Avoiding pharmacy fraud through automation and audit.
Pharmacy data offer some of the most reliable and evaluative information in managed care today. As fraud constitutes up to 10% of our total health care expenditures, the author explains how monitoring the pharmacy network for fraud and abuse is an easy way of reclaiming some of these losses.
Tripodi
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Heritage Information Systems, Inc., Richmond, VA 23220, USA.
D001330:Electronic Data Processing; D005375:Financial Audit; D005607:Fraud / Q000517:prevention & control*; D008484:Medicaid; D006278:Medicare; D010593:Pharmaceutical Services / Q000191:economics / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D018571:Sentinel Surveillance; D014481:United States