With the U.S. healthcare system spending greater than $600 billion on pharmaceuticals yearly, IT’s crucial for Health plans to make sure correct fee for claims for pharmacy providers and drugs lined below the plan’s medical profit.
However this may be difficult for payers. Figuring out and recovering billing and fee errors in medical pharmacy takes time and administrative assets. Learn our new case examine to see how Cotiviti’s Information Mining pharmacy resolution uncovered hundreds of thousands in inaccurate funds for 2 Health plans utilizing predictive analytics and specialist validation.
On this case examine, you’ll be taught:
- How Cotiviti’s diversified group of specialists monitor trade modifications to construct a novel content material library
- How a big Blue Plan recognized >$10M in potential financial savings with knowledge mining
- How a group Health plan recognized a big overpayment pattern in unclassified medicine
Tailor the information mining course of to your wants by collaboration with auditing specialists to establish and validate overpaid claims. Uncover the worth of knowledge mining in fee integrity to assist guarantee thorough medical pharmacy declare overview and improve fee accuracy on your group.
To be taught extra about Cotiviti’s Cost Accuracy and knowledge mining options, set up a conversation with our group. For a deep dive into how Health plans can enhance pharmacy fee integrity, watch our on-demand webinar, Past prior authorization: Making certain accuracy of specialty drug claims.
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