Claims Logic Reviews performed by Sanovia significantly increase the accuracy of billed claims, before actual payment is made to the pharmacy provider. Claims Logic reduces the health plan resources and time required to conduct a daily review of adjudicated claims.

Our application incorporates powerful algorithms to rapidly search and identify discrepancies in the manner billed pharmaceutical claims were submitted by the pharmacy provider. The application identifies claim exceptions for Fraud & Abuse Specialists to more effectively focus their efforts on immediate recovery for the health plan.