Kalderos Review notifies users when a claim has been removed from their account using notifications on the right hand toolbar.
Below are the most common reasons why claims might be removed from an account.
- Drug sale: In the pharmaceutical industry, prescription drugs are often sold to other drug manufacturers, resulting in a change in ownership. If this happens for a drug that was previously owned by a manufacturer partner using Review, we will remove the claims for that specific drug from all impacted covered entity accounts.
- Customer removal: If a manufacturer is no longer partnering with Kalderos, we will immediately remove their claims from covered entity accounts. This is done to ensure data privacy and eliminate additional work on behalf of covered entity users.
- Data matching error: Healthcare data can sometimes be inconsistent, and this may lead to errors. Infrequently, we may identify an error in the claims sent to a covered entity. Such an error could be due to incorrect contract pharmacy matching, mis-matched NPI/340B ID associations or other circumstances. In these instances, we will remove the mismatched claims as soon as they are identified.
Our primary concern is to ensure data integrity and privacy. We’re committed to only ask you to review claims that pose a significant risk of being a duplicate discount, and will continue to communicate further changes to our process that affect your claim counts.
If you have further questions about a specific removal, please reach out to your Customer Success representative for additional information.