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 […]
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PBM Aberrant Product Lists: The Aberrant NDC and Percentage Billed Compared to Total Volume is Only Part of the Issue
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 communication states that billing […]
What medical professionals should know about liability during a pandemic
The past weeks have left medical providers and health care professionals at risk in more ways than one. In addition to their exposure to contagion, our vital workers may be left exposed legally. Currently, medical providers are working under a patchwork of protections. The result? Ongoing uncertainty and potential for catastrophic and expensive legal suits. […]
The problem and potential consequences of upcoding
A physician’s duty is to their patient. While this is true, medical professionals have many other responsibilities as well. There are hospital and clinic rules that you must follow. You must adhere to state and national regulations, and you have ethical obligations to uphold. Your medical license comes with strings attached. In your pursuit of […]