Pharmacy Audit and Compliance Services
Protect your health plan from spiraling pharmacy expenses and prevent fraud, waste and abuse.
Whether added on to an existing audit program or used as a stand-alone service, Conduent’s pharmacy audit and compliance services serve an important role in monitoring retail pharmacy operations by containing spiraling pharmacy expenses, returning overpayments, and providing aggressive oversight and deterrence against fraud and abuse. Our approach improves on rules-based systems by applying detection solutions that learn from the data, and enables us to use multiple claim review approaches that can uncover emerging patterns and anomalies nearly undetectable to hard-coded rules.
