Reliable Claims Processing
Our claims processing system is one of the most sophisticated in the industry and is essential for managing care and cost. By incorporating online capabilities that mirror the retail, mail order and Internet environments, we're able to offer convenient and protective tools, such as safety warnings against drug interactions, generic promotions and plan-specific guidelines.
Our DUECare system is a proactive clinical intervention program that performs current edits on each transaction, such as:
- Refill too soon
- Duplicate claim
- Duplicate therapy
- Drug-to-drug interactions
- Dosage checks
- Age precautions
- Dose duration
- Compliance checking
- Drug-to-drug contraindications
- Poly pharmacy (iatrogenic dosing)
- Pregnancy and lactation
