Fighting fraud, waste and abuse in pharmacy

Every year, plan sponsors lose as much as $300 billion to healthcare fraud, waste and abuse. Optum Rx Fraud, Waste and Abuse Audit Services run 24/7 behind the scenes at no cost to our clients and save significant dollars. See how Optum Rx can help you prevent, detect, and correct these errors

This latest case study showcases how a union fund representing 8,800 lives realized more than $128,000 in savings and recoveries in one year. The audit identified multiple discrepancies such as duplicate fills, quantity violations, refill too soon and duplicate therapies. In addition to helping this client, the suspected fraud uncovered by this audit also led to the termination of 146 pharmacies within our network and, in doing so, generated $184 million in cost avoidance for other clients.

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