4 attributes of a successful specialty drug payment integrity program

Specialty drug claims are notoriously expensive and complex, comprising an estimated $243 billion of U.S. pharmaceutical revenue in 2023. Due to their complexity, specialty drug claims are prone to inaccurate billing, fraud, waste, and abuse (FWA). Prior authorization is the main source of claims verification for many plans, but the nuances of spec...

• Published date: 03-09-2024 06:54 PM