Beacon performs a series of data validations on all 340B pharmacy and medical claims submissions to ensure accuracy, completeness, and compliance with HRSA’s 340B Rebate Model Pilot Program and participating manufacturer policies. These validations occur both before data is ingested (front-end) and after it has successfully entered the platform (back-end).
Tip: More of a visual learner? Check out the Beacon Rebate Model Learning Series: Data Validations for a detailed video explanation on how and why we use validations along with expert commentary.
What are Data Validations?
Data validations are checks Beacon applies to every 340B claim submission to confirm that the data is structurally correct, compliant with program requirements, and suitable for rebate evaluation. These checks help covered entities submit clean, reliable, claims and reduce downstream processing issues and payment delays.
Beacon performs validations in two stages:
Front-end validations – occur before ingestion and focus on data structure, formatting, required fields, and eligibility requirements for submission.
Back-end validations – occur after ingestion and evaluate policy compliance, data consistency, and manufacturer-defined conditions.
Together, these validations help ensure that only accurate and compliant claims proceed to rebate processing.
Front-end Validations
Front-end validations are the first set of checks Beacon performs on pharmacy and medical claim submissions before any data is ingested into the platform. These validations ensure claims include required data fields, meet formatting specifications, and reference eligible entities and products.
Front-end validations take place before Beacon accepts a file for processing, whether claims are submitted through the web application or via the SDK. These validations prevent invalid or incomplete 340B claims from entering the system and ensure that data aligns with HRSA requirements and manufacturer policies governing the 340B Rebate Model Pilot Program.
Front-end validations are designed to:
Confirm the submission includes only 340B-eligible products
Ensure the submitting user is authorized to submit for the covered entity.
Verify data types, formats, and field lengths.
Confirm that all required fields are present.
Only claims that pass all front-end validations proceed to ingestion and subsequent back-end validations.
Tip: For more information on front-end validations, the different types of front-end validations, and how they work, check out Front-end Validations.
Back-end Validations
Back-end validations are the set of checks Beacon performs after a 340B pharmacy or medical claims has been successfully ingested into the platform. These validations evaluate data consistency, program eligibility, and compliance with HRSA guidance and manufacturer policies before claims are approved for rebate consideration.
Back-end validations occur after a claim submission passes all front-end validations and is ingested into Beacon. At this stage, Beacon evaluates the claim against regulatory, policy, and eligibility requirements that cannot be fully assessed before ingestion.
These validations help ensure that each claim is not only structurally correct, but also eligible for a 340B rebate.
Back-end validations are designed to:
Verify submitted data values are valid and active (e.g., NPIs, NDCs, Provider IDs).
Enforce HRSA 340B program requirements, including eligibility, timeliness, and non-duplication requirements.
Ensure alignment with pharmaceutical manufacturer conditions, such as contract pharmacy eligibility, limited distributions networks, and quantity thresholds.
Only claims that pass back-end validations are eligible for rebate payments.
Tip: For more information on back-end validations, the different types of back-end validations, and how they work, check out Back-end Validations.
Data Corrections and Resubmissions
If a claim fails one or more data validations, covered entities may correct incomplete or inaccurate data and resubmit the claim to Beacon. Resubmitted claims are not treated as duplicates, as they were never ingested to begin with, ensuring that corrected data can be reevaluated for rebate eligibility.
All corrections must accurately reflect the original dispense or administration, as submitting claims to Beacon constitutes a request for payment under federal program.
Still have questions?
If you have questions or need additional help, our team is here for you — please feel free to reach out using any of the contact options below:
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Email: [email protected]
Phone: (878) 788-8907