When a pharmacy dispenses a quantity other than what was prescribed, it requires documentation. PBMs will want to know the rationale, whether the quantity was increased or decreased. There are plenty of valid reasons a pharmacy may need to change the quantity, including …
Pharmacies often work in a fast-paced environment with an increasing workload as we see stores closing, more transfer-ins, and higher patient demand. This results in an increased urgency to perform data entry faster, which can lead to the use of override codes to get the claim adjudicated quickly. PAAS National®® is here to remind pharmacies […]
Billing the wrong NDC can correlate to potential audit issues, ranging from recoupments on claims to risking contract termination. In fact, poor performance on invoice audits due to the pharmacy billing the incorrect NDC (in relation to the NDC dispensed), is a leading reason pharmacy contracts get terminated. This issue can be mitigated by …
The Office of Inspector General (OIG) has made it clear that using manufacturer coupon cards with federally funded programs is prohibited by Anti-Kickback Statutes.
