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WEBINAR: Appealing PBM Denials and Recoupments in Your Pharmacy

            Matthew Agnew

Pharmacy benefit managers (PBMs) have set forth burdensome, and oftentimes unnecessary, network participation requirements. Pharmacies that fail to comply with these requirements experience claim denials and recoupments and, possibly, network termination.

But what happens when pharmacies comply with all PBM requirements and their claims are still recouped? For specialty or infusion pharmacies, such errors could cost thousands of dollars. Join attorney Matthew Agnew, from Polsinelli, as he provides tactical strategies on how your pharmacy can stay ahead of the denials curve.

This presentation will help you:

  • Understand how the PBM appeals process works
  • Outline common reasons why PBMs deny claims
  • Identify next steps your pharmacy should take for claims that are wrongfully denied
  • Analyze internal best practices to minimize denials and recoupments going forward



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