Rebate Management

Rebate Management

Rebate Management Services

Delivers Scale and Cost Savings through the Industry’s Leading Managed Services Platform for Claims Adjudication

IntegriChain’s rebate management services offering allows manufacturers to scale their payer analytics and contracting functions to meet today’s complex commercial and government access challenges. Our industry’s leading rebate management offering is the first choice for life science companies in providing claims adjudication, handling all of your needs for your claims payments and rebate processing.

Scaling Your Business through Outsourcing

Our Payer Team helps you reduce risk and increase net profits while managing the ever-changing complexities of rebate management, contract management, processing, and analysis. By partnering with IntegriChain, you can focus time and resources on your managed markets strategies. We act as your trusted partner for government pricing as well as rebate processing — reliably, timely, securely, and efficiently.

Every year, we process hundreds of thousands of claims for a wide range of common fees (GPO, admin, distribution) as well as offer modules to support different rebate types (commercial, price protection, Medicare Part D, Coverage Gap, Medicaid, and TriCare).

Rebate Management Benefits

Scale Operations

Accelerate product launches and company acquisition through the scalability provided by managed rebate claims processing.

Reduce Risk

By interpreting contract language and rebate schedules, we provide streamlined, timely processing of payments and avoid interest penalties. Additionally, our expert teams reduce your risk associated with formulary compliance, price protection agreements, and also ensure accurate management of adjustments and disputes with payers and states.

Manage Increasing Complexity

Whether they’re for Managed Care, Part D, Tricare or Medicaid, rebates can be complex to adjudicate. Worse yet, improperly dealing with stacked rebates or complex bundles can lead to revenue leakage as well as compliance violations. Our team handles millions of transactions annually, helping pharmaceutical manufacturers stay ahead of industry intricacies.

Control Costs

Avoid the need to license or implement software, pay maintenance fees, or purchase and manage servers.

Featured Module: Claim Level Detail (CLD) Validation

Given the growing volume of Medicaid rebate claims, even small discrepancies can add up to significant revenue leakage. Manufacturers are often burdened when trying to determine invoice-level validity without having Medicaid Claim Level Detail (CLD) at their disposal. Unfortunately, processing CLD reconciliation on your own can be complicated, and trying to claw back money via the traditional “pay-and-chase” approach is often costly, inefficient, and time-consuming.

As an add-on module to IntegriChain’s rebate management service, Medicaid CLD performs detailed validation of Medicaid claims, improving the ability to detect and reject invalid claims and eliminating over-payments and/or incorrect payments associated with the claims.

Retrieve Claim Level Detail (CLD) Faster

  • Leverages robotic process automation (RPA) to automatically download Medicaid CLD details for more than 65% of state/programs
  • Significantly reduces turnaround time on CLD acquisition

Eliminate Data Wrangling Hassles

  • Standardizes data formats for easier processing
  • Leverage IntegriChain expert advisor on proper dispute formatting

Enable True In-Line Dispute

  • Automatically translate validation results to invoice-level dispute codes
  • Eliminates the cost, risk, and hassle of traditional pay-and-chase approaches

Rebate Management Case Study

With IntegriChain CLD in place, one top-50 manufacturer identified $6 million in revenue leakage from a single state program, and on average, manufacturers utilizing CLD identify 1% to 2% of Medicaid liability in revenue leakage.

Download our Claim Level Data (CLD) eBook for more information.

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