Pharmacy
An environment of zero tolerance requires compliance-grade prescriber data.
Many of the healthcare industry’s most pressing compliance challenges converge at the pharmacy dispensing process. Mistakes made in a split second can unwittingly abet fraud, waste and abuse (FWA) and pose the threat of significant financial penalties or fines.
Given the voracious appetite for exposing FWA in the heavily burdened healthcare system coupled with the high cost of bad publicity, pharmacies need to proactively manage the claims submission process. Health Market Science offers state-of-the-art compliance solutions that help drive compliance in the processing of prescription claims—without compromising pharmacy workflow and point-of-service customer satisfaction.
Our solutions, based on compliance-grade prescriber data in the HMS Provider MasterFile, helps retail pharmacies comply with federal and state regulations including the Medicare Fraud Waste and Abuse and the Deficit Reduction Act. These regulations establish guidelines for whether or not a healthcare provider can see a patient, write a prescription, and/or submit a claim. If a pharmacy violates one of these regulations, it may be subject to substantial financial penalties and lose privileges to operate in that state or participate in federally funded programs.
