The Challenge
AUTOMATE THE IMPORT AND VALIDATION OF UTILIZATION DATA TO DETECT ERRORS
The client is a major pharmaceutical company aiming to stop paying invalid rebate claims. Aspect previously discovered that utilization data from submitting contract organizations included errors that invalidate an average of 16% of rebate claims. In an increasingly demanding business climate, cost savings is key. Reviewing utilization submission data and flagging errors prevents the pay out of incorrect or invalid rebates, but manually processing rebate claims is time consuming and difficult.
The Solution
DESIGN BUILD AND IMPLEMENT AN APPLICATION TO VALIDATE UTILIZATION DATA
Aspect proposed to design, build, and implement an application that would automate the import and validation of utilization data from all contracted distributors. An automated solution to detect errors across all vendor utilization submissions would result in a significant cost savings.
Over the course of three releases, Aspect would deliver a fully featured, cost saving application, enabling the client to immediately realize a return on their investment.
The first release would deliver a fully functional application, while the second and third releases would allow for additional features, functionality, and efficiency.
The Advantage
EFFICIENTLY VALIDATE UTILIZATION DATA AND ELIMINATE PAYING REBATES ON INVALID CLAIMS
Immediate Realization of Return on Investment
By recognizing errors such as duplicate claims, products that were not listed under contract, invalid product IDs, and other reoccuring errors, the client saw an immediate return on their investment.
Users were given the ability to configure the validations as well as claims scrubbing across multiple segments. Additional functionality that added valuable flexibility were also introduced such as additional aberrant quantity validation, dynamic extract options, enhanced reporting, and the ability to build mapping templates
FEATURES & BENEFITS
- Successfully provided the ability to validate calims efficiently.
- Client was able to review errors allowing them to override or reject invalid claims.
- Created sophisticated reporting controls for better analyses and increased communication.