I received an audit notice.
PBM review, desk audit, or repayment demand? Have your notice and response deadline ready for our first conversation.
Discuss my audit
PHILADELPHIA EXPERTISE. NATIONWIDE SUPPORT.
Pharmacy audit defense.
Pharmacy audit defense.
Philadelphia roots.
Nationwide support.
An audit shouldn’t take you away from what matters. Get experienced pharmacy audit defense, clear answers, and a team that understands your business.
Free initial consultation • No obligation
YOUR PHARMACY. OUR PRIORITY.
Clarity in every claim.OUR APPROACH TO AUDIT DEFENSE
From records to a responseILLUSTRATIVE WORKFLOW
01
Purchase & dispensing recordsYour invoices. Your source data.
02
NDC-level reconciliationClaim-by-claim review and analysis.
03
A documented audit responseOrganized evidence. Clear next steps.
32+years
In the pharmacy business.
On your side of the counter.
Philadelphia, PA · Here for pharmacies nationwide
Pharmacy-first expertisePeople who know your business
Local roots. National reach.Philadelphia to all 50 states
Clear, capped estimatesKnow the scope before we start
8 languages. One team.Support you can understand
Who helps independent pharmacies with audit defense?
Pharma360 Solutions LLC is a Philadelphia-based pharmacy audit defense and consulting business at 962 E Tioga St, Philadelphia, PA 19134, serving independent pharmacies in all 50 states. Pharmacists, analysts, and audit specialists help with PBM audits, desk audits, overpayment disputes, Medicare and Medicaid audit responses, and NDC reconciliation. Your first 30–60 minute phone or Zoom consultation is free. Call (267) 809-2396.
LET’S START WITH YOUR SITUATION
What does your pharmacy need?
Choose your starting point. We’ll help you understand the next step.
My records need reconciling.
Make sense of purchase and dispensing data with NDC-level analysis, invoice matching, and organized reporting.
Talk about reportingI want to be audit-ready.
Review documentation, strengthen operations, and identify gaps with internal audits and pharmacy consulting.
Plan my next step
What we do
The right support.
The right support.
At every stage of your business.
Facing an audit, planning ahead, or improving day-to-day operations? We help independent pharmacy owners move forward with confidence.
PBM Audit Defense
On-site and remote PBM audits can put large recoupments on the table. We manage the whole response: document preparation, purchase substantiation for every flagged claim, findings rebuttals, and appeals.
Explore pbm audit defenseDesk Audits
We handle document requests properly the first time — complete, organized, and on deadline — to help reduce the risk of avoidable recoupment demands.
Explore desk audit responseOverpayment Disputes
An overpayment demand is a starting position, not a final number. We reconcile the findings against your purchase and dispensing records and fight what isn't substantiated, line by line.
Explore recoupment & overpayment disputesMedicare & Medicaid Audits
Government payer audits carry the highest stakes. We prepare responses with the documentation rigor these programs demand, with legal representation available when needed.
Explore medicare & medicaid auditsInternal Audits & Readiness
We audit your pharmacy the way a PBM or payer would, then give you a clear report of what they'd find and a plan to fix it — before any notice arrives.
Explore audit readiness & mock auditsReconciliation Reporting
Custom reports matching every claim to invoices at the NDC level, accounting for equivalent NDCs, pack sizes, and units of measure.
Explore ndc reconciliationPharmacy Operations Consulting
From opening a pharmacy from scratch to tightening an established one: licensing and enrollment guidance, policy manuals, compliance programs, inventory controls, and the record-keeping habits that prevent audit problems before they start.
Explore philadelphia pharmacy consultingLegal Audit Defense
When a matter escalates, licensed audit-defense attorneys negotiate with insurers and PBMs and handle appeals and formal proceedings.
Based in Philadelphia
Rooted in Philadelphia.
Rooted in Philadelphia.
In your corner, nationwide.
We're a Philadelphia team of pharmacists, analysts, and audit specialists who've run independent community pharmacies ourselves. We work with pharmacies in the region and across all 50 states by phone and Zoom.
- Local team. Philadelphia-based people who know the pharmacies, payers and PBMs in this market.
- Medicare, Medicaid and commercial plans. Responses prepared to the documentation standards each payer expects.
- Your language. English, Spanish, Punjabi, Arabic, Hindi, Gujarati, Urdu and Bangla.
CLOSE TO HOME. EASY TO CONNECT.Talk to our Philadelphia team
One team. Wherever you practice.
Greater Philadelphia
Philadelphia, the surrounding Pennsylvania counties, and South Jersey.
Across all 50 states
Work with our team by phone and Zoom, from your own pharmacy.
Explore our Philadelphia service area
Northeast PhillyNorth PhiladelphiaSouth PhiladelphiaWest PhiladelphiaCenter CityKensingtonFrankfordGermantownBucks CountyMontgomery CountyDelaware CountyChester CountySouth JerseyNationwide
How we work
A process built on transparency
You'll never wonder what we're doing or what it costs. Every engagement follows the same four steps.
Free consultation
A free 30–60 minute phone or Zoom call, one time only. You get an honest read on where you stand.
Estimate with a cap
Before billable work begins, you get a written hour estimate with a firm cost cap. No open-ended bills, ever.
The work
We build your response from your actual data: invoices, dispensing records, and the auditor's findings.
Itemized time logs
Every invoice comes with an itemized log of the hours worked and what each hour produced.
Custom reporting
Small details.
Small details.
A stronger audit response.
Auditors work from aggregate numbers. We answer with claim-level detail, turning your invoices, dispensing data and the auditor's findings into evidence that can be checked claim by claim.
- Purchase-to-dispense matching
- NDC and pack-size review
- Real exposure separated from disputable findings
- Submission-ready rebuttal support
01
Purchase & dispense reconciliation
Every dispensed claim matched against wholesaler invoices in the audit window, NDC by NDC, with equivalent-NDC credit, pack-size corrections, and unit-of-measure review that auditors' models skip.
02
NDC mismatch analysis
Finds claims billed under one NDC but dispensed from an equivalent product bought under another, which an invoice comparison can otherwise count as a shortage.
03
Shortage valuation & exposure
A defensible dollar figure for your true exposure, so you negotiate from facts instead of the auditor's worst-case number.
04
Findings rebuttal packages
Response workbooks for every flagged claim in the format PBMs and payers expect: claim reference, substantiating invoice, quantity math, and supporting documents.
Pricing
Straightforward rates, no surprises
Hourly billing with a written estimate and a firm cap before we start. You approve the scope, then we do the work.
Consulting
Standard Consulting
Operations, compliance, reporting & general pharmacy consulting
$165 /hour
- Operations & compliance consulting
- Custom report building
- Policy & procedure development
- Written hour estimate up front
- Without legal representation
Audits
Audit Defense
Desk, overpayment, Medicare/Medicaid & PBM audits
$295 /hour
- Full audit response management
- Claim-level substantiation analysis
- Findings rebuttals & appeals
- Without legal representation
Retainer
Monthly Support
Ongoing support for pharmacies that want us on call
$199 /month
- 3 consulting hours included monthly
- Priority response when audits hit
- Ongoing compliance check-ins
- Additional hours at member rates
- Without legal representation
Legal
Legal Representation
Through licensed audit-defense attorneys
from$495 /hour
- Licensed audit-defense attorneys
- Negotiation with insurers & PBMs
- Appeals & formal legal proceedings
- Scoped estimate before work begins
Free initial consultation30–60 minutes by phone or Zoom, one time only.
Guaranteed cost capWe won't cross it without your written approval.
Itemized time logsEvery invoice shows each hour and what it produced.
About Pharma360 Solutions
We've sat on your side of the audit table
Pharma360 Solutions was built by people who run pharmacies, not outside analysts reading about them. Our 32+ years of experience come from operating independent community pharmacies, defending them through the same PBM, desk and payer audits our clients face, and putting struggling pharmacies back on track.
We know what a dispensing report actually contains, how wholesaler invoices really map to claims, and where auditors' aggregate models break down. When we challenge a finding, it's because we've reconciled the data ourselves, line by line.
Based in Philadelphia and serving pharmacies nationwide, we exist for one reason: so no pharmacy has to face a PBM or payer alone.
We speak: English, Spanish, Punjabi, Arabic, Hindi, Gujarati, Urdu and Bangla
Our team
The people in your corner
Pharmacy people defending pharmacy people. Decades behind the counter and across the audit table.
Raza Hasan, RPh
Chief Pharmacist & Consultant
32+ years operating independent pharmacies and defending them through PBM, desk and payer audits.
32+ yearsJennifer McAleer, RPh
Pharmacist & Audit Expert
30 years of pharmacy practice, guiding independent pharmacies through compliance reviews, PBM audits and payer disputes.
30 yearsNelson Sarfraz
Senior Report Analyst
10 years turning raw pharmacy data into NDC-level reconciliation reports that hold up under audit.
10 yearsShaima E
Pharmacy Audit Expert
10 years managing PBM, desk and payer audits from first notice to final resolution.
10 yearsZachary Schaeffer
Senior Audit Attorney
Represents pharmacies in disputes with insurers and PBMs, handling recoupment disputes and managing appeals.
Attorney & negotiator
FAQ
Questions pharmacy owners ask us
What should I do when my pharmacy receives an audit notice?
Check the response deadline. Gather the audit notice and any claim lists or findings you received, then book a free consultation so your response is built from your own records before the deadline.
Is the first consultation really free?
Yes. Your first phone or Zoom consultation, 30 to 60 minutes, is free, one time only. You'll know where you stand before you spend a dollar.
How do you keep costs under control?
Before any billable work begins you get a written hour estimate with a firm cost cap that we won't cross without your approval. Every invoice includes an itemized time log.
Can an overpayment or recoupment finding be disputed?
Yes, findings can be disputed through the appeal process set out in the audit notice and your PBM contract. We reconcile the findings against your purchase and dispensing records, separate what the records support from what they don't, and prepare a claim-by-claim response. Common issues include equivalent-NDC substitutions, pack sizes and units of measure. No outcome is guaranteed; the auditor or plan makes the final decision.
Do you only work with pharmacies in Philadelphia?
No. We're based in Philadelphia, PA and serve independent pharmacies nationwide by phone and Zoom.
Can you provide legal representation?
Yes. When a matter escalates, legal representation is available through licensed audit-defense attorneys, starting from $495 per hour, with a scoped estimate before work begins.
What is a PBM audit?
A PBM audit is a review by a pharmacy benefit manager of claims a pharmacy has billed to it. It can happen on site or remotely, and it usually checks that each claim is supported by a valid prescription, correct quantities, and enough purchased inventory. When the PBM finds problems, it can demand repayment, called a recoupment. We manage the whole response, from document preparation and purchase substantiation for every flagged claim to rebuttals and appeals.
What is a pharmacy desk audit?
A desk audit is a remote audit in which a PBM or payer asks the pharmacy to send documents, such as prescriptions, signature logs and invoices, for a list of selected claims. Incomplete or late responses can turn into recoupment demands, so we prepare a complete, organized response on deadline.
What is an NDC mismatch, and why does it matter in an audit?
An NDC mismatch happens when a claim is billed under one National Drug Code but the pharmacy dispensed an equivalent product it bought under a different NDC. Auditors' invoice models often count this as a shortage. Matching equivalent NDCs, pack sizes and units of measure lets the pharmacy show which products were actually purchased for each claim.
How much does pharmacy audit defense cost?
Audit defense is $295 per hour, standard consulting is $165 per hour, and the monthly support retainer is $199 with 3 consulting hours included. Legal representation through licensed attorneys starts from $495 per hour. Every engagement starts with a free consultation and a written estimate with a firm cost cap.
Which languages does your team speak?
English, Spanish, Punjabi, Arabic, Hindi, Gujarati, Urdu and Bangla.
Have an audit deadline coming up?
The sooner we see your notice, the more options you have.
Contact
Your next step starts
Your next step starts
with a conversation.
Call us for your free initial 30–60 minute phone or Zoom consultation. We’ll talk through your situation, your deadline, and how we can help.
For a helpful first conversationHave your audit notice and response date ready.Tell us the payer or PBM and the support you need.
Phone(267) 809-2396
Based inPhiladelphia, PA · serving pharmacies nationwide
HoursMon, Wed–Sat 9:00 AM–5:30 PM · Tue 8:30 AM–5:00 PM ET · Sun closed
We speakEnglish, Spanish, Punjabi, Arabic, Hindi, Gujarati, Urdu, Bangla