By now , in pharmacy we are well aware of the extra requirements insurance companies are requiring to participate; and it really is a pay to play scenario. If you want paid you need to play along.
With more Insurers merging with large chain drug stores, we truly believe they are trying to make things so difficult that independent pharmacies can’t keep up and they have a reason to decline initial applications or retract existing contracts.
Not only are they looking at your day to day operations they are looking for specific policiy and procedure for things like Mis-fill, return to stock, sound alike/look alike, Medication Expiration Procedures, and many more.
Pharmacy Owners don’t have time to research the latest regulatory requirements and write their own Policies and Procedures. While facilities may have a guideline for how they operate, most do not have the specific polices being requested.
Our Pharmacy Compliance program has the policies, trainings, and other requirements needed if you are trying to initially secure a contract with an insurance company or meet credentialing requirements in the future. They are written in a recognized format with regulatory site referenced and we provide a cross reference to show that the major insurers are asking for and where to find it with in our program.