Specialty drugs comprise a complex, high-stakes area of claim processing for health plans. These medications are often injectable drugs administered by a provider and are used to treat chronic, complex diseases. And specialty drugs are notoriously expensive and inherently complex, as are the processes for their corresponding claims.
Their complexity and expense make specialty drug claims especially prone to inaccurate billing, or worse, fraud and abuse. And while many plans use prior authorization to handle these claims, relying solely on this process can result in limited details that can leave plans open to inappropriate claims.
Watch our on-demand webinar, as we walk through solving the complex challenges of specialty drug claims. You'll gain a better understanding of:
- The latest trends in specialty drug spending
- Common areas of claim errors, waste, abuse, and fraud
- Concepts to improve claim accuracy and reduce patterns of fraud and abuse