Managed Care Pharmacy Encounters Paid to Meadowbrook Pharmacy

One claim for an unauthorized refill, resulting in an overpayment totaling $552.74.

Four claims with unauthorized medication substitutions, resulting in an overpayment totaling $6.52.

One claim missing confirmation of medication delivery, resulting in an overpayment of $323.69.

Two claims with an inaccurate days’ supply to circumvent MCO limits, resulting in overpayments totaling $75.13.

One claim with a dispensing label containing incomplete instructions for use.

Six claims for compounded medications without documentation of the methodology, equipment, or container used.

Improve dispensing processes to fill prescriptions as authorized by the prescriber and document medication delivery.

Update prescription verification process to verify the accuracy of information entered in the pharmacy system and submitted as claims.

Update claims submission process to validate the days’ supply before submitting each claim.

Implement a process to print dispensing labels with complete instructions for use.