AuditPilot ™

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


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 Analysis – analyzing purchase data to determine problematic purchases and outliers

  • Red Flags Detection – high-audit-probability claims, problematic purchases, unusual claim trends, and other anomalies detection

  • Identification of Outliers – analyzing purchase activity to detect significant outliers compared to the entire universe of purchase data

  • Inventory Analytics – Inventory ageing reports and analytics

  • AuditScore – a simple comprehensive measure of your pharmacy’s audit health

Buy/Sell and Valuation Support

Providing potential 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

  • Buyer Due Diligence – uncovering issues hidden in pharmacy data that extend well beyond a simple review of documents and financial records

  • Seller Prospective – highlighting data metrics that can make the pharmacy stand out

  • Brokers and Valuators Support – We unlock hidden, value-altering trends that paint a full picture of the pharmacy’s operations


Treating your pharmacy’s data with utmost care has never been more important

Pharmacy’s data is extremely valuable.  That is why it should be entrusted to professionals who can properly ingest, convert, store, and produce it on demand whenever it is needed for review and analytics purposes.  If you need your data stored securely and be available on demand for the most demanding tasks, PharmPilot’s DataVault service is up to the task

  • Data Storage – retrieval and secure storage of your pharmacy’s data using state-of-the-art methods

  • Data Conversion and Processing – With unparalleled expertise in dealing with dozens of pharmacy systems and purchasing portals, no data processing challenge is too complex for PharmPilot

  • Retrieval on Demand – We provide you and those you trust with an opportunity to use your data the way you deem fit by allowing on-demand retrieval and collaboration