DUR/Reports

Retrospective drug utilization review involves DUR evaluating medicinal therapies after the medications have been provided to the patient. The purpose of this review is to determine patterns of dispensing that may be inappropriate and are in opposition with your policy. HCIdea 3.0 will be able to match the DEA and NPI numbers to the physician in the processed claim. This allows the health plan to identify the physician so they may communicate their treatment protocol.

Improve member satisfaction while reducing costs by identifying inappropriate patterns such as:

Clinical abuse/misuse
Drug-disease interactions
Drug-drug interactions
Erroneous dosage, duration of therapy or choice of therapy
Over and under utilization
Therapeutic duplication
Under utilization of generic substitutes