Insights
The reimbursement mechanics nobody explained to you.
How MAC lists, effective rate guarantees, PBM audits and clinical billing actually work, and what to do about each one. Long, specific, and written to be used on Monday morning.
| Medical Billing for Pharmacists: The 2026 Guide | The 837P, the identifiers you need, how credentialing actually sequences, and the five mistakes that sink a pharmacy's first medical claim. | medical billing · 5 min |
| Three Losses Your Claims Reconciliation Cannot See | Reconciliation proves the PBM paid what it promised. It says nothing about whether the promise was worth taking. The gaps it misses, and how to find yours. | pharmacy claims reconciliation · 3 min |
| Prior Authorizations Are a Case Management Problem | The form is the cheap part. What costs money is that nobody owns the case, nobody sees the clock, and last year's two hundred authorizations taught you nothing. | prior authorization · 3 min |
| The Point Tool Tax: What Five Vendors Actually Cost | Five tools, five logins, five invoices, and still no single answer to whether the week made money. The real cost of a fragmented pharmacy software stack. | pharmacy software stack · 3 min |
| Your Wholesaler Invoice Is Lying to Your P&L | Invoice cost, contract cost and effective cost are three different numbers. Why your acquisition cost drifts, and a ninety minute monthly check that catches it. | pharmacy acquisition cost · 4 min |
| Switching or Leaving: What You Take With You | Ask before you sign, not after. What you should be able to take with you, how a ten year archive collides with a deletion request, and where the real friction sits. | contracts · 6 min |
| 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. | Pricing · 6 min |
| Medicare Provider Status for Pharmacists: 2026 | What passed, what is still in committee, and what a pharmacy can prepare now without betting the business on legislation that is not law. | provider status · 6 min |
| Multi-Store Pharmacies: What Changes at Five Locations | Five stores is not one store times five. Per store credentials, cost bases that differ by location, and how a cross store view gets built without lying to you. | multi-store · 5 min |
| DSCSA in a Community Pharmacy: What You Must Produce | Transaction information, the six-year retention rule, the small dispenser exemption ending November 2026, and the suspect product process every dispenser has to run. | DSCSA · 5 min |
| Surviving a PBM Audit: What They Ask, How It Is Judged | Desk, on site and invoice audits. The discrepancy categories that cost most, how recoupment is calculated, and state protections pharmacies never invoke. | PBM audit · 5 min |
| The Margin Formula: 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. | margin · 6 min |
| When to Stop Stocking a Drug That Loses Money | Separate a purchasing problem from a contract problem, price the real cost to serve, and decide what to do about a drug that loses money every time you fill it. | inventory · 5 min |
| Acquisition Cost: Wholesaler Invoices vs NADAC | Invoice cost, NADAC and manual overrides produce three different qualities of answer. What each one is worth, and how the cost basis reaches the platform. | margin · 5 min |
| Evaluating a HIPAA Business Associate: What Matters | A signed BAA is the entry fee. Tenant isolation, access logging, subprocessors and breach clocks are what separate vendors, and every one of them is testable. | HIPAA · 7 min |
| Event Sourcing 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. | audit · 6 min |
| What NADAC Is, and When to Trust It | NADAC is a voluntary invoice survey of retail community pharmacies. How the number is built, where it now carries legal force, and where it is genuinely useful. | NADAC · 5 min |
| Integrating With PioneerRx: What Real Time Means | How the Rx Event API, per store credentials and an archive first pipeline work in practice, including the failure modes and the latency you should expect. | integrations · 6 min |
| What a PSAO Does for a Pharmacy, and What It Does Not | PSAOs handle network access, contracting and audit coordination at scale. They do not set your rates or watch your claim margin. Where the line actually sits. | PSAO · 5 min |
| Build vs Buy: What Per-Fill Margin Actually Takes | The weekend-project version is revenue minus cost. Seven problems sit underneath it, and knowing them tells you whether to build this yourself or buy it. | build vs buy · 6 min |
| 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. | documentation · 5 min |
| What Changes for Your Staff on Day One | Attergo reads prescription events and changes nothing at the counter. What your technicians see on day one, what the owner sees, and what we never touch. | operations · 5 min |
| Effective Rate: How a PBM Hits Its Discount Target | A generic effective rate guarantees an aggregate, not your claim. Here is the arithmetic that lets a network meet its target while individual fills go below cost. | effective rate · 5 min |
| Questions for a Pharmacy Revenue Analytics Vendor | Ten questions that expose whether a vendor can prove its numbers, the answers that should end the conversation, and our own answers on the record. | Vendor evaluation · 6 min |
| 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. | credentialing · 5 min |
| How to Read a PBM Remittance and Find the Underpayments | The NCPDP amounts that must balance, the three reconciliations worth running in order, and the specific places pharmacy money goes missing on a remittance. | remittance · 5 min |
| A Pharmacy Pilot, Week by Week, and Where They Break | Four weeks from credential to decision. What happens in each one, where pilots actually break, and the conditions under which you should walk away. | pilot · 5 min |
| Medical vs Pharmacy Billing: The Immunization Claim | One flu shot, two possible claims. The codes, timelines and records the pharmacy rail and the medical rail each demand, and where the money goes missing. | medical billing · 5 min |
| When a Prescription Reimburses Below What You Paid | MAC lists, generic effective rate guarantees and post-2024 point of sale concessions each explain part of the gap between what you paid and what the PBM pays you. | reimbursement · 5 min |
Connect one store. We will tell you what the month cost you.
Read-only credentials you can revoke. We come back with the fills that went out under cost, the services you could have billed, and the fills an auditor would ask about.