Claims are submitted through the Data Submissions module, which includes two submission options for pharmacy and medical claims. While specific data requirements may vary, the general process for attaching claims files, applying column mappings, reviewing submission data and Validation Alerts, and submitting claims is consistent across both submission types.
Please review the manufacturers' policies from our resources page for more information on claim submission requirements.
Starting a claims submission
The submission experience begins by selecting the type of claims data you are submitting and attaching one or more claims files. Once files are attached, Rebate Model processes the data and provides tools to help you understand what was identified, what is available for submission, and what may require additional review.
Navigate to Data Submissions from the side panel menu and select the appropriate submission module based on the type of claims data you are submitting.
Click Start a Submission to add one or more files for submission.
Attach your claims file.
Once a file is attached, claims are identified within the file. Before the claims can be submitted, review your column mappings to ensure the data in your file is associated with the appropriate Beacon fields.
Tip: If you're unsure which type of claims to submit, refer to the Claims Data Requirements for guidance on submission requirements and selecting the appropriate module.
Reviewing column mappings
Column mappings determine how the data in your attached file corresponds to the fields required by Beacon. Reviewing these mappings before continuing helps ensure your claims data is interpreted correctly and identifies mapping issues that could prevent rows from being included in the submission.
Select the appropriate column mapping template from the dropdown. Templates are specific to the type and structure of the claims file being submitted. If no appropriate template exists, create a new mapping before proceeding.
Under the Column Mappings tab, review your mappings and correct any errors. If a mapping issue is detected, Beacon will display an alert. Remove the incorrect mapping and assign the appropriate field header before proceeding.
Once your mappings are complete, you can use the new submission views to understand how Beacon has processed your attached files and determine which rows are available for submission.
Tip: If you have not already created and saved a column mapping template, you can save one after attaching your claims file. For more information, see How to Create a Column Map for Data Submissions.
Reviewing a claims file before submission
After your files are attached and column mappings are applied, the new submission experience provides several views for understanding your claims data before you submit it.
Start with the Submission Summary for a high-level view of your submission. Review Original Rows, Selected Rows, and Rows for Submission to understand how many rows were uploaded, selected based on valid NDCs and 340B ID entity access, and ultimately included in the submission. You can also review the covered entities, manufacturers, NDCs, and 340B IDs identified across your attached files.
Each attached file also displays a status to help you determine whether additional review may be needed. If a file contains Validation Alerts or the number of rows available for submission differs from what you expect, use the additional submission views to investigate:
Submission Data shows the claims currently included in your submission and allows you to review and filter the data across your attached files.
Original Files preserves the source-file view and helps you understand which rows were selected, excluded, mapped, or associated with Validation Alerts.
If you identify an error or Validation Alert that needs to be corrected, return to your local source file to make the necessary changes. Remove the affected file from the submission and attach the corrected version so Beacon can process and validate the updated data.
Before continuing, review Rows for Submission to confirm how many claims are available for submission and use the submission checklist to confirm your submission is ready.
Note: Validation Alerts do not prevent a submission from proceeding. Rows containing Validation Alerts will be excluded from the submission, but Valid Rows can still be submitted.
Reviewing and submitting your claims
When you are ready to submit, select Save and Submit to proceed to the Review and Submit screen. This provides a final opportunity to confirm what will be submitted before your claims are processed.
Review the submission checklist to confirm the files, covered entities, manufacturers, and rows included in the submission. You can also download the Submission Data that will be processed and, when applicable, the Validation Alert Rows that will be excluded.
The Submission Data export includes the Claim ID assigned to each claim. The Claim ID remains associated with the claim after submission and can be used to identify and track it across Rebate Model. Then, when you are ready to proceed, select Confirm & Submit.
Tip: For more information on using the Submission Summary and a detailed breakdown of its components, see Claims Submission Overview.
Reviewing your submission receipt
After your submission is confirmed, Beacon processes your claims and displays a Submission Receipt with an immediate summary of the results.
Use the Submission Receipt to review processed claims, Conforming and Non-Conforming results, identified issues and warnings, and claim activity by covered entity.
From the Submission Receipt, you can also download your submitted claims, including the Claim ID assigned to each processed claim, or save a PDF copy of the receipt for your records.
Tip: For more information about interpreting submission metrics, reviewing Conforming and Non-Conforming claims, investigating issues and warnings, and exploring results by covered entity and manufacturer, see Submission Receipt Overview.
What's next
Your submitted claims remain available in Beacon Rebate Model after submission. To continue reviewing, searching, and investigating individual claims, use the applicable Claims Submission module.
For more information, see How to Review Submitted Claims in Beacon Rebate Model.
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:
Chat: Available via in-app messenger
Email: [email protected]
Phone: (878) 788-8907