What is AWP?
What is MAC?
What is WAC?
What is FUL?
HOW MUCH SHOULD THESE COST?
DOES YOUR CONTRACT SPECIFY PRICING?
These are some of the acronymns used in pharmacy contracts, but most people do not know the meaning. Many contracts do not even have pricing specified.
Facilities rely on their pharmacy to price medications according to their contract, but have no idea how much the prescription should really cost. The only way to be guaranteed you are being charged correctly is through a post billing adjudication.
IS THIS YOUR CONTRACT?
IT CAN BE OVERWHELMING!
Audit for Accuracy
We audit pharmacy bills monthly to ensure the billed amount is the amount that should be charged according to your contract. Our payment is based on the overbill that results in credit to the facility.
The publication, Approved Drug Products with Therapeutic Equivalence Evaluations (the List, commonly known as the Orange Book), identifies drug products approved on the basis of safety and effectiveness by the Food and Drug Administration (FDA) under the Federal Food, Drug, and Cosmetic Act (the Act).
An authorized exchange of therapeutic equivalents in
accordance with previously established and approved written guidelines or protocols.
Working with your physicians and pharmacy, one of our pharmacist can make recommendations that could significantly lower your bill.
Are You Owed Money?
Our software program allows us to verify pricing from the date a medication is released. When pricing errors are found, we give you an assessment of the findings and help with the next steps in recovering what is owed to the facility.