In September 2022, the U.S. Department of Health and Human Services Office of Inspector General (OIG) put out a report on program integrity risks concerning Medicare telehealth services during the first year of the COVID-19 pandemic.
About Jenevra Azzopardi, CPhT
I grew up in a family of nurses and other medical professionals but was never interested in the clinic setting. I was drawn to pharmacy because I like to help people and could easily use the knowledge I grew up with to do so. It was a great fit.
I have a Bachelor of Arts in Communications from the University of Wisconsin – Madison. Prior to joining PAAS in 2017, I worked for Walgreens for 19 years.
As an Analyst at PAAS, I really enjoy being able to help independent pharmacies succeed. I have always been a fan of the underdog and am excited to be able to give you the tools you need to take on the giants of the PBM industry.
Entries by Jenevra Azzopardi, CPhT
Humana has recently sent out audits to pharmacies with a subject line stating Review of claim(s) billed after member’s deceased date.
Diazepam rectal gel continues to confuse prescribers and pharmacies alike when it comes to how a prescription is written and then ultimately filled and billed.
Anytime you dispense a quantity different from what was prescribed, you should note why.
The new inhaler was not an exact replacement of the old one. What happens if the plan will not allow a 20-day supply?
Make sure you have good documentation of the conversation with the prescriber’s office to successfully pass an audit that may occur years later.
This partnership was designed to allow both companies to operate independently with ESI providing services to Prime, including performing some audits.
PAAS National® recommends attention to detail when it comes to typing directions for patient labels.
PAAS National® has seen an increase in audit results from Elixir where the pharmacy was cited for “Claim not covered under Medicare Part D (NPD).”
Plan limit rejections are intended to help control costs, provide clinical edits, and assist pharmacies in ensuring patient safety. When an initial claim adjudication is rejected for exceeding plan limits (e.g., Max Quantity Limit or Quantity vs Time Limit), pharmacies need to proceed with caution.