RPHI
RPHI – Data & Analytics, Artificial Intelligence
Client Profile
RPHI connects doctors, Pharmacies, and manufacturing companies to ensure every beneficiary benefits from the 340B program while ensuring a win-win situation. RPHI meets program compliance while maximizing 340B savings for the communities they serve.
RPHI Supports the 340B Program, Audit, Claims Processing, and Data Augmentation.
Client Industry
Healthcare
Business Challenges
Previously, RPHI used manual SQL queries to generate reports and program files for each TPA separately. RPHI sought an innovative approach to streamline the labor-intensive process of creating reports, one that would significantly reduce days’ worth of manual effort and human input. For RPHI, the arduous process of tracing and correcting errors within an immense expanse of SQL code was nothing short of daunting.
Solution
- We built a brand-new logbook system with modifications to an existing load to automate the process of adding new TPAs and creating 340b reports.
- The system was a remarkable cost-saving solution, successfully reducing both financial outlay and labor demands.
- Plego created flexible rules to comprehend the new type of file or a third-party administrator (TPA) without further programming.
- Our calculations took care of Dispense, Replenishment, and Audit by accumulating the raw data and reports sent by the TPA into the system.
- In addition, the system collects and analyzes medicine names, codes, prices, and effective dates, incorporating them into the arithmetic operations.
We created a workflow to avoid complexities and designed the categories such as:
- Formats
We designed the prerequisite formats like Excel, XML, and CSV to automate the process - Timeline of data
We developed Batches to keep track of and monitor data for accuracy. - Sender Information
We designed Storage Location with the help of the File path to acquire the accumulations, inventory adjustments, claims, replenishment, and their status (active/inactive), and we created CrossWorks to avoid the complexity of multiple senders sending files from one location. - Templates of files
To expedite the compilation of our report, we selected starting and ending columns in advance. - Information on combinations
Our advanced workflow technology has simplified the complexity of managing TPA, Doctor, Pharmacy and location information – streamlining processes that were once handled manually. - Setting Rules
We built rules and logic with equations from the significant number of columns in logbooks and added the prerequisite input based on the requirement. - Output
Plego created several Columns to accommodate the requirements of many different files. - SSIS Packages
Plego developed different packages based on the requirements, in which we collect data from SharePoint and store it in the RPHI folder before moving on to the database. The data then flows through the entire process, including deploying the tools and generating output, which is then saved to excel files and subsequently shared using SharePoint.