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Data Mining for pharmacy payment errors yields high savings

See how Cotiviti’s Data Mining pharmacy solution uncovered millions in inaccurate payments for two health plans using predictive analytics and specialist validation.

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With the U.S. healthcare system spending more than $240 billion on prescription drugs annually1, it’s more important than ever for health plans to ensure payment integrity for claims for pharmacy services and medications covered under the plan’s medical benefit. But this can be challenging for payers.  

See how Cotiviti’s Data Mining pharmacy solution uncovered millions in inaccurate payments for two health plans using predictive analytics and specialist validation. Learn how Data Mining can:

  • Validate findings
  • Help ensure thorough medical pharmacy claim review
  • Increase payment accuracy for your organization 

1 Source: Drug Channels Institute.

About the Author

As director of audit operations, Matthew is responsible for managing and overseeing all pharmaceutical audit activities including overpayment recoveries, contract commitments, and customer satisfaction measure scores. With almost a decade in the healthcare services industry, he applies his information technology and data science expertise to improve the payment integrity space. Matthew's strategic leadership yields significant financial recoveries, enhances operational efficiency, and nurtures client engagement.

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