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.
Close
