Case #00861

PROBLEM:
Client had pharmacies enrolling patients in Medicare and Medicaid rebate programs via manual paperwork. The associated claims submission, claims processing, and rebate payment processes were very labor intensive. In addition, there were several manual processes to verify the qualifications of participants to receive the products from the approved supplier.

SEP SOLUTION:
SEP designed, developed and verified a web-based application to address these issues. The solutions included:

• Automated the qualification and enrollment process for the client’s retail and mail order channels.
• Automated contract generation and execution processes
• Enhanced rebate processing with an automated an standardized claims process
• Provided support for check register functionality and integration with the client’s check processor

This effort involved defining software requirements, architecting a software design, coding, automated unit testing, continuous integration testing, and verification testing.