Payment Optimizer^® Solution 2,5

The double-digit healthcare increases in the US are driven by several factors, including drug and treatment advances, an aging population, fraud and abuse and policy and system errors. Some of these factors are beyond the control of payers. But one important cost driver—losses due to fraud, abuse and errors—can be managed and controlled. Payment Optimizer^® solution is the first fraud, abuse and error detection system for healthcare payers that provides both prepayment scoring and postpayment analysis to reduce fraud losses and ensure payment integrity in pharmacy and medical claims processing environments.