AUDITPILOT TM
PharmPilot's proactive audit preparedness service, AuditPilot, serves as the first line of defense against PBM audits.
Of all types of PBM audit types, the most concerning ones are invoice shortage audits. PBMs and governmental programs treat invoice shortages as telltale signs of fraud and abuse. Countless pharmacies have lost their PBM contracts as a result of audit shortages findings. Adverse findings also result in payment holds, withholdings, terminations from PSAOs, and in some cases, criminal prosecutions.
AuditPilot is here to prepare pharmacies for invoice shortage audits. By combining our deep understanding of pharmacy practice with using sophisticated analytical tools, we are able to anticipate problems and highlight them so that pharmacy owners can act upon them before audits happen.
- ✓Claims Data Processing – claim records are continuously collected and categorized
- ✓Purchase Records Processing – all purchase records are collected, processed, converted and normalized
- ✓Reconciliation & Analytics – using our unique coding databases and artificial intelligence tools, we reconcile purchase and claims records and analyze your data monthly to spot inconsistencies and areas of concern
- ✓Results Delivery & Summary – we deliver our findings to decision makers in an easy, relevant format, highlighting our recommendations and areas of concern that make audit preparedness and compliance extremely easy to implement
AUDITSIGNAL
Finding anomalies and trends that lead to audits and investigations, and comparing your store's performance to others
At PharmPilot, we believe that every pharmacy can succeed and thrive in today's complex business environment when armed with the right data and tools. That is why we bring you a comprehensive, unique perspective on your pharmacy's data. Our capabilities allow us to parse your data to detect outliers, identify trends, see red flags, and compare your pharmacy's metrics to those of others.
- Purchase Data Analysisanalyzing purchase data to determine problematic purchases and outliers
- Red Flags Detectionhigh audit probability claims, problematic purchases, unusual claim trends, and other anomalies detection
- Identification of Outliersanalyzing purchase activity to detect significant outliers compared to the entire universe of purchase data
- Inventory Analyticsinventory aging reports and analytics
- AuditScorea simple comprehensive measure of your pharmacy's audit compliance
BUY/SELL AND VALUATION SUPPORT
Providing prospective buyers with deep insight into the pharmacy's operations. Helping sellers to put their best foot forward. Uncovering hidden value from contextual analysis of the pharmacy's data
Today's pharmacy practice is multi-faceted and complex, and is driven in large part by reimbursement trends. While traditional due diligence methods focus primarily on easily observable criteria and superficial review of pharmacy's operations, they are nowhere near painting the full picture. Data-driven due diligence assisted by PharmPilot is critical when evaluating a pharmacy purchase. Sellers can rely on PharmPilot to present an attractive story by highlighting value-adding factors. PharmPilot also works closely with pharmacy brokers and valuators to unlock critical information hidden in massive and constantly evolving streams of operational data.