Sold by: FactspanÂ
Rx Optimizer enhances pharmacy benefit management with AI-driven insights, improving claims processing, formulary optimization, and cost containment to boost patient outcomes and financial efficiency.
Overview
Factspan's Rx Optimizer on AWS empowers healthcare providers and insurers to streamline pharmacy benefit management using AWS Gen AI services for formulary optimization, claims adjudication, and compliance tracking. It enhances cost efficiency, detects fraud, and ensures accurate prescription coverage analysis. By reducing administrative burdens and optimizing drug benefit programs, Rx Optimizer on AWS helps organizations improve patient care while maintaining financial sustainability.
AWS Services Used in this solution are: Bedrock, SageMaker, Lambda, RDS, S3, and Comprehend.
Key Capabilities: Formulary and Claims Analysis: Uses AI to optimize drug formulary management and claims adjudication Cost Management: Identifies cost-saving opportunities and enhances financial efficiency Compliance Automation: Ensures adherence to industry regulations and policies Fraud Detection: Detects anomalies in claims and prescription patterns
Highlights
- Fraud and Waste Detection: Anomaly detection helps insurance companies detect fraudulent claims by identifying claims that deviate from established patterns of normal claim behavior. This allows insurers to investigate suspicious claims, saving money and protecting the industry's integrity. Additionally, continuous monitoring and adaptation of models help insurers proactively identify and prevent emerging fraud trends.
- Personalized Drug Recommendations: Create personalized medication plans by analyzing patient history and current health conditions. Use data-driven insights to identify drug interactions and adjust dosages. Continuously monitor patient response and adjust medications to ensure optimal outcomes.
- Regulatory Compliance Automation: Ensure adherence to healthcare policies and standards, including but not limited to HIPAA, GDPR, and other relevant regulations. This includes maintaining data privacy and security, obtaining proper consent for data collection and use, and ensuring compliance with all applicable laws and regulations
Details
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Delivery method
Deployed on AWS
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Support
Vendor support
We offer comprehensive support to help you get the best out of Factspan FLUX: Email: Contact@factspan.com /genaihub@factspan.com Phone: +91-6364465639 Support Portal: <www.factspan.com/contact-us/ > Our support team is available to assist with integration, configuration, and troubleshooting. Expect timely responses and tailored assistance to meet your specific requirements.