Pharmacy audits are costly, time-consuming and can result in significant financial losses. Whether triggered by discrepancies in claims, government regulations or coordination of benefits issues, audits disrupt workflows and put reimbursements at risk. Pharmacies need proactive solutions to maintain compliance and reduce audit exposure before issues arise.
surge in third-party audits in 2023[0]Inventory Purchase Reminders for Successful Audits. News Report. PAAS National. October 29, 2024
Third-party audits are a routine part of pharmacy and physician dispensary operations but unclear metrics and shifting requirements can threaten business viability.
average audit cost for pharmacies[0]Pharmacies Face Extra Audit Burdens That Threaten Their Existence, KFF Health News, Aug. 6, 2021
increase of audit costs over five years[0]Pharmacies Face Extra Audit Burdens That Threaten Their Existence, KFF Health News, Aug. 6, 2021
CoverMyMeds offers integrated audit protection solutions designed to help pharmacies reduce common compliance risks before they become audit issues. With automatic validations, real-time alerts and configurable safeguards, pharmacists can proactively address potential audit risks before submission. These solutions work alongside our pre and post claim editing services to enhance claim accuracy, reduce manual interventions and support compliance with payer and regulatory requirements.