NEWS
PRESS RELEASES - 05-07-2007
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MORGAN HEALTHCARE AUDITS IDENTIFIES OVER $200 MILLION IN RETROSPECTIVE PBM RECOVERIES
HARRISBURG, PA — David Morgan, president of Morgan Healthcare Audits (MHA), announced today that over $200 million of identified recoveries were found for their clients in 2006. This translates to 9 to 15 percent of a client’s RxSpend.
“RetroRx©, the in-house developed retrospective audit software, is amazing,” said Mr. Morgan. It allows 100 percent readjudication of claims for contract compliance as well as identifying hidden PBM business practices that are increasing clients’ Rx spend.”
Dottie Morgan, vice president of Information Technology, adds, “RetroRx© can easily be tailored to a client’s PBM contract terms and has flawlessly handled databases in excess of 20 million claims.”
Mr. Morgan noted that Retrospective PBM audits have been so successful that MHA has taken the knowledge gained from that product and created RxPro©.. RxPro© software can analyze pharmacy claims data before payment is made. Disputed claims and payments can now be withheld rather than recovered. Since implementation in July of 2006, clients have reduced payments on an average of six percent.
Morgan Healthcare Audits also works closely with Federal and State agencies to detect Fraud, Waste, and Abuse in the pharma industry.
Mrs. Morgan concludes, “It is this background in case development, attention to detail and documentation that separates MHA from other PBM auditing companies. All findings are supported with the associated claims data and/or documentation necessary for successful communication with the Pharmacy Benefit Managers.”
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