Expert Tip from PharmaForce

An outdated or incomplete provider list can severely undermine your 340B program’s performance and compliance. Without an accurate roster, your organization risks missing eligible claims, leading to significant revenue loss and potential audit issues. Many 340B claim capture systems rely heavily on provider data to identify eligible prescriptions – if a provider isn’t properly listed, their 340B-eligible prescriptions may go unrecognized, leaving potential savings on the table.

When compiling and updating your provider list, consider multiple sources to ensure completeness. This may include your credentialing system, human resources records, state licensing boards, and periodic surveys of your clinics and departments. Don’t forget to include all eligible provider types, such as physicians, nurse practitioners, physician assistants, and other prescribers who may be working within your 340B-eligible areas. Regular review and reconciliation of these sources can help catch discrepancies and ensure no eligible providers are overlooked. By investing time in maintaining a robust provider list, you’ll maximize your 340B program’s capture rate and minimize compliance risks.