As PBMs continue to subject pharmacies to strict credentialing terms, gaining network access becomes a difficult and daunting task, particularly for those located in designated “HEAT Zones” that often require enhanced credentialing. Unfortunately, several PBMs do not allow for a formal appeals process if a pharmacy is denied access to the network. Recently, a pharmacy was denied network admission into a particular PBM’s pharmacy networks for various reasons despite the pharmacy having made several efforts to clarify the perceived discrepancies. Although there was no formal appeals process, Frier Levitt assisted the pharmacy by negotiating with the PBM to resolve any stated concerns that led to the pharmacy’s denial. Frier Levitt intervened, and through its in-depth knowledge and experience of the PBM application process, assisted the pharmacy to gain network access within a few weeks where the pharmacy would have otherwise needed to wait a year to reapply.
How Frier Levitt Can Help
If your pharmacy was denied entry to a PBM network and requires assistance in securing network access, Frier Levitt can help. Frier Levitt’s attorneys have substantial experience and knowledge in the specific concerns that PBMs have with respect to network access and have assisted numerous pharmacies in overcoming PBM contracting issues. In addition, if your pharmacy is seeking network access, Frier Levitt can assist in the credentialing process to help prevent any potential network denials. Contact Frier Levitt today to speak with an attorney.
