Rebate Services & Aggregation

REBATE SERVICES &

REBATE AGGREGATION





Rebate Service Offering

ProCare Rx offers both customizable pharmacy and medical rebate programs. Use the program that best fits the needs of your organization:


  • ProCare Rx configured hybrid rebate
  • Your own designed (direct or indirect)
  • A rebate aggregator


Whichever option you choose, ProCare Rx will ensure the best possible yield by implementing the selected complementary formulary and clinical utilization management programs, while managing to the best level of formulary compliance.


We negotiate with over 125 manufacturers (directly and indirectly) and offer formularies that target
your different possible financial goals, while lowering the resulting net cost of dispensed medications.

Pharmacy Rebate Administration


ProCare Rx’s broad-based pharmacy rebate administration services fit your needs and financial goals. Whether a PBM, TPA, employer group or other health care entity, our offerings are flexible and transparent, providing recommendations to enhance and maximize rebates offered by manufacturers for branded pharmaceuticals, devices, and biosimilars.

  • Direct, Indirect & Hybrid Program Models
  • Formulary Analysis & Grandfathering
  • Transparent Reporting as Allowed
  • NDC Level Tier Files by Formulary
  • Data Scrubbing Services to Reduce Rejects
  • Response Files to Maximize Rebates
  • Monthly or Quarterly Submissions
  • Invoice Reporting at Drug Level
  • Reject Reports at Claim Level (if provided)
  • Payment Reports at NDC or Claim Level
  • Write-Off Reports for Non-Collectables
  • Monthly or Quarterly Payments

Medical Rebate Administration


ProCare Rx designed our medical rebate administration services to reduce costs for medical drugs typically administered in a hospital or healthcare setting by a healthcare professional. We work with risk bearing entities by providing manufacturer approved medical policies, submission processes and rebate opportunities for select high-cost medical drugs where rebates are available. Using our program, we provide a better opportunity to collect rebates on medical drugs being dispensed by healthcare facility providers for on-site administration of the product.


We offer:

  • Standardized Claim Format
  • Private Label Medical Policies
  • J-Code Based Billing (No NDC Conversion)
  • Data Scrubbing Services to Reduce Rejects
  • Monthly or Quarterly Submissions
  • Invoice Reporting at Drug Level (if available)
  • Payment Reports at Claim Level
  • Write-Off Reports for Non-Collectables
  • Physician Analysis Reports
  • Quarterly Payments
A variety of pills and capsules on a white surface

Pharmacy Rebate Administration

ProCare Rx’s broad-based pharmacy rebate administration services fit your needs and financial goals. Whether a PBM, TPA, employer group or other health care entity, our offerings are flexible and transparent, providing recommendations to enhance and maximize rebates offered by manufacturers for branded pharmaceuticals, devices, and biosimilars.

  • Direct, Indirect & Hybrid Program Models
  • Formulary Analysis & Grandfathering
  • Transparent Reporting as Allowed
  • NDC Level Tier Files by Formulary
  • Data Scrubbing Services to Reduce Rejects
  • Response Files to Maximize Rebates
  • Monthly or Quarterly Submissions
  • Invoice Reporting at Drug Level
  • Reject Reports at Claim Level (if provided)
  • Payment Reports at NDC or Claim Level
  • Write-Off Reports for Non-Collectables
  • Monthly or Quarterly Payments

Medical Rebate Administration

ProCare Rx designed our medical rebate administration services to reduce costs for medical drugs typically administered in a hospital or healthcare setting by a healthcare professional. We work with risk bearing entities by providing manufacturer approved medical policies, submission processes and rebate opportunities for select high-cost medical drugs where rebates are available. Using our program, we provide a better opportunity to collect rebates on medical drugs being dispensed by healthcare facility providers for on-site administration of the product.


We offer:

  • Standardized Claim Format
  • Private Label Medical Policies
  • J-Code Based Billing (No NDC Conversion)
  • Data Scrubbing Services to Reduce Rejects
  • Monthly or Quarterly Submissions
  • Invoice Reporting at Drug Level (if available)
  • Payment Reports at Claim Level
  • Write-Off Reports for Non-Collectables
  • Physician Analysis Reports
  • Quarterly Payments
A stethoscope is laying on a piece of paper next to a pen


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