Every state invoice validated, disputed on time, and reconciled.
iContracts runs the full quarterly Medicaid cycle in one place, from invoice intake through validation, disputes, ROSI and PQAS, approval and payment.
Miss the dispute window, and a wrong invoice becomes a final payment.
Every quarter, each state sends its own invoice, in its own format, based on utilization you can’t see at the source. Variances have to be researched and disputed inside a fixed window, or the money is gone.
How iContracts solves it.
The challenge
How iContracts handles it
Every state is different: formats, portals, deadlines, electronic or paper.
State differences as configuration, not institutional memory. Invoices are received, logged and tracked by state and period.
Dispute windows are short and fixed.
Variances found inside the window, then researched, submitted and tracked through to resolution.
You can’t see the scripts behind the invoice.
Invoice tested for consistency, duplication, eligibility and trend against your own data.
The URA used on the invoice may not match what you calculated.
One platform holds both, the URA from Government Pricing and the invoice that used it, so they’re tested against each other.
Prior-quarter adjustments reopen past quarters every quarter.
Full reconciliation of prior-quarter adjustments, credit balances and payment history, with ROSI and PQAS created and supported.
Payment is manual and deadline-bound.
Payment handled: ACH or check prepared and issued, with confirmations and state communications.
What we validate
- NDC validation
- Units validation
- URA validation
- Product eligibility for the period
- Business rule validation
- Trend and variance review
- Dollar and unit reconciliation
- Duplicate and prior-dispute detection
- Supplemental program rules
- Independent QA before approval
The value
- Disputes filed on time, so you’re not paying invoices you should have challenged
- One source of truth for the URA and the invoice
- Every payment carries its reconciliation, exactly what an audit asks for
- No single point of failure, because state rules live in the system, not in one analyst’s inbox
From state invoice to payment, we manage every step.
Medicaid dispute work is specialized, deadline-bound and quarterly, the hardest kind of work for a small team to staff. Our Medicaid specialists run the full cycle with your team every quarter, from invoice intake through disputes and payment, so your rebate payments don’t depend on one person.
How it works
Electronic and paper invoices from every state received, logged, scanned and tracked by state and period.
Invoices validated for NDC, units, URA and product eligibility for the period.
Prior-quarter adjustments, credit balances and payment history reconciled, with trend and variance review.
Variances researched, submitted to the state inside the dispute window and tracked to resolution.
Reconciliation of State Invoice and Prior Quarter Adjustment Statements created and supported, with the documentation an audit will ask for.
Independent QA, then your team reviews the results and approves payment.
ACH or check prepared and issued, with confirmations and state communications handled.
You stay in control. Nothing is paid to a state until your team has reviewed the results and approved payment. Your sign-off, our execution.
Choose the scope that fits. Add managed services for Medicaid rebates on its own or alongside other modules, such as government pricing or state price transparency, and change the mix as you grow.