Rebate Processing
Managing the invoice process for more than 300 Medicaid plans is no small feat. Tracking and validating prior period adjustments is even harder as different programs provide different information.
We remove this burden by providing claims validation, processing, and payment generation of rebates paid to Medicaid, TRICARE, Medicare (Part D and Inflation Rebates), commercial plans, and PBMs.
Our customized services include:
Receive invoices
Validate utilization
Handle dispute resolution with the states (when applicable)
Create ROSI/PQAS and payment request
Provide trending reports based on product, period, and/or programs
Issue payment on behalf of the manufacturer (contact us for more information)
As the designated invoice contact for our clients, we are responsible for the meticulous management of various government rebate programs. Our services involve receiving, documenting, and processing each rebate or claim. This process includes validating rebate amounts and utilization, ensuring no duplicate claims are processed, and processing all validated claims promptly.
We keep our clients informed when claims are ready for review and manage any potential disputes on their behalf. Following client approval, we can process payments while also providing detailed quarterly reports.
Our system tracks prior period transactions to ensure duplicate payments are not issued, and our team of Medicaid subject matter experts can efficiently process rebates utilizing industry best practices.
Our team also maintains a wide network of contacts at the state level to help resolve any issues and discrepancies quickly.