Processing Coverage Gap Invoices
Features and Benefits
- Loads invoice and detail files provided by TPA
- Runs validation and finds disputes
- Detects pharmacies – outliers
- Shows PDE analytics
- Passes rebates paid by NDC to SAP and other systems for Gross-to-Net calculations
- Comprehensive dispute management, including automated creation and import of Dispute files and Dispute Response files
- Offer insightful reports based on the whole PDE history
- Coverage Gap rebate amounts by NDC are provided to SAP, or any other ERP, for cost-center analysis and Gross-To-Net calculations
- Reports make transparent all rebates aspects: rebates paid by quarters of service and billing; Quantities, prescription counts and refills; activities by prescribers and products; Average rates and pharmacy outliers
The program saved 450K to one manufacturer in just one quarter, when CMS agreed to credit all disputes submitted by the program for just one particular outlier specialty pharmacy.
Relasoft Medicare Coverage Gap Solution is a must-have tool for companies with large Coverage Gap invoices.