Fraud Waste & Abuse: Vigilant Oversight and Management Will Dictate Success!
Pro Pharma Provides a Multi-Pronged Approach to FWA Detection and Management to Assist Health Plans!
By: Pro Pharma
Pro Pharma's approach relies on predictive analytics to identify patterns of behavior that indicate areas of potential FWA., states Carol Stern, CEO. She further states that "since technology by itself will not change behavior, Plans must proactively develop and implement targeted communications programs to reach out and suggest corrective action to potential offenders."
"FWA is not always clear cut", notes Dr. Craig Stern, President, "since FWA can occur when prescribers, patients and/or pharmacies err for any one of numerous reasons". He goes on to say that "not all billing errors are fraudulent and the distinctions between the types of FWA are not always obvious. From accidental waste to intentional deception, recognizing the nuances of these emerging patterns enables a health plan to better predict and prevent payment for claims of all types".
"In summary", Dr. Stern states "Pro Pharma can assist you and your organization, so that when FWA is focused on prevention as the priority, it is a valuable and cost-efficient resource to improve efficiencies and quality".
If you would like to learn more, please let us know your thoughts and we can schedule a short online demo. In that way you can see some of these functionalities as you take a visual journey to explore the potential usefulness of a program like this in your organization.
Please call us at (888)701-5438, extension 725 or email us at firstname.lastname@example.org to schedule a sort Demo. Also, please feel free to visit our Website at www.propharmaconsultants.com
About PRO PHARMA
Pro Pharma is a multi-service, woman owned, privately held consulting firm offering a vast portfolio of services to public and private entities including self-insured employers, unions, public employers, for-profit hospitals and integrated health networks, health care insurance companies, worker's compensation insurers, small-to-medium sized HMO's, and physician groups.
As a primary service to plan sponsors for achieving below trend results, Pro Pharma provides an integrated program of administrative process improvements, clinical quality oversight, and provider/member education.
Pro Pharma's Consulting services are grounded in the use of data and the communication of that information to define benefit trends, drivers and other analytical indicators. Pro Pharma Markets Biotech Modeling™, Invoice Screening™, Quality Management Program™, and Treatment Calendar™. The Company directly markets its products in the U.S. and collaborates with partners to reach international markets.
For more information about PRO PHARMA, please visit www.propharmaconsultants.com.
CONTACT: PRO PHARMA PHARMACEUTICAL CONSULTANTS, INC.
Carol Stern, (888)701-5438