CVS/Caremark Audit Tips
July 19, 2016;Volume 2016, No.3
Author: Jessica Bohm/Friday, July 22, 2016/Categories: CAPS
Proper Billing for Nasal Sprays
Provider must submit the days supply accurately. If the Prescriber indicates ambiguous directions such as "use as directed" or "as needed," Provider must obtain the dosing range, note it on the prescription hard copy, and calculate the days supply by using the maximum daily dosage. Directions may be obtained from either the Eligible Person or the Prescriber. Documentation of correct dosing schedule is required prior to the medication being dispensed. Always consider product expiration and manufacturer storage recommendations when calculating days supply for claim transmission.