Case Study: Prime Therapeutics achieves fraud investigation efficiency gains with Case IQ

Prime Therapeutics saves $56 million and boosts FWA efficiency 25% with Case IQ

Prime Therapeutics, a pharmacy benefit manager, faced significant challenges in managing its fraud, waste, and abuse (FWA) investigations. Their previous system, which relied on shared drives and spreadsheets, was disjointed and inefficient, making it difficult to track cases, share information between teams, and maintain oversight. This inadequate process was preventing the team from reaching its goals and required a more robust solution. They turned to Case IQ for a comprehensive case management system.

Case IQ implemented a configurable, web-based solution that integrated with Prime’s existing SAS analytics tool. The platform centralized all case information, automated workflows for seamless hand-offs between teams, and provided supervisors with complete visibility into case activity. As a result, Prime’s FWA team achieved a 20-25% efficiency gain and was able to handle twice the workload. Most significantly, Case IQ helped Prime achieve $56 million in savings for its clients through fraud prevention and recovery efforts.

Prime Therapeutics