Failure to Receive 340B Ceiling Prices from Manufacturers

$10,000–$40,000 annually in unresolved invoicing disputes; delayed refunds from manufacturers; staff time spent on manual follow-up ($5K–$15K annually) • $10,000–$75,000+ annually in lost 340B discounts per covered entity; patient access/adherence impact if discounts not passed through • $15,000–$100,000+ annually in lost 340B savings; inventory/cost errors cascade

Handwritten notes on receiving documents; flag in spreadsheet for later review; verbal communication to Pharmacy Manager; no formal dispute tracking system • Manual audit of sample invoices using spreadsheets; review of email trails; comparison of invoices to pricing agreements; documentation in Word/Excel; informal communication with vendors • Manual chart audits; review of billing records against 340B eligibility; spreadsheet tracking of compliance gaps; manual correspondence with manufacturers about pricing discrepancies; remediation documents prepared ad-hoc