SPS Health Pharmacy Rebates:
In-Patient Health SystemsSPS Health qualifies eligible unmanaged In-Patient Pharmacy rebates on behalf of customers by collecting, processing, and submitting claims for formulary management rebate dollars. Our technology-driven and customized approach maximizes these untapped rebate dollars, driving revenue back to the health system and patients.
SPS Health works with hospitals and health systems to ensure that claims submitted are rebate eligible so that rebates are a sustainable new earnings stream, including:
- Validating that hospitals are not already accessing rebates on the claims
- Excluding 340b claims
- Excluding any significant buy-side GPO or DSH discounts
Our program enables hospitals to access rebates and capture untapped claim dollars:
Pharmacy Rebates
For pharmacy benefits (e.g., in-patient pharmacy medications), SPS Health can help hospitals maximize rebates available through their existing formularies or capture more value by updating formularies to favor preferred products when clinically appropriate.
How It Works
Steady-State Process:
- SPS Health receives monthly data feed for pharmacy rebate submission
- SPS Health provides pharmacy rebate payments directly to clients
- SPS Health provides transparent reporting and quarterly business reviews with Client Services team to review the last 90 days of rebate impacts
How It Works
Steady-State Process:
- SPS Health receives monthly data feed for pharmacy rebate submission
- SPS Health provides pharmacy rebate payments directly to clients
- SPS Health provides transparent reporting and quarterly business reviews with Client Services team to review the last 90 days of rebate impacts