Caution with Script Care Audits
PAAS National® has seen a rise in desk audits from Script Care. While this PBM may not be familiar to some pharmacies, we would like to share specific information they have been looking for on their audits.
Prescriptions we have frequently seen flagged discrepant are:
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- DAW Code Error
- This plan is very specific about the appropriate terminology on the prescription per each states’ guidelines. (e.g., “Brand Medically Necessary”)
- REMS Requirements
- Prescriptions that do not have appropriate documentation, including REMS requirements, are frequently flagged
- Applicable medication guides
- See the FDA website for REMS requirements
- Clinically Inappropriate
- Prescriptions for off-label use and dosage or instructions that are outside FDA guidelines may require current literature to validate the prescription
Script Care does not currently have a Provider Manual; however, PAAS has been informed that they plan to release one soon.
Remember to send in any audit request upon first receiving and a PAAS analyst will be happy to assist you through the audit process. You can send in your audits by fax (608) 873-4009, email info@paasnational.com or upload to our portal available on our website under Access Services.
I attended Madison College in nearby Madison, WI (PAAS headquarters are in the Madison suburb of Stoughton). Prior to coming to work at PAAS, I worked as a Certified Pharmacy Technician in a retail setting for 25+ years. Pharmacy has been my life’s work.
Helping our members have a successful audit experience is very rewarding. Celebrating with them, when PAAS often helps generate positive post-audit results, is the best part of my work.
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