Checklist template

Prescription fraud and forgery detection

A ready-to-use checklist with 97 items in 6 sections, covering Verification, Red flags, Prescriber checks, Documentation, Reporting, Training. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 97 Items
  • 81 Yes / No checks
  • 5 Scored ratings
  • 106 Points

Use this template How audits work

1. Verification 18 items

  1. Paper prescriptions for controlled substances are checked for the security features of the pad (watermark, void pantograph, heat-sensitive ink) Yes / No 1 pt
  2. A reference showing the security features of prescription paper used in the area is kept at the intake station Yes / No 1 pt
  3. The quantity on paper prescriptions is checked for a matching written-out amount or check box Yes / No 1 pt
  4. Paper prescriptions are examined for different inks, different handwriting or erasures Yes / No 1 pt
  5. Photocopied or scanned prescriptions presented as originals are refused Yes / No 1 pt
  6. Electronic prescriptions are accepted only through the certified e-prescribing channel of the dispensing system Yes / No 1 pt
  7. Faxed prescriptions are checked for the sending fax number in the header Yes / No 1 pt
  8. The header number of a faxed prescription is compared with the prescriber's number on file Yes / No 1 pt
  9. Phoned-in prescriptions are taken by a pharmacist or an employee authorized by local regulation Yes / No 1 pt
  10. The name of the caller is written on each phoned-in prescription Yes / No 1 pt
  11. Government-issued photo identification is checked for new patients presenting a controlled substance prescription Yes / No 1 pt
  12. The identification number or type is recorded where company policy requires it Yes / No 1 pt
  13. The patient's address on the prescription is compared with the profile Yes / No 1 pt
  14. The prescription monitoring program is consulted before a controlled substance is dispensed to a new patient Yes / No 1 pt
  15. The date written is checked against the validity period allowed for the drug Yes / No 1 pt
  16. Prescriptions from out-of-area prescribers are confirmed before filling Yes / No 1 pt
  17. Controlled substance prescriptions refused or not filled in the last 30 days Number
  18. Verification of paper and phoned-in prescriptions observed Rating
    • Every step followed 5 pts
    • Some steps skipped when busy 3 pts
    • Prescriptions filled without verification 1 pt

2. Red flags 17 items

  1. A list of red flags for forged or altered prescriptions is posted at the intake station Yes / No 1 pt
  2. Employees asked could name three red flags without looking at the list Yes / No 1 pt
  3. The posted list includes handwriting that is unusually neat for a prescriber Yes / No 1 pt
  4. Quantities or strengths above the prescriber's usual pattern are questioned Yes / No 1 pt
  5. The posted list includes directions written in full with no medical abbreviations Yes / No 1 pt
  6. Several patients presenting similar prescriptions from the same prescriber within a short time are flagged Yes / No 1 pt
  7. Combinations of an opioid, a benzodiazepine and a muscle relaxant are reviewed by the pharmacist before filling Yes / No 1 pt
  8. Requests to pay cash when the profile shows insurance are questioned Yes / No 1 pt
  9. Patients traveling a long distance past other pharmacies are asked why Yes / No 1 pt
  10. Prescriptions presented just before closing or on weekends, when prescribers cannot be reached, are held until confirmed Yes / No 1 pt
  11. Refill numbers that look added or changed are confirmed with the prescriber Yes / No 1 pt
  12. Prescriptions for promethazine with codeine syrup in large volumes are confirmed with the prescriber before filling Yes / No 1 pt
  13. Requests for a specific brand, color or manufacturer of a controlled substance are noted on the profile Yes / No 1 pt
  14. A person picking up for several unrelated patients is flagged Yes / No 1 pt
  15. Early-refill alerts on controlled substances are resolved by the pharmacist, not by the technician at intake Yes / No 1 pt
  16. Alerts from other pharmacies or the regional fraud network are posted or filed where employees can see them Yes / No 1 pt
  17. Employee awareness of red flags Rating
    • Named red flags readily and gave recent examples 5 pts
    • Named red flags only with prompting 3 pts
    • Could not name red flags 1 pt

3. Prescriber checks 15 items

  1. Prescribers are called at the number in the pharmacy's own records or a public directory, not the number printed on the prescription Yes / No 1 pt
  2. The prescriber's license is checked on the regulator's website when the prescriber is new to the pharmacy Yes / No 1 pt
  3. The prescriber's authority to prescribe controlled substances is confirmed for new prescribers Yes / No 1 pt
  4. The drug is checked against the prescriber's scope of practice (for example a dentist or a veterinarian) Yes / No 1 pt
  5. The pharmacy keeps a record of prescribers whose pads were reported stolen Yes / No 1 pt
  6. Notices of prescriber license suspensions received from the regulator are filed in the pharmacy Yes / No 1 pt
  7. The prescriber file in the dispensing system has no duplicate records with different phone numbers for the same prescriber Yes / No 1 pt
  8. Changes to a prescriber's phone or fax number in the system are made by a pharmacist Yes / No 1 pt
  9. Signatures on paper prescriptions are compared with earlier prescriptions from the same prescriber Yes / No 1 pt
  10. Prescriptions signed by a nurse or an office agent are confirmed as allowed for the drug Yes / No 1 pt
  11. A call-back is made to the prescriber's office when a phoned-in controlled substance order comes from an unknown voice or number Yes / No 1 pt
  12. The pharmacist records who at the prescriber's office confirmed the prescription Yes / No 1 pt
  13. Prescriber call-backs recorded in the last 30 days Number
  14. Prescribers whose prescriptions the pharmacy no longer fills are listed, with the reason Yes / No 1 pt
  15. Prescriber verification practice Rating
    • Independent number used and result recorded 5 pts
    • Called but not recorded 3 pts
    • Number on the prescription used or no call made 1 pt

4. Documentation 16 items

  1. The date and time of each verification call are written on the prescription or in the profile Yes / No 1 pt
  2. The outcome of the call is written on the prescription or in the profile Yes / No 1 pt
  3. The reason for refusing a prescription is recorded in the patient profile Yes / No 1 pt
  4. A prescription confirmed as forged is kept, where the law allows, rather than returned to the presenter Yes / No 1 pt
  5. A copy is made of a suspect prescription that is returned to the presenter Yes / No 1 pt
  6. Forged prescriptions kept as evidence are handled as little as possible and stored in a sleeve or envelope Yes / No 1 pt
  7. The description of the person who presented a forged prescription is written down while it is fresh Yes / No 1 pt
  8. The date and time of the visit are noted so that camera video can be found Yes / No 1 pt
  9. Video of the presenter is saved before the recorder overwrites it Yes / No 1 pt
  10. Notes on the profile of a patient who presented a forgery are visible to the next pharmacist Yes / No 1 pt
  11. Original paper prescriptions are filed in number order and can be retrieved for the auditor's sample Yes / No 1 pt
  12. Controlled substance paper prescriptions sampled by the auditor Number
  13. Sampled prescriptions with no verification note where a red flag was present Number
  14. Phoned-in controlled substance orders are reduced to writing with all required elements Yes / No 1 pt
  15. A log of suspect and forged prescriptions is kept in the pharmacy Yes / No 1 pt
  16. Quality of verification records on the sample Rating
    • Complete on every prescription 5 pts
    • Partial notes 3 pts
    • No notes 1 pt

5. Reporting 15 items

  1. Confirmed forgeries in the last 12 months were reported to police Yes / No 1 pt
  2. Confirmed forgeries were reported to the regulator or the monitoring program where local regulation requires Yes / No 1 pt
  3. The prescriber whose name was forged was told Yes / No 1 pt
  4. Loss prevention was told of each forgery within the time set by company policy Yes / No 1 pt
  5. Neighboring stores of the company were alerted on the same day Yes / No 1 pt
  6. The police non-emergency number is posted at the pharmacy phone Yes / No 1 pt
  7. The procedure tells employees not to detain or confront the presenter Yes / No 1 pt
  8. The procedure tells employees to delay politely while the prescription is checked Yes / No 1 pt
  9. Forgeries filled and discovered later are reported in the same way as those caught at intake Yes / No 1 pt
  10. Insurance claims paid on a prescription later found to be forged are reversed Yes / No 1 pt
  11. Controlled substances lost to a filled forgery are recorded as a loss in the inventory records Yes / No 1 pt
  12. Forged or altered prescriptions identified in the last 12 months Number
  13. Forged prescriptions that were filled before detection in the last 12 months Number
  14. Date of the most recent forgery report Date
  15. Each report on file has a police or company reference number Yes / No 1 pt

6. Training 16 items

  1. Every pharmacist completed forgery detection training in the last 12 months Yes / No 1 pt
  2. Every technician and assistant who takes in prescriptions completed the training Yes / No 1 pt
  3. New intake employees are trained before working the drop-off window alone Yes / No 1 pt
  4. Training includes examples of real forged prescriptions seen by the company Yes / No 1 pt
  5. Training covers fraudulent electronic and faxed prescriptions, not only paper Yes / No 1 pt
  6. Training covers phone calls from a person posing as a prescriber's office Yes / No 1 pt
  7. Relief pharmacists are shown the store's suspect prescriber list and forgery log on their first shift Yes / No 1 pt
  8. Employees asked could describe the steps to take when a prescription looks altered Yes / No 1 pt
  9. Employees asked knew that the pharmacist makes the final decision to fill or refuse Yes / No 1 pt
  10. Recent forgery alerts are discussed at the pharmacy team huddle Yes / No 1 pt
  11. Pharmacy employees with no forgery training on record Number
  12. Date of the last forgery detection training session Date
  13. Corrective actions from the previous review have been completed Yes / No 1 pt
  14. Name of the pharmacist on duty during the visit Short text
  15. Overall ability to detect forged or altered prescriptions Rating
    • Checks made and recorded, employees name the red flags 5 pts
    • Checks made but poorly recorded or known to some employees only 3 pts
    • Suspect prescriptions filled without checks 1 pt
  16. Corrective actions required Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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