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Artificial intelligence (AI) is revolutionizing pharmacy benefit performance by flagging claims errors, preventing fraud and streamlining contract reviews. A session at the AMCP Nexus 2023 meeting highlighted four case studies from CareSource, demonstrating how machine learning – a subset of AI – expedites contract review, improves pharmacy claims error detection, and tackles fraud, abuse, and waste. In addition to these solutions, AI promises enhanced customer service, predictive modeling for specific outreach, and personalized formulary management.
By Dr. Tony Hoang4.6
99 ratings
Artificial intelligence (AI) is revolutionizing pharmacy benefit performance by flagging claims errors, preventing fraud and streamlining contract reviews. A session at the AMCP Nexus 2023 meeting highlighted four case studies from CareSource, demonstrating how machine learning – a subset of AI – expedites contract review, improves pharmacy claims error detection, and tackles fraud, abuse, and waste. In addition to these solutions, AI promises enhanced customer service, predictive modeling for specific outreach, and personalized formulary management.

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