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MAIN/Who We Help
Who We Help/
WHO WE HELP
  • Pharmaceutical Manufacturers
  • Emerging Biopharma
  • MedTech
  • Financial Institutions
  • Government and Public Health
  • Health Plans
  • Hospital and Health Systems
  • Insurers and Risk
  • Medical Specialty and Patient Advocacy
Pharmaceutical Manufacturers

Harness unparalleled healthcare data, advanced analytics, and cutting-edge technologies with our expertise to accelerate the development and commercialization of innovative medicines, enhancing patient lives.

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Pharmaceutical Manufacturers
Emerging Biopharma (Global page)

Boost your innovation with IQVIA's expert team. Our comprehensive solutions integrate top-tier insights, technology, and expertise to maximize your asset's success in a competitive landscape.

Discover Innovations
MedTech

Navigating MedTech's unique landscape: U.S. decision-making now rests with GPOs, IDNs, and payers, who demand solid value proof through rigorous outcomes analyses and pricing scrutiny.

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MedTech
Financial Institutions

Invest in healthcare with confidence. Stay ahead of pharma and medical device trends using real-time, high-quality data. Access market insights, historical sales, prescription trends, and emerging product information for informed, risk-reduced decisions.

Access Insights
Government and Public Health

Unlock deeper health insights with unmatched data and innovative technology to enhance decision-making for your essential government programs.

Unlock Innovations
Government and Public Health
Health Plans

Accelerate digital innovation with our data-driven expertise in data science and healthcare, optimizing business processes for smarter decisions.

Navigate Health Plans
Hospital and Health Systems

Leverage digital innovation to cut costs, boost efficiency, and elevate patient engagement, all while enhancing quality and health outcomes.

Streamline Decisions
Hospital and Health Systems
Insurers and Risk

Enhance your ability to evaluate and forecast population risk swiftly and accurately by integrating unmatched data, expertise, and technology.

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Medical Specialty and Patient Advocacy

Transform into a data-driven organization that enhances your specialty and showcases value to your members through digital transformation.

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MAIN/Insights
Insights/
U.S. PROGRESS POINT

A curation of IQVIA's best thinking on topics and trends driving change, disruption, and progress in the United States healthcare market.

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BLOGS, WHITE PAPERS & CASE STUDIES

Explore our library of insights, thought leadership, and the latest topics & trends in healthcare.

DISCOVER INSIGHTS

PODCASTS

"Discover the future through our enlightening podcasts available in the United States.

EXPLORE PODCASTS

FACT SHEET

"IQVIA AI Medical Record Review

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BLOG

"Decoding DSCSA: Ensuring Compliance in the Pharmaceutical Supply Chain

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MAIN/Events
Events/
ON-DEMAND WEBINARS

Visit our library of on-demand webinars.

WATCH ON-DEMAND WEBINARS
UPCOMING EVENTS & WEBINARS

View our upcoming events and webinars.

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EVENT

"26th Controlled Substances and State Regulatory Conference

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MAIN/Contact Us
Contact Us/
Contract & Revenue Management

Rebate Operations

Defend your contract integrity by ensuring adherence to incentive terms and conditions. If you are paying invoices at face value today, you may be paying invalid claims.

IQVIA Rebate Operations services compare summary-level invoices to Claim-Level Data (CLD) to analyze eligibility decisions made by payers to identify and prevent revenue leakage. Our on-demand dashboards and analytical reports give you visibility into prescriptions at the provider level, as cross-referenced to our OneKey National Provider Identifier (NPI) registry.

Learn more about how IQVIA uses data science through Connected IntelligenceTM to protect contract integrity. 

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Locations United States Our U.S. Solutions Life Sciences Commercial Solutions Market Access Solutions Contract and Revenue Management Rebate Operations

Stop paying invalid claims by using data science to validate summary invoices against Claim-Level Data (CLD)

In today’s complex healthcare market, payers are faced with the enormous task of evaluating claim eligibility against a multitude of shifting factors. As a result, a certain degree of claim error exists across virtually all pharmaceutical claims. Unfortunately, for manufacturers, the data that support these eligibility decisions is not available due to invoice summarization.

That’s why IQVIA uses Connected Intelligence with Claim-Level Data (CLD) to analyze each prescription in combination with industry-leading data assets such as OneKey, and our Longitudinal Access and Adjudication Data (LAAD) to establish eligibility. CLD analyses are compared to summary requests and disputes are automatically identified with supporting documentation. Your IQVIA team will assist with tracking and dispute management through resolution.

  • Claim receipt and load directly from payers
  • Superior validation technology using CLD and industry-leading data assets
  • Advanced analytics and reporting dashboards
  • Payment services
  • Dispute management support
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Commercial Managed Care

Support for all commercial managed care programs, including contract management, risk identification, validation, payment, and performance measurement. Industry leading validations include:

  • Terms validation
  • Data integrity evaluation and product validation
  • Duplicate claim identification
  • Ineligible pharmacy / plan identification
  • 340B claim identification
  • Formulary compliance analysis
  • Online dashboards and analytical reporting

Medicaid

IQVIA’s Medicaid Solution services manage the collection of state Medicaid invoices and claim level data. Our full list of services include:

  • Claim-level Validation: IQVIA manages the process of collecting State claim-level data and the application of this data to validate summary State Medicaid invoices.
  • Validation Technology IQVIA’s validation technology is specifically designed for Medicaid programs and fine-tuned for effective 340B exclusion identification.
  • Rebate Processing Services We specialize in data integration, validation technology, and dispute recovery for a complete and scalable solution.
  • Subject Matter Expertise Subject matter expertise and superior knowledge of Medicaid program regulations, state policies, and revenue leakage mitigation.
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Medicare

Support for all Medicare programs, including contract management, risk identification, validation, payment, and performance measurement.

  • Part B
  • Part D
  • Inflation Reduction Act rebates

Industry leading validations include:

  • Data integrity evaluation and product validation
  • Duplicate claim identification
  • Ineligible pharmacy / plan identification
  • 340B claim identification
  • Online dashboards and analytical reporting
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TRICARE & IFF

IQVIA can receive and process TRICARE rebate invoices and calculate your Industrial Funding Fee (IFF) administrative fees.

  • TRICARE rebate validation and payment
  • IFF calculation and payment

Payments

IQVIA can send approved payment requests to your financial systems or authorize payments directly to payers by way of a funded bank account in the form of check or Automated Clearing House (ACH) transfer. Supported payment account types include:

  • High control
  • Block funding
  • Zero balance accounts
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