In our previous post highlighting the value of Model N Validata, we provided a brief overview of some of the key challenges the solution can overcome in commercial programs and the Medicaid Drug Rebate Program. Now we will explore how manufacturers can rely on Validata to keep pace with ever-evolving NCPDP standards.
The National Council for Prescription Drug Programs (NCPDP) is a not-for-profit organization whose members include pharmaceutical manufacturers, health plans, and government agencies, among others. Using a consensus-based process for developing industry-wide standards, the NCPDP aims to connect healthcare electronically, streamline processes, and safeguard patients.
The NCPDP’s Manufacturer Rebate Standard provides a standardized format for the electronic submission of files intended to be used in an integrated manner, with the utilization file being supported by the plan, formulary, market basket, and reconciliation files. Enhancements are made frequently, with the latest update (version 07.03) featuring additions to diagnosis code information, patient liability, claim detail standards, reconciliation formats, and more.
When followed, these standards help streamline communication and workflows by reducing manual processes required to match information to process rebates. In short: It’s a better way to share information – one that reduces costs, avoids disputes, and simplifies coordination among manufacturers and payers.
Verify and process payments for improved financial reconciliation
As NCPDP standards evolve, so does Validata. Model N makes core adjustments to the platform to support standard changes, whether they be layout or code values. By updating and supporting the full range of standard versions, Validata facilitates easier contract negotiation, communication, and transparency between manufacturers and payers.
Bottom line: Visibility is an asset
When manufacturers have visibility into data to explain why claims are being rejected, they can better negotiate contracts with payers.
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