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Up to date information in the field of Independent Pharmacy written by the PRS Pharmacy Consulting Experts and Pharmacists for Pharmacy Owners. Experience Matters. 

Medicare Compliance for Refills

Are you Billing Medicare Part B for Blood Glucose Testing Supplies and other items that are refilled on a recurring basis? If you are, Medicare has some new rules and clarifications for some older ones. These apply to ALL suppliers, whether accredited or not. Contact between the Supplier and Beneficiary The new Medicare compliance for refills mandates that pharmacies are required to contact the beneficiary or designee regarding refills prior to providing the refills and must not automatically dispense the

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Medicare Audits Are On the Rise

In recent Medicare Audits, over 80% of glucose testing supplies and nearly 70% of nebulizer and nebulizer solutions claims were denied.  This resulted in BILLIONS of dollars being recouped from Medicare suppliers and providers. Purpose of Medicare Audits & What to Expect Before you start preparing for a Medicare audit, it’s important to understand its primary rationale so you clearly know what to expect. When an auditor pays you a visit, keep in mind that they have a two-fold purpose: checking that your

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NSC Site Visit vs. Accreditation Survey

Do you know the difference between an NSC Site Visit and an Accreditation Survey? As a Medicare Part B Supplier you will go through periodic onsite surveys by the National Supplier Clearinghouse and your Accreditation Organization. These two types of surveys are separate and distinct from one another and not allowing either to take place could have negative effects on your ability to bill Medicare. Confused? No worries, many Medicare Part B Suppliers are because they have so many different surveyors coming in to

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HIPAA Readiness Wrap-Up

So, just a few months ago, I let you all know that HIPAA was back in the news with new court rulings, enforcement activities and how future HIPAA Audits would be occurring proactively (instead of reacting to breaches and complaints). Since then we have taken a long journey together to go over some of the items that need to be in place and happen on a daily basis, so that your pharmacy is HIPAA ready. We also looked at what

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HIPAA Compliance Policies and Procedures

We have been talking HIPAA Readiness for a little over a month now and I hope that it is helping you to realize you can’t afford to ignore HIPAA Compliance, or put your program on a shelf.  Our final topic before we sum it all up is another HIPAA basic, policies and procedures. Mind your Ps and Qs, or in this case, your P and Ps. In the old days, many people had formal living rooms or parlors that were

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Notice of Privacy Practices

We have taken a long journey in this HIPAA Readiness series, so let’s not forget the basics. Stop Me If You’ve Heard This One: Notice of Privacy Practices Communication is the key to success. Or so read a poster on the wall in my high school English class. Communication is also the key to HIPAA compliance. You need to give every patient a Notice of Privacy the first time you provide any health service. The Notice of Privacy Practices must

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HITECH Requirements for Business Associate Agreements

Wow! We are covering a lot of topics in this HIPAA Readiness Series! If you haven’t had a chance and want to, visit the Blog archives to catch up on the topics we have gone over so far. This next topic is an important one. Let’s Share! (Business Associate Agreements) We’ve all been taught that sharing is good. In 21st century healthcare, sharing data is essential. But, it’s also a bit worrisome. Criminals can do a lot of harm with

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