Five free pilot audits · independent pharmacy
I’m Aaron Crowley, and I spent 20 plus years on the operator’s side of PBM contracts, reimbursement math, and accreditation work. The Pharmacy Margin Audit turns 90 days of your dispensing data into ranked findings, dollar figures you can check line by line, and a 30-day plan.
Who runs the audit
For more than two decades I ran pharmacy operations: the buying, the payer mix, the contracts, the accreditation work. Much of that career was spent taking operations that were losing money and making them profitable again. That’s the part of my background that matters here. I have opened the same reimbursement reports you open, and argued the same line items.
What I kept seeing is that the money independents lose is almost never dramatic. It’s a generic that reimburses a few dollars under acquisition, filled ninety-six times a quarter. It’s an effective-rate true-up or an audit recoupment that lands months later, against claims you already counted as margin. It’s a plan that looks fine on volume and is negative on net. None of it arrives on the P&L with a label on it.
So I built the audit I wish someone had run for me. I run it myself, on your data, with a dollar figure and a confidence label next to every finding.
The seven domains
Each domain is a specific question asked of your own records. Where the data supports a dollar figure, you get one. Where it doesn’t, the report says so and names the file that would answer it. That distinction is the whole product.
Every claim gets the same simple test: total reimbursement minus what the drug cost you. The negatives get counted, grouped by NDC, ranked by how often they repeat, and totaled into a monthly bleed figure. Thin-but-positive claims get flagged separately, because those are the ones that go underwater next.
Recurring underwater generics are usually appealable, and in my experience most operators aren’t filing consistently. It’s tedious work that competes with running the store. You get the ranked list, the fill counts, and an honest recovery range. It’s labeled as a range, never as a promise.
Audit recoupments, effective-rate true-ups, and the performance and fee adjustments your commercial and managed Medicaid lines still take after adjudication. Since 2024 Part D price concessions come off at the point of sale instead, which is why they show up in domain 01 as thinner reimbursement rather than here as a clawback. Part D audit recoupments do still land after the fact. Where your remittance data allows it, what remains is tied back to the claims it hit, so you’re looking at true net instead of gross.
Generic effective rate guarantees, audit and recoupment rights, termination and amendment language, and which benchmark your rates actually ride on. This one is judgment rather than arithmetic, and it is labeled that way in the report.
Where the same item was bought at meaningfully different prices inside the same period, and where a secondary or your buying group likely beats the primary. Your generic compliance rate against your wholesaler’s target gets checked too, because missing it raises the price of everything.
Net margin by plan and by category: brand, generic, compounded, cash and discount-card. Plans that are net-negative after fees get named, with the claim counts behind them, so the decision is yours to make on evidence.
The one to three highest-return additions for your specific volume and mix: med sync and adherence, MTM, immunizations, point-of-care testing, compounding expansion. Sized roughly against your numbers, and labeled as estimates.
What a finding looks like
A finding that can’t be reconciled against your own export isn’t worth much. Every one carries the claim counts behind it, the period it covers, and how strongly your data supports it.
Illustrative figures from the published sample report: fictional pharmacy, fictional data.
What you receive
Five to eight pages, written to be read once and acted on. Every finding is grounded in the data you send, labeled by confidence, explained in plain English, and ordered by what is most practical to fix first.
The evidence standard
Each finding states how strongly your records support it. Estimates stay labeled, limitations stay visible, and missing data becomes a named next step instead of a hidden assumption.
Directly supported by the records you supplied and reproducible from the evidence shown.
A meaningful pattern that needs your confirmation or another file before the number is precise.
Directionally useful, but not presented as a basis for action without more evidence.
The report records which dispensing, reconciliation, sourcing, and contract data you supplied, what was missing, and which findings a missing file would have unlocked. Where your data cannot support a number, it says so instead of estimating quietly.
A low-lift process
A five-minute intake: your systems, your volume, your networks and wholesalers, and what’s actually worrying you. No files, no uploads, no account to create.
I reply with the report to run on your system (retail, long-term care, specialty, or compounding) and the fields that matter. Strip the patient identifiers before you send it. Thirty to ninety days is the sweet spot.
Ranked findings with dollars and confidence labels, a 30-day action sequence, and a live call to go through it. Thirty days later we get back on and re-measure what you implemented.
The analysis runs on drug, quantity, acquisition cost, reimbursement, plan, and date. It does not need names, addresses, dates of birth, or prescriber identifiers. Strip them before you send anything, and I’ll tell you exactly which columns to keep. This site accepts no uploads at all. Transfer method, retention, and deletion are agreed before a single file moves, and I’ll sign an NDA if you want one.
Founding pilot
The first five independent operators receive the complete seven-domain audit at no cost, in exchange for candid feedback on the findings, the report, and the process. The cap is five, and it is a real cap. If the audit turns up nothing worth acting on in your pharmacy, you’ll hear that from me too.
Request your auditPlanned standard audit after the pilot: $1,999. Implementation engagements are scoped separately, from $5,000.
Coming next
An audit is a photograph. MAC lists move week to week, and the item that looked fine in April is the one bleeding in July. Margin Watch is the recurring version of this work: the same seven-domain engine, run on a cadence, against your current claims.
Common questions
One de-identified export covering 30 to 90 days, with drug, quantity, acquisition cost, total reimbursement, plan or BIN, and date. Most pharmacy systems have a canned report that produces close to exactly this, and I’ll tell you which one for yours. If you also have a remittance or reconciliation file, the clawback analysis becomes possible on top of it.
I need the economics, not your patients’ names. Strip the identifiers before you send anything, or tell me and I’ll specify exactly which columns to drop. The site accepts no uploads at all. Data exchange happens by agreement after we’ve spoken. Files are handled confidentially, deleted after the engagement, and I’ll sign an NDA on request.
Your PSAO administers the PBM side (contracting, credentialing, audits, reconciliation), and that is real work. Your buying group is a different lever again: it negotiates what you pay, not what you get paid. Neither one is structured to hand you a ranked list of where your own fills and your own contract terms are losing money, because neither is on your side of that particular table. You know your top line; this looks at the leakage underneath it.
The intake is about five minutes, and then one report out of your pharmacy system. I do the rest. It’s built low-lift on purpose, because I know what your day looks like.
It’s built for independent operators: retail, compounding, long-term care, and specialty-adjacent. Fit is confirmed in conversation before any data is requested, and I’ll tell you if the answer is no.
No. It is an operational and financial review of the data you supply. Contract, tax, and legal decisions should go to the appropriate licensed advisers before you act on them, and the report says so on the page where it matters.
No, and I’d be careful with anyone who does. The audit tells you what your data shows, with a confidence label on each finding and the limitations stated. What you recover depends on your data quality, your decisions, and your execution.
The standard audit is planned at $1,999. If you want help executing the fixes (the appeals, the contract conversations, the sourcing changes), that’s a separate implementation engagement starting at $5,000.
Start the conversation
Five minutes of intake, one export out of your pharmacy system, and a report you can check line by line. No account, no subscription, and nothing uploaded to this site.