA agents, FDA inspectors and state Board of Pharmacy inspectors can also make unannounced visits.
New Dispensing Platform? Be Ready in Case of an Audit!
Pharmacies updating or changing their dispensing platform may face unique audit issues.
