[webinar] understanding the 2014 coverage gap discount program (cgdp) invoice processing changes
DESCRIPTION
Register to watch the recorded webinar: http://goo.gl/YZ6tRT In January 2014, CMS announced 2014 changes to the Coverage Gap Discount Program (CGDP) related to Negative Invoice Reconciliation and resulting changes to the Quarterly Invoice process. The changes will be in effect for 1Q2014 processing quarter with invoice reports hitting Manufacturers by mid to late April 2014. Quickly reacting to change can cause uncertainty, but with the right awareness, focus, and preparation you can position your organization for a successful transition. This presentation will enable you to better understand these changes, how they will impact your business process, and what you need to consider and evaluate to prepare for these changes. The change overview and impact considerations will offer insights to companies of all stages. What you can expect to learn: - Overview of 2014 CGDP Changes; Negative Invoice Reconciliation and Changes to Quarterly Invoice Process. - How these changes will impact your business process. - How to prepare for these changes.TRANSCRIPT
Register Now
Open and hide your control panel Join audio bull Choose ldquoMic amp Speakersrdquo to use VoIP bull Choose ldquoTelephonerdquo and dial using
the information provided
Submit questions and comments via the Questions panel
Note Todayrsquos presentation is being recorded and will be provided within 48 hours by email or by visiting httpwwwconsultparagoncomwebinars
Your Participation
Paragon is a professional services firm providing a full spectrum of consulting services from advisory through solution design and implementation for tighter alignment between business and IT
Leverages a proprietary set of methodologies and approaches to develop a pragmatic path to reaching business objectives
Provides application architecture and development project management and implementation integration services
Quick Facts
bull 550 Employees
bull Global Clients
bull NJ Headquarters
bull 5 US Offices amp 2 overseas
bull Dual-shore Development capability
bull Privately owned 32-year history
Principal Consultant Paragon Solutions Connect with Me bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
bull Current State - Negative Invoice Reconciliation bull Invoice Reconciliation - Negative Balance Solution
- New Plan Phase 1 - New Plan Phase 2
ndash Resulting Quarterly Invoice Process changes effective 1Q2014
bull What to expect in each phase bull What yoursquoll be required to do in each phase bull How to prepare for each phase bull The Business Process Impact
Are you aware of the CGDP 2014 invoice process changes and how
they will affect your business processes
bull On January 22 2014 CMS announced a ldquonew planrdquo for reconciling the negative invoices
bull New Plan = New Name - Invoice Reconciliation - Negative Balance Solution
bull October 31 2013 reports
were erroneous
bull Reports should be
discarded
bull Reports will not be
reissued
bull Payment should not have
been issued
The new plan for the Negative Balance Solution is a two phased approach
PHASE 1 PHASE 2
Reconciliation of negative invoices accrued between
1Q11 to 4Q13
Long term solution for reconciling on-going negative
invoices 1Q14 and beyond
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Open and hide your control panel Join audio bull Choose ldquoMic amp Speakersrdquo to use VoIP bull Choose ldquoTelephonerdquo and dial using
the information provided
Submit questions and comments via the Questions panel
Note Todayrsquos presentation is being recorded and will be provided within 48 hours by email or by visiting httpwwwconsultparagoncomwebinars
Your Participation
Paragon is a professional services firm providing a full spectrum of consulting services from advisory through solution design and implementation for tighter alignment between business and IT
Leverages a proprietary set of methodologies and approaches to develop a pragmatic path to reaching business objectives
Provides application architecture and development project management and implementation integration services
Quick Facts
bull 550 Employees
bull Global Clients
bull NJ Headquarters
bull 5 US Offices amp 2 overseas
bull Dual-shore Development capability
bull Privately owned 32-year history
Principal Consultant Paragon Solutions Connect with Me bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
bull Current State - Negative Invoice Reconciliation bull Invoice Reconciliation - Negative Balance Solution
- New Plan Phase 1 - New Plan Phase 2
ndash Resulting Quarterly Invoice Process changes effective 1Q2014
bull What to expect in each phase bull What yoursquoll be required to do in each phase bull How to prepare for each phase bull The Business Process Impact
Are you aware of the CGDP 2014 invoice process changes and how
they will affect your business processes
bull On January 22 2014 CMS announced a ldquonew planrdquo for reconciling the negative invoices
bull New Plan = New Name - Invoice Reconciliation - Negative Balance Solution
bull October 31 2013 reports
were erroneous
bull Reports should be
discarded
bull Reports will not be
reissued
bull Payment should not have
been issued
The new plan for the Negative Balance Solution is a two phased approach
PHASE 1 PHASE 2
Reconciliation of negative invoices accrued between
1Q11 to 4Q13
Long term solution for reconciling on-going negative
invoices 1Q14 and beyond
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Paragon is a professional services firm providing a full spectrum of consulting services from advisory through solution design and implementation for tighter alignment between business and IT
Leverages a proprietary set of methodologies and approaches to develop a pragmatic path to reaching business objectives
Provides application architecture and development project management and implementation integration services
Quick Facts
bull 550 Employees
bull Global Clients
bull NJ Headquarters
bull 5 US Offices amp 2 overseas
bull Dual-shore Development capability
bull Privately owned 32-year history
Principal Consultant Paragon Solutions Connect with Me bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
bull Current State - Negative Invoice Reconciliation bull Invoice Reconciliation - Negative Balance Solution
- New Plan Phase 1 - New Plan Phase 2
ndash Resulting Quarterly Invoice Process changes effective 1Q2014
bull What to expect in each phase bull What yoursquoll be required to do in each phase bull How to prepare for each phase bull The Business Process Impact
Are you aware of the CGDP 2014 invoice process changes and how
they will affect your business processes
bull On January 22 2014 CMS announced a ldquonew planrdquo for reconciling the negative invoices
bull New Plan = New Name - Invoice Reconciliation - Negative Balance Solution
bull October 31 2013 reports
were erroneous
bull Reports should be
discarded
bull Reports will not be
reissued
bull Payment should not have
been issued
The new plan for the Negative Balance Solution is a two phased approach
PHASE 1 PHASE 2
Reconciliation of negative invoices accrued between
1Q11 to 4Q13
Long term solution for reconciling on-going negative
invoices 1Q14 and beyond
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Principal Consultant Paragon Solutions Connect with Me bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
bull Current State - Negative Invoice Reconciliation bull Invoice Reconciliation - Negative Balance Solution
- New Plan Phase 1 - New Plan Phase 2
ndash Resulting Quarterly Invoice Process changes effective 1Q2014
bull What to expect in each phase bull What yoursquoll be required to do in each phase bull How to prepare for each phase bull The Business Process Impact
Are you aware of the CGDP 2014 invoice process changes and how
they will affect your business processes
bull On January 22 2014 CMS announced a ldquonew planrdquo for reconciling the negative invoices
bull New Plan = New Name - Invoice Reconciliation - Negative Balance Solution
bull October 31 2013 reports
were erroneous
bull Reports should be
discarded
bull Reports will not be
reissued
bull Payment should not have
been issued
The new plan for the Negative Balance Solution is a two phased approach
PHASE 1 PHASE 2
Reconciliation of negative invoices accrued between
1Q11 to 4Q13
Long term solution for reconciling on-going negative
invoices 1Q14 and beyond
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
bull Current State - Negative Invoice Reconciliation bull Invoice Reconciliation - Negative Balance Solution
- New Plan Phase 1 - New Plan Phase 2
ndash Resulting Quarterly Invoice Process changes effective 1Q2014
bull What to expect in each phase bull What yoursquoll be required to do in each phase bull How to prepare for each phase bull The Business Process Impact
Are you aware of the CGDP 2014 invoice process changes and how
they will affect your business processes
bull On January 22 2014 CMS announced a ldquonew planrdquo for reconciling the negative invoices
bull New Plan = New Name - Invoice Reconciliation - Negative Balance Solution
bull October 31 2013 reports
were erroneous
bull Reports should be
discarded
bull Reports will not be
reissued
bull Payment should not have
been issued
The new plan for the Negative Balance Solution is a two phased approach
PHASE 1 PHASE 2
Reconciliation of negative invoices accrued between
1Q11 to 4Q13
Long term solution for reconciling on-going negative
invoices 1Q14 and beyond
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Are you aware of the CGDP 2014 invoice process changes and how
they will affect your business processes
bull On January 22 2014 CMS announced a ldquonew planrdquo for reconciling the negative invoices
bull New Plan = New Name - Invoice Reconciliation - Negative Balance Solution
bull October 31 2013 reports
were erroneous
bull Reports should be
discarded
bull Reports will not be
reissued
bull Payment should not have
been issued
The new plan for the Negative Balance Solution is a two phased approach
PHASE 1 PHASE 2
Reconciliation of negative invoices accrued between
1Q11 to 4Q13
Long term solution for reconciling on-going negative
invoices 1Q14 and beyond
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
bull On January 22 2014 CMS announced a ldquonew planrdquo for reconciling the negative invoices
bull New Plan = New Name - Invoice Reconciliation - Negative Balance Solution
bull October 31 2013 reports
were erroneous
bull Reports should be
discarded
bull Reports will not be
reissued
bull Payment should not have
been issued
The new plan for the Negative Balance Solution is a two phased approach
PHASE 1 PHASE 2
Reconciliation of negative invoices accrued between
1Q11 to 4Q13
Long term solution for reconciling on-going negative
invoices 1Q14 and beyond
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
The new plan for the Negative Balance Solution is a two phased approach
PHASE 1 PHASE 2
Reconciliation of negative invoices accrued between
1Q11 to 4Q13
Long term solution for reconciling on-going negative
invoices 1Q14 and beyond
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
bull On April 17 2014 the TPA will distribute negative invoice reconciliation reports
bull The reports will be collective and will reconcile negative
invoices accrued from 1Q2011 to 4Q2013 bull These reports will be distributed to all Manufacturers even if
negative invoices did not exist during these qtrs bull EFT payments from Sponsors to Manufacturers are due
within 38 days from distribution of invoices WH
AT
TO
EX
PE
CT
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Track Receipt of Funds Confirm Receipt of Funds
bull Track receipt of EFT funds through AR system
bull Reconcile to Reports bull Summarize variances
bull Generate payment confirmation report bull Confirm receipt or non-receipt of funds for
negative invoice payments bull Note applicable amount on report bull Send payment confirmation report to TPA
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Phase 1
bull Reconciliation of negative invoices accrued between 1Q11 to 4Q13
Phase 2 bull Long term
solution for reconciling on-going negative invoices 1Q14 and beyond
The new plan for the Negative Balance Solution is a two phased approach
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
bull Negative invoice amounts will continue to be included in standard invoice reports
bull As of 1Q14 Negative invoices will be resolved during the invoice quarter in which they are reported
bull Negative invoice balances will not be carried forward bull Sponsors will be required to pay negative invoice amounts
to Manufacturer at the time of the applicable invoice quarter
bull This will all occur within the standard 38 day processing window
bull This will result in changes to the quarterly invoice process WH
AT
TO
EX
PE
CT
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Whatrsquos New bull EFT funds will flow both ways in a given quarter
bull New effective 1Q14 - Negative invoice amount = Sponsor sends funds to Manufacturer via EFT
bull Existing Process - Positive invoice amount = Manufacturer sends funds to Sponsor ndash no change from existing process
bull Sponsors can submit EFT funds to Manufacturer for negative invoices anywhere within the traditional CGDP 38 day payment cycle
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Whatrsquos The Same bull Invoice file formats and layouts bull Timelines and deadlines for receipt and
submission bull Timelines and deadlines for payment to
sponsors and payment confirmation report to the TPA
bull Dispute Process
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Paragon Solutions Inc Proprietary and Confidential
- 17 -
New in
2014
Process positive invoice
payments
Confirm payment of
invoices
Track receipt of negative invoice
payments
Confirm payment or non-payment
of negative invoices
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Implement process to Confirm receipt of funds
Confirm payments received for negative invoices Confirm payments not received for negative
invoices Confirm payments made for positive invoices
Implement Reconciliation Process
Funds expected vs actual funds received Internal tracking vs TPA tracking Summarize amp report variances
Implement AR process to track receipt of funds
Identify amp allocate AR resources Create reports to support tracking Define overall AR process process timeline amp SLA
to track receipt of funds
Implement process to receive funds
Setndashup account to receive funds from Sponsors via EFT
Provide applicable EFT banking information to TPA Ensure AR system is equipped to receive EFT
funds for CGDP payments
Implement process to receive amp translate Negative Balance Reports
Evaluate file formats Determine process andor system changes Implement applicable changes
Applie
s to
Phase 1
amp
Phase 2
Ph
ase 1
On
ly
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
How prepared are you to respond to these changes
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
bullMultiple reports
bullManual Updates
bullConfirming payments in and out
bullAdditional Processing
bullSame 38 day timeframe
bullTracking Funds coming in
bullTracking funds going out
bullPhase 1 amp Phase2Qtrly Invoice Process
bullPhase 2 amp Standard Qtrly Invoice Process
Processing Overlap
EFT Funds Tracking
Payment Confirmation
Reports
Resource amp Time
Constraints
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
1Q14 April May June 7 14 21 28 5 12 19 26 2 9 16 23 30
Phase 1 Negative Invoice Reconciliation
Onetime Negative Invoice Recon Reports Distributed
Receive funds from Plan Sponsor for Negative Invoice Amts
Payment Confirmation Report Due to TPA for Negative Invoice Payments
Phase 2 Quarterly Invoice Process effective 1Q14
Updated EFT File Distributed 425
1Q14 Quarterly Invoices Distributed
1Q14 Quarterly Invoices Received
Invoice Correction Process if applicable
Payments Received for Negative Invoices in 1Q14 Sponsor Manufacturer
1Q14 Invoice Payments Due Manufacturer Sponsor
1Q14 Payment Confirmation Report Due to TPA
Standard Processing Deadlines New 2014 Process Changes for Negative Invoice
430
425
68
613
38 Day Payment Cycle
56 59
417
417 38 Day Payment Cycle 525
530
51
38 Day Payment Cycle 51
68
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Data Management Requirements
Data Receipt Invoice Data Management
Detail Data Management
EFT File Management
Payment Requirements
Maintain EFT banking info for 600+ contracts
38 day processing
deadline
Send EFT payments for 600+
contracts
Reporting Requirements
Payment Confirmation
report
Operational Reports
Financial amp Trend Reports
Retain data for 17 quarters
Negative Balance Solution
Negative Invoice Reconciliation
Report
Maintain EFT info for receipt of
Negative Invoice payments
Receive EFT payments (Negative Invoices)
Confirm receipt of negative invoice
payments
The below figure illustrates the minimum high level requirements Manufacturers should have in place to support the administration amp processing of CGDP payments
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
TPA site
bull httptpadministratorcominternettpansfdocsCatHomeThird20P
arty20Administrator
Final Notice Negative Invoice Process
bull httptpadministratorcominternettpansffilesHPMS_MEMO_Negat
ive_Invoice_Process_Change_FINAL[1]pdf$FIleHPMS_MEMO_N
egative_Invoice_Process_Change_FINAL[1]pdf
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
If we do not get to your question during the webinar we will reach out to you directly with the answer
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Principal Consultant Paragon Solutions bull Email sbermudezconsultparagoncom bull Read my blog bull Connect with me on Linkedin
Paragon Solutions Website
bull Paragon Life Sciences bull Government Pricing amp Revenue Management Practice
Social Media bull httpwwwfacebookcomparagonsolutions bull httpwwwtwittercomconsultparagon bull httpwwwlinkedincomcompanyparagon
Register Now
Register Now