Address FWA in claims submission compliance.
Validation. Risk Mitigation. Real-time.
State and Federal government have aggressive plans to impose substantial fines on organizations making false claims to Medicaid and Medicare. Private insurers are also placing more scrutiny on FWA (Fraud, Waste and Abuse). In some cases, they also have imposed significant fines, or “clawbacks,” on major pharmacy chains and independents that have improperly submitted prescription claims.
So, if you’re ready to dramatically reduce the state, federal, DEA, Medicaid and Scope of Practice Fraud, Waste and Abuse (FWA) risk from your claims processing, Health Market Science is ready to help with Prescriber Eligibility.
This real-time validation service ensures prescriber credentials are current and attributed to the correct individual. It validates the federal, state, Medicaid and scope of practice eligibility attributes confirming an individual’s right to prescribe. And it determines the prescriptive authority by product, therapeutic category and drug class. .
Prescriber Eligibility is a real-time application with incredible deployment flexibility. Comprehensive data is updated on a weekly basis making it the only service capable of truly addressing compliance needs for prescription claims.
Contact us for more information about Prescriber Eligibility
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