WHAT’S NEW IN THIS RELEASE
Feature
- Carve-out Fee Field
- Paid Rebate Total Field
- Separate Specialty Retail and Mail Guarantees
- HIV Retail Rebate Toggle
- Device Exclusion Breakout
- Dessicated Thyroid Exclusion Extract
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Carve-out Fee Field
When entering in the incumbent contract information, you now have the ability to enter a Carve-out Fee amount and a Carve-out Fee Basis. Options for the carve-out fee basis are, "Per Claim", "PEPM", "PMPM", and "Lump Sum"
The Carve-out Fees Total will be applied to all of the non-incumbent bidders on the financial summary.
When entering the incumbent rebate information you now have the ability to pass-through a Paid Rebate Total to the financial summary instead of using the calculated rebate total. When entering in the paid rebate total you will also enter the timeframe associated with the paid rebate total. With this information, Ringmaster Rx will automatically adjust the paid rebate total to align with the number of months of data in the analysis.
The RFP questionnaire has been updated to break out the specialty guarantees into separate Specialty Retail and Specialty Mail guarantees. This will allow users to more accurately account for contracts with separate specialty retail and specialty mail guarantees.
The RFP questionnaire has been updated with a new HIV rebate toggle which asks bidders to confirm whether, "HIV claims will be included in the specialty rebate guarantee." If a bidder indicates that HIV claims will not be included in the specialty rebate guarantee then the system will apply the non-specialty guarantee regardless of whether the HIV claim is on the bidder's specialty list.
To capture greater specificity around what devices are excluded from the guarantees, the previous "Devices" exclusion has been broken out into four separate exclusions: "Diabetic Monitoring Devices and Supplies", "Insulin Pumps", "Insulin Syringes and Needles" and "Non-Diabetic Devices and Supplies".
Desiccated Thyroid Exclusion Extract
A new "Desiccated Thyroid Extracts" exclusion has been added to the exclusion lists for both discounts and rebates.
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