Contracts & Pricing Excellence
Accelerated Pharmaceutical Contracting for Market Access Excellence
IntegriChain has been instrumental in helping us navigate government programs. We thought we were on the right program path, but with the new CMS final rule, IntegriChain helped us quickly shift our strategy.
Government Reporting and Revenue Manager
Agile Pricing & Contracting Strategies for an Ever-Changing Industry
While a strong pharma pricing and contracting strategy can play a major role in nearly every aspect of drug commercialization, manufacturers often lack efficient processes to interpret, create, and manage contracts; navigate new regulations; and comply with all local, county, state, and federal laws. Manufacturers who rely on piecemeal processes leave themselves vulnerable to increased risk, delays, compliance violations, and revenue leakage.
Successful pharmaceutical manufacturers can achieve contracting excellence by choosing a partner that can manage regulatory process and compliance standards across government price, rebate, and chargeback management that can easily be maintained and adhere to growing demand.
IntegriChain’s pricing and contracting strategic services provide pharmaceutical manufacturers with the following resources and outcomes:
Experienced GP analysts with a network of attorneys, auditors and risk advisors.
Scrub and unify transaction data to IntegriChain point of care outlet and Class of Trade master.
Government pre-deal analysis and contract document creation
Best-practice methodology and configuration by price type and contract
Calculate & validate all monthly, quarterly and annual prices
Audit trail explaining final prices, interim results, and calculation methodologies.
Expertise and proven methodology for over 200 manufacturers
Communicates 340B & FSS Prices to wholesalers, distributors and 3PL
More than 200 manufacturers rely on IntegriChain’s business processes for rebate adjudication and government pricing
Proactively Manage Drug Rebates
Pharmaceutical rebates, originally created to better align the incentives of payers and providers, have now become an essential element of complex commercial and government access challenges. This complex rebate process makes it extremely difficult for manufacturers to focus their time and resources on business processes and managed market strategies.
As a trusted partner for government pricing as well as rebate management, IntegriChain processes hundreds of thousands of claims for a wide range of common fees annually. With modules to support different rebate types, manufacturers can scale their payer analytics and contracting functions.
Interpret contract language, rebate schedules, formulary compliance and amendments
Reconcile price protection against actual contract language.- Calculate unit rebate amounts for Medicaid, SPAP, Tricare and Managed Career Commercial and Part D Contract
Validate claims for eligibility, 340B pharmacy, duplication & aberrant quantities
Manage adjustments, disputes and interest with Payers / States or TPA
Generate payment packages including reports, ROSI, PQAS, etc.
Coordinate payments, fund replenishment and bank reconciliation
Experienced SMEs provide consulting and advisory services
Integration expertise and proven methodology
$9B+ industry rebates processed through ICyte
Eliminate Chargeback Overpayments
Chargebacks are a constant source of material business risk and revenue leakage. Because chargeback errors persist for a multitude of reasons, all pharmaceutical manufacturers that pay fees need a tool to verify contract compliance, otherwise they could be paying triple what they should.
Chargeback Data Reconciliation Services
- Account and Class of Trade master data management
- GPO membership maintenance
- Government-program-eligible accounts (Big 4, OGA, and 340B)
- Pricing management
- Contract management
- Contract price notifications to authorized wholesalers and 3PLs
- 844 EDI management (chargeback claims)
- Chargeback data reconciliation
Chargeback Processing Services
- Managing debt memos and lines
- Validations and HDA error processing reconciliation
- Resubmission processing
- Chargeback reconciliation reporting and 849 integration
- Generate chargeback payment request to ERP
- Operational reporting
- Wholesaler scorecards
IntegriChain’s chargeback data management uncovers 10-15% gross margin erosion.
Interested in learning more?
Webinar
State Price Transparency: 2022 Legislative and Regulatory Overview
IntegriChain subject matter experts discuss the current status of drug pricing transparency laws that have been recently introduced and updated at the state level. Topics include disclosures themes, types of reports, and new reporting updates for nearly a dozen states.
Watch THE WEBINAR
eBook
Improving Revenue Leakage Through Better Medicaid Claims Validation
With a growing population of program participants, the amount of Claim Level Data (CLD) will continue to grow exponentially. Invoice level validations alone cannot bring to light all the potential disputes in the Medicaid data. Without a solid CLD strategy in place, manufacturers are prone to errors and significant revenue leakage.
READ the eBOOK