Duplicate Discount Recovery
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Medicaid
Commercial
COMMERCIAL - MEDICAID
DUPLICATE DISCOUNT RECOVERY
Detecting Duplicate Rebates for Commercial and
Medicaid Channels and identifying Associated
Co-Pay claims
The Revenue
Intelligence Company
SIGNIFICANCE OF
THE PROBLEM
Duplicate Payments: Depleting Resources and Elevating
Compliance Risks!!
Financial Drain
Duplicate transactions in rebate programs lead
to unnecessary dual payments to Medicaid and
commercial insurers along with Co Pay Claims
on Duplicate Commercial Rebates, straining
financial resources.
Implementing robust systems to manage rebates
is crucial for preventing financial losses, ensuring
regulatory compliance, and supporting healthcare
affordability and access while safeguarding the
financial and legal integrity of manufacturers.
Importance of Effective Solutions:
Operational Burdens
Managing duplicate transactions across 3
channels demands substantial administrative
effort, increasing operational costs and
diverting resources from core business
functions.
The need for precise rebate payments under strict
legal standards exposes manufacturers to
compliance risks and potential legal penalties.
Legal and Compliance Risks:
The Revenue
Intelligence Company
fundae DDR Solution
features
Medicaid vs.
Commercial
Co-Pay Detection
Advanced Duplicate
Detection algorithms
Business Rules
Management
Compliance
Reporting
Identify Errant
Deep Dive Analysis
Pharmacies
100%
User-Controlled
Longitudinal
Trail
Accuracy
Guarantee
Madicaid Commercial
The Revenue
Intelligence Company
DUPLICATES
DETECTION WORKFLOW
Begins with gathering data from reliable sources such as PBM
transaction records and scrubbed State Medicaid Data to
create a comprehensive dataset for analysis.
Data Collection
The collected data is rigorously standardized, aligning critical
fields into a common format to facilitate further analysis.
Data Standardization
Utilizes advanced algorithms with fuzzy matching to pinpoint
potential duplicate transactions based on specific criteria such
as NPI IDs, Rx IDs, and NDCs, Fill Date
Duplicate Detection
Focuses on extracting duplicates from Commercial Rebate
Transactions and Co-Pay transactions for duplicate commercial
transactions, ensuring the analysis is both focused and efficient.
Targeted Extraction
The process is fully automated, culminating in the generation of
detailed transaction-level reports that provide insights into the
duplicates identified.
Compliance Reporting
The Revenue
Intelligence Company
ADVANTAGES OF
ADVANCED DUPLICATE
DISCOUNT DETECTION
Our solution not only meets but EXCEEDS the
expectations !
Enhanced capability to identify
both exact and near-duplicate
transactions, leading to
comprehensive error correction.
Tracked transactions over
multiple periods.
Deep Dive Analysis
Our system has also proven its
long-term value and reliability.
It has successfully identified
duplicates from the past two
years, totaling over $0.6 million
in value.
Significant Recoveries
Reduction in manual
processes has allowed staff
to concentrate on more
critical tasks, thereby
boosting productivity.
Operational Efficiency
The system's strong
compliance framework
reduces financial risks
associated with non�
compliance, ensuring
long-term financial health.
Robust Report
Identify Errant Pharmacies
User-Friendly UI
Accuracy Guarantee
The Revenue
Intelligence Company
NEXT STEPS
We invite you to visit our booth at the upcoming industry event for a
live demonstration of our Duplicate Discount Recovery system. Our
team will be available to provide tailored demonstrations and answer
any questions you may have.
info@fundae.io
www.fundae.ai
201-948-8472
Scheduling a one-on-one consultation with
our experts.
https://reserve.fundae.ai/#/ddr
Click here to book your meeting
The Revenue
Intelligence Company
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