Providers

General Questions

You can find answers to our most commonly-asked questions below. The questions are grouped by subject area for easy reference.

• Audit Processes and Specific Audited Claims
• Audit Findings and Results
• On-Site Audit
• Change in Address, Telephone or Ownership
• Submission Deadlines
• HIPAA

• Can I call Prudent Rx with the information about the prescription in question?
• Exactly what documentation is being requested or is required for each prescription?
• Did you receive my audit response (either via mail or fax)?
• We have already responded to this audit request. Why am I receiving another request?
• What if I have already corrected and/or made a change to the claim. Do I still need to respond to the audit request?
• The prescriptions requested are telephoned prescriptions. What documentation should we send?
• What if the prescription requested does not belong to my pharmacy?
• What is a Level 2 prescription?

• How are audit findings recovered?
• What does this audit code mean? What should I do if I have a question about the audit findings?
• When do I send an appeal?

• I need to reschedule an on-site audit or have questions regarding an on-site audit.

• This store has been closed.
• The address, telephone number and/or contact information for this store has changed.

• What is the deadline for the submission of my audit responses?
• What if I missed the response deadline?

• Does Prudent Rx have written authorization from the patients to receive copies of the prescriptions?