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Revenue protection - audit defense and profit intelligence, for VisipillRx Pharmacy #4021.
Caremark (CVS Health)
desk auditAUD-2026-CMK-44815Received Jul 6, 2026 · 19 claims requested
Due in
9d
At risk
$2,059
Ready
15
Needs attention
3
At risk
1
The letter that arrived
CVS Caremark
Pharmacy Audit Services
One CVS Drive
Woonsocket, RI 02895
Jul 6, 2026
VisipillRx Pharmacy #4021
820 Massachusetts Ave, Cambridge, MA 02139
RE: Notice of Prescription Benefit Audit
Reference: AUD-2026-CMK-44815
Dear Pharmacy Provider,
This letter serves as notice that your pharmacy has been selected for a desk audit of 19 claims adjudicated during the review period. Per your Provider Agreement, you must submit supporting documentation for each claim listed in the enclosed schedule.
For each claim, the following elements are required:
- Original prescription (hard copy, front and reverse)
- Signature log / proof of receipt or delivery
- Dispensing label as printed
- Record of patient copay collection
Documentation must be received within 9 days. Claims lacking required documentation are subject to recoupment.
Sincerely,
M. Donnelly
Audit Program Manager, CVS Caremark
Parsed into a case, automatically
VisipillRx read the audit letter, extracted every requested claim and element, and matched them against artifacts already captured in the workflow. What used to be days of scrambling is a review screen.
Auditor
Caremark (CVS Health)
Type
desk audit
Claims
19
Response due
9 days
Generate a complete, print-ready packet for any documented claim - cover sheet, Rx image, label, claim record, and proof of delivery.
Downloads a real multi-page PDF · Apixaban 5mg · H. Tanaka
Requested elements
Auto-detected from the letter · 5 selected
VisipillRx read the PBM's letter and pre-selected the documentation it asks for. Different PBMs request different elements - toggle any box to match this letter exactly.
Completeness matrix · 19 claims · 5 elements
| Claim | Billed | Rx | Sig | Label | POD | Copay | Status |
|---|---|---|---|---|---|---|---|
RX-203110 H. Tanaka · Apixaban 5mg | $520.25 | ||||||
RX-202991 E. Rodriguez · Ozempic 1mg | $716.25 | ||||||
RX-203255 T. Berg · Jardiance 10mg | $603.25 | Review | |||||
RX-203201 M. Johnson · Atorvastatin 40mg | $10.50 | ||||||
RX-203300 D. Weiss · Rosuvastatin 20mg | $15.10 | ||||||
RX-203015 C. Mendoza · Albuterol HFA | $50.60 | Ready | |||||
RX-203077 S. Rossi · Losartan 50mg | $6.60 | Ready | |||||
RX-203120 J. Okonkwo · Lisinopril 10mg | $5.80 | Ready | |||||
RX-203145 N. Petrova · Levothyroxine 75mcg | $15.30 | Review | |||||
RX-203180 G. Okoye · Metformin 500mg | $6.90 | Ready | |||||
RX-203190 K. Mensah · Escitalopram 10mg | $10.30 | Ready | |||||
RX-203210 O. Haddad · Pantoprazole 40mg | $10.10 | Ready | |||||
RX-203225 P. Kapoor · Sertraline 50mg ⚠ Locate scanned Rx image - original fax not attached. Assigned to Dana P. | $10.50 | At risk | |||||
RX-203240 E. Cohen · Omeprazole 20mg | $11.90 | Ready | |||||
RX-203260 L. O'Brien · Gabapentin 300mg | $9.10 | Ready | |||||
RX-203275 I. Santos · Amlodipine 5mg | $6.30 | Ready | |||||
RX-203288 Y. Nakamura · Montelukast 10mg | $11.50 | Review | |||||
RX-203299 W. Zhang · Duloxetine 30mg | $11.40 | Ready | |||||
RX-203355 Compound R. Nasser · Diclofenac/Baclofen/Gabapentin 10/2/6% cream | $148.50 | Ready |
Audit exposure simulation
If every PBM audited you today, this is what's undocumented.
$83,400
exposed · 61 claims · last 90 days
Attach missing proof-of-delivery
3 claims
Backfill signature logs
2 claims
Locate scanned Rx image (fax)
1 claim
Rebill 90-day billed as 30
1 claim