Run 340B Duplicate Discount Prevention Review — Free

Review Setup and Scope

Review period is defined and matches the claim extract date range critical (required)

Yes No N/A

Covered entity sites and contract pharmacies included in scope are listed critical (required)

Medicaid claim file and 340B dispense file were obtained for the same review period critical (required)

Yes No N/A

State Medicaid duplicate discount policy and carve-in/carve-out status were verified for the review period critical (required)

Yes No N/A

Claim and Dispense Reconciliation

Number of Medicaid claims reviewed critical (required)

Note (optional)

Number of 340B dispenses reviewed critical (required)

Note (optional)

Claims billed to Medicaid were matched to dispense records using patient, date of service, NDC, and prescription identifier where available critical (required)

Yes No N/A

Potential duplicate discount exceptions were identified and logged critical (required)

Yes No N/A

Claims with missing or conflicting identifiers were flagged for manual review

Yes No N/A

Carve-In / Carve-Out and Billing Controls

Medicaid carve-in or carve-out status is consistently applied for the reviewed locations critical (required)

Yes No N/A

Claims excluded from 340B billing were not submitted as 340B-eligible Medicaid claims critical (required)

Yes No N/A

Managed care, fee-for-service, and other Medicaid payer types were separated according to policy

Yes No N/A

Billing edits or claim exclusion logic prevented duplicate discount submission critical (required)

Yes No N/A

Exception Review and Root Cause

Number of potential duplicate discount exceptions critical (required)

Note (optional)

Each exception has a documented root cause critical (required)

Yes No N/A

Exceptions were categorized as data issue, billing setup issue, pharmacy workflow issue, or policy issue

High-risk or repeated exceptions were escalated to compliance or pharmacy leadership critical (required)

Yes No N/A

Corrective Actions, Documentation, and Sign-Off

Corrective actions were assigned for all unresolved exceptions critical (required)

Yes No N/A

Supporting documentation for the reconciliation is retained and retrievable critical (required)

Yes No N/A

Follow-up review date

Inspector sign-off critical (required)

Get your results

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Run: 340B Duplicate Discount Prevention Review

Review Setup and Scope

Claim and Dispense Reconciliation

Carve-In / Carve-Out and Billing Controls

Exception Review and Root Cause

Corrective Actions, Documentation, and Sign-Off

Get your results