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Case study

Fighting fraud

How one plan sponsor recovered $315,000 in six months.

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Every year, plan sponsors lose as much as $300 billion to health care fraud, waste, and abuse. Optum Rx Fraud, Waste, and Abuse Audit Services run 24/7 behind the scenes at no cost to our clients and save significant dollars.

This latest case study showcases how we were able to recover $315,000 within six months for a nursing union representing 1.2 million lives. In addition to helping this client, the fraud uncovered by this audit also led to the termination of 45 pharmacies within our network and, in doing so, generated $80.5 million in cost avoidance for other clients.

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