Oral inhalers remain a high audit risk for all PBMs and being able to identify billing pitfalls may mean the difference between a claim safe from recoupment and one lost due to an improper DAW code, early refill, or overbilled quantity.
Though the definitions were revised to include biologic drug products, the guidance holds true for all legend drugs. Now is the time to refamiliarize yourself with the best-practices for using DAW codes and to review DAW code audit pitfalls most seen by PAAS National® analysts.
While this chart is useful, you may be asking yourself – What does this all mean?! Let us go through several examples.
As pharmacies across the country are gaining access to this anti-viral COVID-19 therapeutic agent, it is important to understand the specifications of the EUA…
There has been a sharp increase in the number of Targeted Probe and Educate Program audits on diabetic testing supplies.
Ever wonder if you were billing the correct NDC for a Humira® prescription and had to spend precious time investigating? Or how about questioning if you were billing the correct package size for Gvoke® and had to consult multiple references just to try and figure out the answer?
Manufacturers go through rigorous testing to bring their products to market and part of the tedious approval process includes stability, sterility, and beyond-use date (BUD) testing.
Transfer prescriptions carry a high audit risk due to the additional documentation required based on state regulations.
On March 29, 2022, the CDC and FDA issued press releases to provide updated COVID-19 vaccine recommendations.
