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Dummy Article 3 – Customerinsights

Learn How to Leverage ML Algorithms to Combat Pharmacy Claims Fraud

      There has been a significant rise in pharmacies making fraudulent claims with pharmaceutical companies on their co-pay and voucher programs. The pharmacies submit claims for payments on expensive prescriptions that were never filledor distributedto patients. The sefake claims have been risingby theday. This riseis fueledbytheincrease in the number and budgets of co-pay and voucher programs by pharmaceutical companies ….. Rebate claims data submitted by the pharmacies can be used to predict whether a claim is a bogus claim. A suspicious activity can be identified by detecting anomalies in the data using statistical techniques like clustering, univariate and multi-variate outlier analysis, etc.

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    Meet The Authors

    MicrosoftTeams-image (2)

    Vishwadeep Singh

    Head of Product, ciPARTHENON,

    Vishwadeep has 18+ years of experience with global
    experience (US/Ex US) leading engagements for top
    life sciences organizations that includes, designing &
    developing information management strategy,
    supporting sales force operations, institutionalizing
    the digital data hubs for brand marketing,
    establishing the global framework for harmonizing
    the data, reporting & analytics, conceptualizing the
    model for taxonomy standardization across
    marketing tactics & campaigns.

    Ricky Smith

    Director, Commercial Access,
    Dermavant Science

    Ricky has 18+ years of experience in commercial,
    trade, marketing and sales analytics, patient access,
    forecasting, marketing mix modeling, and global
    supply chain management. Relevant experience
    Ricky has spent the last decade of his career in the
    healthcare industry building various analytics teams
    from the ground up. Incorporating new datasets,
    implementing best in class processes, and pioneering
    award-winning patient access solutions across several
    disease states.