Validate every chargeback. Pay only what you owe.
iContracts checks 100% of claim lines against contract, customer and product eligibility and price before a credit is issued. We flag and dispute what’s wrong and let the clean majority through with no friction.
$15B
in chargeback credits validated annually
230M+
claim lines validated annually
99.4%
of claim value passed validation rules with no friction
$21M
in overpayments disputed back to wholesalers
You're validating someone else's data.
Every chargeback is built from a wholesaler’s claim, the membership roster and your contract file. When they drift apart, nothing rejects the claim. At millions of lines a year, manual review is a sample, not a control. A $1 error on one contract price, at 50,000 units a month, can run about $50,000 a month before anyone notices.
How iContracts solves it.
The challenge
How iContracts handles it
Volume makes manual review impossible. Spot checks leave the rest unchecked.
Every line adjudicated automatically, on 100% of volume, against your contracts and master data.
Eligibility keeps moving. Rosters change monthly and retroactively.
Eligibility as of the transaction date, drawn from one master record with effective dating.
Rejecting claims restarts the cycle and strains wholesaler relationships.
Automated repair. Claims are corrected to the right amount instead of being rejected outright.
Not every variance is worth a dispute.
Tolerance controls. You decide what auto-pays, what auto-corrects, and what a person reviews.
Errors run both ways. Understated claims come back later as disputes.
Two-way accuracy. 76% of corrections stopped an overpayment; 24% caught an underpayment before it became a dispute.
Bad chargebacks corrupt AMP and your Medicaid obligations.
Clean chargebacks feed a clean AMP, protecting your government price calculations and the rebate and fee calculations that depend on them.
Plus: EDI 844 claims in and EDI 849 responses out on your cadence, with line-level credit reconciliation and AR tracking.
What we validate
- Contract missing, incorrect or expired
- Customer not covered, expired, or ID missing or invalid
- Product not covered or expired
- NDC missing or invalid
- Contract price missing or wrong
- WAC missing or incorrect
- Extended amount incorrect
- Duplicate or stale claims
The value
- Pay only what you owe. $40M corrected to the right amount annually
- Scale without increasing headcount. 99.4% of claim value goes through with no one needing to touch it.
- Evidence for every decision. Each correction carries a code and an audit trail, so disputes are settled with facts.
- A better channel partner. Correct payments in both directions mean less friction with the wholesalers you depend on.
Managed Services
From daily claim receipt to wholesaler response, we manage every step.
Chargebacks arrive every day, and every exception needs research before it can be paid or disputed. Our chargeback specialists run the full cycle with your team daily, from EDI claim receipt through posting and reconciliation, so your credits don’t depend on one person.
Daily EDI 844 claims run through iContracts validation, with batch audit emails to your team, your EDI provider and your analyst.
Invalid and non-covered customers and duplicate claims worked by your analyst team, following an agreed SOP and cadence.
New or missing customers and prices updated in Core, class of trade assigned and reviewed, and PHS entities and contract pharmacies validated against HRSA.
A daily discrepancy report of remaining errors goes to your team for adjudication and direction.
Chargebacks posted as you direct, with a reconciliation summary report sent to you.
An AR interface file delivered by batch or email, and the EDI 849 reconciliation file sent to your EDI provider for transmission to your wholesalers.
A complete audit trail and downstream analytics on every processed claim.
You stay in control. Nothing is paid or disputed until your team has reviewed the daily discrepancy report and given direction. Your decisions, our execution.
Choose the scope that fits. Add managed services for chargebacks on its own or alongside other modules, such as core contracts and pricing or rebates and fees, and change the mix as you grow.