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.
Why Conduent Pharmacy Audit and Compliance Services?
We have 30+ years’ experience helping payers and PBMs contain the cost of providing quality healthcare to groups and members throughout the country.
Our clients have trusted us to conduct more than 25,000 pharmacy audits annually in all 50 states and Puerto Rico.
We have a web-based client dashboard providing real-time results and analytics for enhanced transparency and reduced waiting times for provider audit results.
Pharmacy Audit and Compliance Services Overview
To learn more about Conduent’s Pharmacy Audit and Compliance Services, download our overview and see how we can help you pay claims accurately the first time.Download Overview