The Workflow for Contracts & Chargebacks on the MediLedger Network

In our first blogpost we provided an overview of the Contracts & Chargebacks solution. Here we walk through how the Contracts & Chargebacks solution compliments the current industry process with data, updates and chargeback claims flowing through the MediLedger Network.

Step 1: GPO Roster Updates

Roster updates are received real time by manufacturers and distributors, with agreed upon rules to ensure that the data is accurate and complete. Even if GPOs don’t participate, we can enable the upload of current rosters via CSV files to deliver the processing benefits to manufacturers and distributors.

Benefits:

• Cleaner data
• Real time updates (vs biweekly)
• Improved efficiency as roster upload and evaluation is automated

Step 2: Customer Mapping

In our evaluation of the data used by the industry today, the only number that companies were confident never changed was companies’ own internal customer ID. We have set up evaluation rules to allow the manufacturer to define the customer, and then we connect the manufacturer to the appropriate distributor and GPO’s internal customer IDs ensuring they are referencing the same customer.

Benefits:

• Precise understanding that all trading partners are referencing the same customer
• Reduced disputes, ability to more rapidly troubleshoot changes

Step 3: Customer Evaluation

We have established linkages with all the associated databases that the industry uses today to evaluate customer eligibility: HIBCC, DEA, HRSA(340B), AHD, NPI. With all these linkages, the trading partners know that everyone is working off the same data at the same time; from this we have enabled rules engines that can execute each manufacturer’s unique eligibility evaluation, including Class of Trade assessment. This will also allow customers to be assigned to specific contracts as per the manufacturer’s rules, and all trading partners have visibility to those assessments, so any disagreements can be solved prior to any sales taking place.

Benefits:

• No data mismatches because everyone is working from the same data at the same time (not always true when companies update their core systems by themselves)
• Manufacturer’s ability to vet the entire roster rather than just the customers that they have previously sold to before, decreasing risk for the distributors
• Distributors efforts reduced by being able to reduce eligibility research

Step 4: Contract Updates

Now the manufacturer can send updates, real time, to both the GPO and distributor, acting on all the updates, and subsequent impact on eligibility to provide the latest state of the contract: products, prices, and eligible customers. A cryptographic proof of the contract is then stored on the blockchain, which provides the trust between manufacturer and distributor, so that when the product is sold some time later to the customer, the manufacturer can know the right price and eligibility is being used.

Benefits:

• GPOs that have no visibility today can see latest eligibility of their customers to assist in troubleshooting or customer service
• Everyone is updated real time with all updates incorporated
• Everyone is working off the same data
• The latest state of the contract is available to check against, without revealing any business intelligence to other network participants (i.e. pricing)
• Can eliminate EDI 845

Step 5 & 6: Chargeback Claims and Credit Transactions

The distributor, upon sale of their product, can check the eligibility and price against the proof stored on the blockchain, knowing that if the Chargeback complies, it will automatically be approved by the manufacturer. The manufacturer knows they won’t receive chargebacks that don’t comply with the latest state of the contract, fully automating the process. The distributor can receive the credit transaction immediately.

Benefits:

• Enables full automation for the manufacturer — knows all chargebacks are accurate
• Distributor knows they will get paid — can provide stability of financial plans, reduce reserves
• Eliminates the EDI 844 and EDI 849

Figure 1: Contracts and Charegback Process. MediLedger Nodes easily integrate with current internal systems and processes, plugging in as a new sources of validated data and transactions for all partners

Conclusions

Using blockchain, we have enabled trading partners and competitors to sit in the same network, knowing they can all leverage the same solution while adopting the level of automation they are ready for. Distributors can especially benefit from running the same process for their suppliers, regardless of EDI adoption. We have also designed a deployment model making it easy to integrate with existing core systems, improving on existing investments, with a variety of adaptors to make integration as easy as possible.

We are bringing to market a comprehensive solution that solves a myriad of pain points this industry has suffered with for the last 20+ years. By leveraging modern technology we can now automate complex workflows, decision trees, and bespoke logic with a solution designed for both conservative and bold companies in the life science industry to easily adopt and deliver value to their customers and ultimately the patients we all serve.

If you are interested in learning more email us at info@mediledger.com or go to Contact Us