Today’s guest post is from Becky Holloway, Product Marketing Manager at Revitas. In this informative article, Becky describes the flaws of manual data management and the limits of outsourced data cleansing.
Becky highlights Revitas’s new Online Savings Calculator, a neat tool for assessing the savings from in-sourced prescription level data scrubbing
Please contact Becky Holloway (bholloway@revitasinc.com) with any questions about the article.
The Deal with Dirty Data
by Becky Holloway, Product Marketing Manager, Revitas
We’ve all heard the saying: “You’re only as strong as your weakest link.” In the managed care world, that truism could also read: “Your rebate payments are only as accurate as your dirtiest data.”
In reality, managed care rebates are paid out on summary utilization data, which can hide costly prescription level inaccuracies and errors. Even if you’re doing a bang-up job managing your pricing incentives, you could still be losing money.
Given the large and complex product portfolios managed by pharma companies, manually cleansing script-level data during claims processing is impractical. Large volumes of data managed in spreadsheets by multiple employees are highly susceptible to errors, oversights, and inconsistencies. Plus, managing data from multiple managed care trading partners means different data sources, formats, and/or delivery times. The data become even more difficult to navigate. The system quickly becomes unwieldy and unmanageable.
Ever-increasing contract complexity also complicates data validation. Increasingly, terms and conditions of rebate programs are granular and complex. Standard validations that routinely cause the greatest area of revenue loss include: time validations; pharmacy identity; aberrant quantities; duplicates; and coordination of benefits. Given the large data volumes being processed, even the largest, most resourceful companies find it taxing to validate every data level.
Thus, for most pharma companies, manual validation systems and processes ultimately fail. The result is lost revenue due to overpayments, duplicate payments, and penalties.
As an alternative, many manufacturers outsource the cleansing of their prescription-level data. While this may seem like a reasonable solution, there are a few drawbacks.
One, depending on the parameters of your third-party vendor agreement, not all validations or data volumes may be included. This means you could still be paying rebate claims based on dirty data. Two, outsourcing script-level data scrubbing means relinquishing full control of your data. Three, incomplete scrubbing by a third-party source could rob you of powerful insights about the success or failure of your rebate strategies.
Revitas has developed a handy little online savings calculator that assesses the savings from in-sourcing your prescription level data scrubbing. There are many benefits to a flexible, configurable, and adaptable solution. High on the list is the ability to gain greater visibility into your own product usage and penetration.
Please try this new calculator app. Be sure to email me at bholloway@revitasinc.com and let me know how much money you could be saving!
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