Who is HBT?

Healthcare Benefit Technologies provides state of the art pharmacy claim auditing and services tailored to meet the specific and ever-evolving auditing needs facing our clients. Please read these terms carefully before using this web site.

CONTACT INFO
  • Address: 10233 South Parker Road, Suite 300
    Parker, Colorado 80134
  • Phone: 303-495-2529
  • Email: contactus@hbtechllc.com

Balancing act: Auditors should be respectful but doggedly committed to thier purpose

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Putting a pharmacy at ease helps with the process, but there’s also a time to be firm

Audits of any kind tend to be disruptive, unwelcome events to most people. That certainly includes pharmacists. At Healthcare Benefit Technologies (HBT), we’re sensitive to that sentiment. We go out of our way to be “pharmacy respectful.”

But as we seek this goodwill, we’re mindful about maintaining a balance. After all, we function as an extension of our clients -- the health plans, plan sponsors and pharmacy benefits managers (PBMs). It’s important, therefore, that we not project an image of being too cozy with the pharmacies. If our relationship with the pharmacy gets overly congenial, clients could worry that we’re going to be lenient and “let things slide” if we find problems.

There’s a certain finesse to making this work. Maybe even an art.

Managing perceptions

As mentioned earlier, audits upset the normal flow of operations for the pharmacy, which generally views these procedures as intrusive. We do what we can to mitigate this perception -- again, within reasonable limits.

Tone and demeanor can go a long way. If we’re outwardly respectful of a pharmacy (rather than hard-nosed and adversarial), it makes everyone’s work easier. We get more cooperation. After all, some of these pharmacists have probably had negative experiences with auditors who truly appear out to get them -- oftentimes, government program auditors. Some are determined to uncover an error, even a harmless procedural anomaly and bring a fine down on the pharmacist’s head. They consider it a “win.”

That’s not us: We don’t go into an audit with that attitude. HBT is there to assess the way things really are. Gratuitous harassment isn’t our style.

Sometimes we just listen when pharmacies are unhappy with our findings -- we let them vent. We’ve found that they’ll occasionally figure out their own issues in the process of talking things out. Other times, we just have to be firm and unwavering.

Chain and independent pharmacies

Not all pharmacies react the same to an audit. There’s a marked difference between the way independent pharmacies relate to us compared to the big chains. The latter tend to take audits in stride much better than the independents do. A chain will usually have a central individual for us to deal with, an audit account executive. We’ll work with this person to set up the audit, whether it’s a desk or onsite audit. This is a professional accustomed to working with auditors and, therefore, isn’t especially defensive in most cases.

On the other hand, independents tend to be more apprehensive about an impending audit, at least in our experience. Being independent, these smaller pharmacies lack a corporate structure to back them up. As a result, they may feel outnumbered and alone.

In these cases, we try to set them at ease by being as respectful and cheerful as possible. But again, we do so without conveying the false impression that we’re forming an unbreakable alliance with them. We’re still working for clients who want to make sure these pharmacies are doing everything above board.

Maintaining respect

We always give these pharmacies ample notice of an impending audit. Often, they’ll get an entire month’s notice, even though we’re required to give them only two weeks.

But even when we’re maintaining an optimal level of respect and understanding, pharmacies don't always agree with our findings, which is fine. They have a right to disagree and appeal. It’s all part of the process.

Emotional intelligence

Dealing with the various shades of pharmacies means auditors need emotional intelligence to do their jobs well. An auditor should have understanding, firmness and a thick skin -- and the ability to know when each of these attributes is necessary.

It’s all part of the art.