Why Adhering to Your Return to Stock Policy Is So Important
Pharmacies often struggle with patients not picking up prescriptions on a timely basis. The lag time could be caused by several reasons – cost concerns, transportation issues, mental health factors, or miscommunication are just a few of the possibilities. While pharmacies are sympathetic to patient situations, it is prudent to be aware of the consequences for not following a strict return to stock policy.
PBM return to stock policies range from 10 to 30 calendar days. Accordingly, PAAS National® advises pharmacies…
Become an audit assistance member today to continue reading this article. As a member, you’ll have access to hundreds of articles and receive our monthly proactive newsletter!
to abide by the most stringent 10-day policy to eliminate risk of full claim recoupment during an audit. Unfortunately, these discrepancies are often not appealable. PAAS has created the Return to Stock tool to assist pharmacies with staying up to date on each major PBM’s requirement.
PAAS Tips:
- Review any changes or updates to your return to stock policy with staff
- Provide dedicated time for an assigned employee to complete this task
- Check with your software vendor to run daily reports to identify prescriptions outside your current policy window
- Point-of-sale systems may provide an option to stop claims dated outside your policy from being sold, allowing the claim to be reversed and rebilled
- When patients insist they will be in soon, reverse and rebill to assign a new date and restart the clock
- Be mindful of prescriptions ready in oversized bins, refrigerator, and special-order areas
- Completion of partially filled prescriptions must also be dispensed within your return to stock policy
- Do not leave claims billed for medications on backorder, only bill when product is in-stock
- LTC prescriptions are not exempt from these policies, be aware the clock starts when the claim is billed, not the date the prescription is physically prepared
- Be mindful of REMS prescriptions that may have restrictions for pick up, see our June 2021 Newsline article, Would Your REMS Prescription Pass an Audit?
- PAAS FWA/HIPAA Compliance Program members can review their written policy in Section 4.1.1 of their PAAS National® FWA/HIPAA Policy and Procedure manual
Interested in a customized FWA/HIPAA Compliance Policy and Procedure program? Contact PAAS National® at info@paasnational.com or (608) 873-1342 to get started today!
I attended Madison College in nearby Madison, WI (PAAS headquarters are in the Madison suburb of Stoughton). Prior to coming to work at PAAS, I worked as a Certified Pharmacy Technician in a retail setting for 25+ years. Pharmacy has been my life’s work.
Helping our members have a successful audit experience is very rewarding. Celebrating with them, when PAAS often helps generate positive post-audit results, is the best part of my work.
- Delivering to a Clinic? Avoid Audit Risks! - July 13, 2025
- From Headache to Hassle Free: Best Practices in Migraine Medication Billing - July 7, 2025
- Why Adhering to Your Return to Stock Policy Is So Important - June 30, 2025
