How to Respond to a PBM Audit Notice From An Industry Insider
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Boesen and Snow s, Mark Ziegler, a former PBM auditor, shares tips on responding to a PBM audit notice. SCOTTSDALE, Ariz. (PRWEB) May 05, 2021 Mark Ziegler, a former PBM auditor, shares tips on responding to a PBM audit notice.
Pharmacies are plagued by the burdens of addressing the terms of their pharmacy benefit manager (PBM) agreements, whether those terms are reasonable or not. Pharmacies are dogged with PBMs wielding their power by initiating a PBM audit – sometimes to root out actual discrepancies, sometimes to injure your business in favor of the PBM’s own affiliated pharmacies. Then, of course, there is the specter of a PBM suspension, in which your PBM might suspend payments and/or threaten termination based on minor, inconsequential claims discrepancies.