PHARMACY DATA MANAGEMENT
Integrated Pharmacy Solutions, Inc. (IPS) pharmacy data management services and network solutions are among the most comprehensive in the industry. Our data management expertise and experience stem from a wide variety of managed care and government sponsored pharmacy claim processing specials projects.
Most data management and audit projects are customized to meet client’s specific requests and serve in an educational capacity to effectuate behavior modification and quality assurance rather than solely financial sanctions.
DATA MANAGEMENT
Examples of data management projects include:
· Network Pharmacy claims audit experience ranging from retail, long-term care, home infusion, 340B, veterans, Medicaid, and Medicare Part D pharmacy audits across the 48 contiguous states
· Pharmacy Benefit Management (PBM) audits
· Rebate Auditing
· Fraud, Waste, and Abuse Investigations
· Clinical drug utilization analysis and programs designed based on the results
· Improvement of operational effectiveness
· Compounding audits
· Regulatory Compliance Assessments
SAMPLE PROJECTS
A self-insured health plan contracted with IPS to conduct and audit on the pharmacy claims process by their PBM. The audit reviewed up to date pricing, accurate dispensing fees, application of co-payment, compound prescription pricing, and other criteria. IPS evaluated the claims and reported all discrepancies as well as made recommendations for reclaim.
A pharmacy data management firm contacted IPS to conduct an audit on manufactures rebates on behalf of a client. IPS identified inconsistencies in rebate payment practices in our audit findings and provided recommendations for reclaim.
After a reported controlled substance loss, a hospital contacted IPS to perform routine site inspections, audits and review of all aspects of pharmacy services related to controlled substance management, delivery, administration, record keeping and disposition.
A nursing home contacted IPS after the Department of Public Health directed them to engage in an outside independent pharmacy service. IPS performed a full review of all patient profiles and medication orders to ensure accuracy, prepared a report of the findings and provided recommendations for correction.
