Insights
The mechanics of pharmacy revenue, documented.
Reimbursement, clinical billing, audit defense and the economics of the fill, analyzed at the level where the money actually moves. Written for the people who run the operation.
Switching or Leaving: Data Export, Exit, and What You Keep
Ask before you sign, not after. What you should be able to take with you, how the ten year archive interacts with deletion, and where the real friction sits.
Per-store pricing vs percentage of collections
Flat subscription, contingency recovery, or bundled into your PSAO. The arithmetic, the incentive problems, and the compliance question your accountant will raise.
Medicare Provider Status for Pharmacists in 2026: Where It Actually Stands
What has actually passed, what is still in committee, and what a pharmacy can usefully prepare now without betting the business on legislation that is not law.
Multi-Store Pharmacies: What Changes at Five Locations
Five stores is not one store times five. Per store credentials, isolation boundaries, cost bases that differ by location, and how a cross store view is built without lying to you.
DSCSA in a Community Pharmacy: What You Must Be Able to Produce
Transaction information, the six-year retention rule, the small dispenser exemption ending November 2026, and the suspect product process every dispenser has to be able to run.
Surviving a PBM Audit: What They Ask For and How Records Get Judged
Desk, on-site and invoice audits, the discrepancy categories that cost the most, how recoupment is actually calculated, and the state law protections most pharmacies never invoke.
How Attergo Computes Margin, and Why Unknown Cost Shows Nothing
The exact formula, why every value is an integer number of cents, and why a fill with no acquisition cost on file shows no margin rather than a confident zero.
How to Decide Whether to Keep Stocking a Drug That Adjudicates Badly
A structured way to separate purchasing problems from contract problems, price in the real cost to serve, and decide what to do about a drug that consistently loses money.
Getting Acquisition Cost In: Wholesaler Invoices vs NADAC
Margin is only as good as the cost you compare against. The trade offs between invoice cost, NADAC as a fallback and manual overrides, and how each one is labeled.
Evaluating a HIPAA Business Associate: What Actually Matters
The BAA is the floor, not the evidence. Tenant isolation, access logging, subprocessors, breach clocks, and how to verify a vendor's controls beyond the logo wall.
Why Event Sourcing Matters When a PBM Asks for 200 Claims
An audit request is a question about the past. Systems that store only current state cannot answer it. What an immutable event archive changes about your defense.
What NADAC Is, What It Is Not, and When to Trust It
NADAC is a voluntary invoice survey of retail community pharmacies, not your cost and not a payer promise. Here is how it is built and where it is genuinely useful.
Integrating With PioneerRx: What Real Time Actually Means
How the Rx Event API, per store Basic Auth credentials and an archive first pipeline work in practice, including the failure modes and the latency you should expect.
What a PSAO Does for an Independent Pharmacy, and What It Does Not
PSAOs handle network access, contracting and audit coordination at scale. They do not set your rates, watch your claim margin, or carry your compliance risk. Where the line sits.
Build vs Buy: What Computing Per-Fill Margin Actually Takes
The weekend-project version is revenue minus cost. The seven problems underneath it are why it is never a weekend, and when building it yourself is still the right call.
The Documentation an Auditor Expects on a Single Fill
Fourteen items an auditor looks for on one prescription, from the sig-derived days supply to the wholesaler invoice, and the specific way each one tends to fail.
What Changes for Your Staff on Day One, and What Deliberately Does Not
Attergo reads prescription events and changes nothing at the counter. Here is what your technicians see on day one, what the owner sees, and what we refuse to touch.
Effective Rate: How a PBM Hits Its Target While Your Claims Lose Money
A generic effective rate is an aggregate guarantee, not a rate on your claim. The arithmetic showing how a network can meet its target while individual fills go below cost.
What to ask a pharmacy revenue-analytics vendor before you sign
Ten questions that separate a vendor who can prove its numbers from one who cannot, the answers that should worry you, and Attergo's own answers today.
What a Pharmacist Needs to Bill a Clinical Service
NPI type 1 versus type 2, credentialing, payer enrollment and CLIA. The paperwork that has to exist before a clinical service claim can be paid, and in what order.
How to Read a PBM Remittance and Find the Underpayments
A field-level guide to pharmacy remittance reconciliation: the NCPDP amounts that must balance, the three reconciliations worth running, and where the money usually goes missing.
A Pharmacy Pilot, Week by Week, and What Could Go Wrong
Four weeks from credential to decision, the specific failure mode at each stage, what we need from you, and the conditions under which you should walk away.
Medical Billing vs Pharmacy Billing: Why an Immunization Is a Different Claim
An immunization can bill through NCPDP or through an 837P, and the two rails want different codes, timelines and records. A practical walkthrough of both.
Why a Prescription Can Be Reimbursed Below What You Paid For It
MAC lists, generic effective rate guarantees and the post-2024 concession landscape each explain part of the gap between acquisition cost and what a PBM actually pays you.