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Patient Copayments and the Use of Manufacturer Coupons

How Saving a Patient Money can Cost Your Pharmacy the Entire Paid Claim Amount or Worse, Your Pharmacy’s PBM Contract. Most who have worked in a pharmacy for some time can remember the Purple Pill Card, the Nexium Savings Coupon with the catchy name and bright purple colors. Not only did this program have catchy …

Signature Log Audits: Are you Maintaining the Proper Documentation for In-Person and Mail-Delivered Prescriptions?

Many PBMs relaxed the requirements on signature logs for both in person and delivered medications due to the Covid-19 Pandemic. Some PBMs even allowed mailed prescriptions when otherwise prohibited. While the ease in restrictions made providing patients with their medications easier, the PBMs retained the right to audit signature logs regardless of the lifted restrictions. …

PBM Aberrant Product Lists: The Aberrant NDC and Percentage Billed Compared to Total Volume is Only Part of the Issue

Billing of Aberrant NDCs Beginning in January of 2020, at least one of the major PBMs began monitoring its network pharmacies for the billing of specific NDC numbers the PBM considered “Aberrant”. The list of NDCs was sent to network pharmacies in November of 2019 and has since been updated in November of 2020. The …