Users will submit 340B claims data for separately payable drug administrations and outpatient drug administrations. Separately payable drug administrations are products that have been physician administered to a patient and are reimbursed at the procedure code level for the specific administered drug. Outpatient drug administrations generally include drugs that are used as part of an outpatient procedure. These are included at a bundled rate (e.g. APG or negotiated case rate with a payer) and are not separately payable.
Before You Begin
You must be a registered user for the entity
You must have access to a medical claims file containing the required medical claims data, listed on the Data Template: Medical Claims Data
Steps
Uploading a Medical Claims File to Beacon
Navigate to the Claims module from the side panel menu and select Medical Submissions from the dropdown menu.
Click Attach, to add one or more files for submission.
Select the appropriate column mapping template from the dropdown. If no template exists, create a new one before proceeding.
Under the Column Mappings tab, correct any field mapping errors that may have occurred during column mapping, indicated in the column map. If a formatting issue is detected, Beacon will display an error alert. To correct the issue, click the trash icon to remove the incorrect mapping, then assign the correct field header.
Tip: If you have not already created and saved a column mapping template, you will be able to save it after you attach your claims data file. For more information on column mapping and fixing field errors, check out How to Create a Column Map for Data Submissions.
Reviewing and Submitting a Medical Claims File to Beacon
Navigate to the Submission tab to preview your medical claim file. The Submission view will include all the rows that are eligible for submission along with any data validation errors.
If there are no errors and you are ready to submit, proceed to Submission.
If errors are present, please follow the instructions below to resolve them before submitting.
Review highlighted errors, indicated in red, to determine which data elements require updating in order to submit your medical claims data. For more information on using the Submission and Original File views, check out Understanding Data Submissions in Beacon.
Update the source file in your system of record or spreadsheet editor, ensuring that all values meet Beacon's file format and validation standards.
Remove the errant file and upload the updated, corrected file.
Submission: Once all formatting issues are corrected and no red cells appear in the Submission view, and there are no flagged issues identified in the Submission view, you may Save and Submit your claims file.
You will receive a confirmation that allows you to Confirm Submission for back-end validation and the chance to Download Receipt.
The download will produce a submission download of the data submission including a Beacon ID that serves as a unique identifier at the claim level appended by Beacon.
After submission, you can track and review your submissions history, processing status, line-level details, and outcomes under the Medical Claims tab, in the Data Submissions module.
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