HCIdea® enables you to reduce fraud, waste and abuse by managing prescriber information more efficiently and gaining greater insight into the identity and integrity of each prescriber. You can better assess risk associated with prescriber identities and make more informed decisions with HCIdea integrated into your claims database system.
Better manage fraud and abuse costs
Billions of dollars a year are lost to healthcare fraud and abuse, including prescriptions written by unauthorized providers. The expertise needed to perform proper investigation and recovery efforts is substantial. The costs incurred are significant, and there is no guarantee any recovery amounts will actually materialize.
There are multiple methods for preventing fraud, waste, and abuse, but the most effective and proactive solution is ongoing claims review. HCIdea's highly accurate data helps ensure that your claims detail includes only validated prescribers, preventing payment to schemers and reducing compliance problems.
Validating NPIs through HCIdea's prescriber database allows you to stay compliant, in particular, with the 2013 CMS regulation requiring identification of valid and active NPIs for all Medicare Part D claims, including controlled substance prescriptions.
Improve claims submission to speed payment
If you are reviewing claims manually, you can save time and money by integrating NCPDP's HCIdea data into your claims processing system. HCIdea's clean prescriber information will help you identify prescriber discrepancies more quickly, identify fraud and abuse, extend your ability to quickly settle claims payment, and prevent fraudulent or erroneous submissions that could result in penalties.
Make the smart move to HCIdea.