Frier Levitt recently assisted a New Jersey-based specialty pharmacy audited by a large health plan and its PBM which had placed over $500,000 at issue through various audit discrepancies, including alleged invalid prescriptions, insufficient proof of delivery, and failure to collect copayment. Frier Levitt worked with the pharmacy and the health plan to appeal the audit findings at issue and received a reversal on a significant portion of the audit results. However, as there were still outstanding findings following the first round of appeal efforts, Frier Levitt identified additional documentation and information from the pharmacy to prepare a further appeal of the outstanding final results and was able to ultimately overturn 100% of the alleged discrepancies.
How Frier Levitt Can Help
Regardless of the size of your pharmacy or the amount at issue, Frier Levitt can assist you in challenging PBM audits. Our attorneys include clinicians who take an aggressive approach to fight for your rights following a PBM audit. If you have a question or need help with a PBM audit, contact us today to speak to an attorney.
