All guides
- How to respond to a PBM desk audit
How an independent pharmacy should answer a PBM desk audit: read the notice, pull records claim by claim, check them against the claim and respond on time.
- The PBM audit appeal process, explained
How the PBM audit appeal process works for independent pharmacies: find the deadline in the findings letter, sort findings and build claim-level evidence.
- What is NDC reconciliation?
NDC reconciliation compares what a pharmacy bought with what it dispensed, drug by drug. How it works, what causes mismatches and why it matters in audits.
- Pharmacy audit documentation checklist
A practical pharmacy audit documentation checklist: prescription records, claims history, signature and delivery logs, invoices and returns to keep ready.
- How to prepare for a PBM on-site audit
How independent pharmacies can prepare for a PBM on-site audit: read the notice, pull records, check licenses, brief staff, and handle the visit and follow-up.
- What is a PBM audit?
What a PBM audit is, the main types (desk, on-site, investigative), what auditors review and how the process usually runs for independent pharmacies.
- Medicare Part D pharmacy audits, explained
Who audits Medicare Part D and Medicaid pharmacy claims, what they review, how they differ from PBM audits and which records independent pharmacies should keep.
- How to dispute a PBM recoupment
How an independent pharmacy can dispute a PBM recoupment: read the demand, get claim-level detail, sort findings and send claim-by-claim evidence on time.
- Fraud, waste and abuse (FWA) audits for pharmacies
What fraud, waste and abuse (FWA) means for pharmacies, how an FWA review differs from a routine audit, and the compliance basics independent pharmacies keep.
- Days’ supply errors in pharmacy audits
Why days’ supply is a common pharmacy audit finding, which products are hard to calculate, and how to document the calculation for each claim.
- Which purchase invoices count in a pharmacy audit?
Why auditors compare purchase invoices with dispensing, which invoices pharmacies should keep and how to organize them by NDC and date for an invoice audit.
Need help with a specific audit?
Pharma360 Solutions supports independent pharmacies with PBM audit defense, desk audit responses, NDC reconciliation and audit readiness. Call (267) 809-2396 or request a call back.
Published by Pharma360 Solutions LLC · Updated .