Strike a Balance Between Compliance and Efficiency
to Detect Fraud

Pharmacy Fraud and Abuse

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With ever-growing regulations and increasing areas of prescription fraud, waste and abuse, today’s pharmacies and pharmacy benefit managers must find a balance between risk mitigation and operating efficiency.

LexisNexis® offers a multi-layered approach to help identify and reduce prescription fraud related to provider, claims and member schemes; new member enrollment via Health Exchange Marketplaces; complex billing schemes; and organized fraud rings.

Uncover collusive schemes

Through data linking, unravel complex prescription fraud conspiracies perpetrated by organized crime groups.

Relationship visualization

Combine visualization capabilities, disparate data and linking technology to resolve identities and uncover relationships that may suggest prescription fraud.

Operate efficiently

LexisNexis solutions automate pharmacy fraud detection, minimizing manual investigative effort, reducing overpayments and enhancing recoveries.

Identify Suspicious Prescription Practices

Get flagged on unusual prescribing practices, aberrant dispensing patterns and drug-seeking behavior that may suggest illegal activity.

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to manage risk & uncover opportunity.