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I-many Validata®

Retain Profits Through Prescription-Level Validation

The stakes are high when it comes to claims submissions against Managed Care and Medicaid contracts. Duplicate or even triplicate submissions easily mask erroneous claims in a large volume of prescription-level data and, not surprisingly, pharmaceutical manufacturers mistakenly pay the price. It is estimated the amount paid out against erroneous claims is in excess of 2%–4% of revenue creating a compelling reason for pharmaceutical manufacturers to verify the claims submissions they receive.

I-many Validata, one of the I-many Contract Management Suite for Life Sciences™ solutions, is a comprehensive, integrated solution to Managed Care and Medicare rebate claims validation. The solution improves the claims process by automating and simplifying import, validation, summarization and analysis of data dramatically reducing inaccurate and duplicate claims and payments.

Compelling Key Benefits

• Improves the claims process by automating and simplifying import, validation, summarization, and analysis of data.
• Provides a potentially high return on investment given the large
  volumes of duplicates submitted for processing.
• Checks prescription-level information to ensure data is valid and that
  there are no duplicate prescriptions. The information may go through several validation checks, such as ensuring the plan is eligible for the contract, the products are available on the contract, and the
  prescription is for the manufacturer or a competitor’s product.
• Allows for faster processing of more information in less time with
  greater accuracy.
• Automates the import process by allowing users to intelligently map
  data to I-many Validata database tables and specify default values
  for missing data. Users can create or re-use mapping sets for each submission file received.
• Allows for powerful Coordination of Benefits validation checks for
  duplicates across segments (e.g., Managed Care, Medicare and
  Medicaid) and processes the identified duplicates based on
  user-defined segment-prioritization rules.
• Ensures users can quickly and accurately validate 100% of the
  imported data.
• Easily identifies product debit/credit pairs within a file, within a source,
  or across sources.
• Validates data against specific time periods, contracts, and plans,
  allowing for more accurate data reconciliation and rebate payment.
• Reconciles validation results and summarizes valid transaction items.
• Fully maintains history, from import, to validation and results, to summarization and export, at both the submission file and individual transaction item levels.

Click on the following products for more information:

• I-many Contract Manager™
• I-many CARS® NG
• I-many Government Pricing™
• I-many Medicaid Rebates™
• I-many Validata®
• I-many Medicaid Analytics™
• I-many CARS® BI
• I-many Architecture