Kalderos FAQ

Who should I reach out to if I have questions about Kalderos tools and solutions?

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You can access our Help Center 24/7 for assistance in using the Kalderos Platform of Tools and Solutions. If you need additional help, we provide comprehensive Technical and User Support via phone at 844-930-2322 and email via support@kalderos.com, Monday through Friday from 8am CST to 8pm CST. During non-business hours we also provide limited phone and email User Support to walk you through using the Kalderos Platform of Tools and Solutions. If you have a technical issue and we are unable to assist you during this time, we will report your request to our Support team and someone will be able to follow up with you during normal business hours.

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Who is Kalderos?

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Kalderos is a technology company focused on building trust, transparency and equity across the healthcare system. We work with all stakeholders - providers, payers, manufacturers and patients - to ensure the right discount to the right party on the right transaction℠.

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What does Kalderos do?

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Kalderos provides unifying technologies that bring transparency, trust and equity to the entire healthcare community. Our first-of-its-kind Drug Discount Management solution ensures that drug discount programs work on behalf of patients.

Who does Kalderos work with?

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Kalderos is proud to partner with manufacturers, payers, providers and others, including government agencies, to ensure drug discount programs work as intended.

What problems does Kalderos solve?

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We are on a mission to solve systemic problems of the healthcare system, leading off with noncompliance in drug discount programs. This noncompliance totaled nearly $8.5 billion in 2018.

What is the Drug Discount Management platform?

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After years of observing noncompliance in drug discount programs, Kalderos is launching the Drug Discount Management platform to establish the infrastructure that allows discounts to be validated and paid accurately the first time. The Drug Discount Management platform is the infrastructure that all our products are built on to protect the long-term viability of drug discount programs and to ensure that patients can afford the medications they need.

What security protocols does Kalderos’ Drug Discount Management platform use?

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For more information, click below to download a detailed document.

Read information security overview

How do I know if a manufacturer uses Kalderos’ Drug Discount Management platform?

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Kalderos maintains a list of products for which Kalderos is the 340B discount effectuator. Please follow the link below to see the list.

See product list

What does Kalderos do to address privacy/HIPAA concerns?

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For more information, click "Learn More" below to download a detailed document.

Read additional HIPAA FAQ

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What are the Kalderos tools available to manufacturers?

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Kalderos currently offers two tools for manufacturers. The first, Verify, is part of the 340B Pay solution, and is a secure and intuitive tool designed to enable manufacturers to work with thousands of providers to facilitate the exchange of drug discounts on a single platform. The second, Review, is an easy-to-use tool that allows manufacturers to work with 340B covered entities in “good faith” to validate suspected duplicate discounts.

Kalderos for drug manufacturers

What are the benefits of a manufacturer choosing Kalderos?

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Kalderos delivers a multifaceted, collaborative approach to drug discount effectuation for manufacturers. The “Verify” and “Review” tools include a monitoring control to identify past instances of noncompliance and a preventative control to stop revenue leakage now and in the future, ensuring the right discount to the right party on the right transaction®

Can Kalderos interface with contract pharmacies?

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Yes, Kalderos can support a covered entity’s contract pharmacy relationship(s). For drugs dispensed at contract pharmacies, through 340B Pay, the 340B discount will be realized in the form of a rebate after compliance is confirmed.

What is the justification for permissibility of 340B rebates?

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The Pharmaceutical Pricing Agreement (PPA) that is signed by manufacturers of covered outpatient drugs participating in the 340B program (and MDRP) does not prohibit rebates or mandate any mechanism for ensuring that 340B covered entities do not pay more than the statutory 340B ceiling price. As such, the legal status quo is that rebates are permissible as a mechanism to achieve appropriate prices for covered drugs purchased by covered entities under 340B. Furthermore, HRSA's own guidance supports the conclusion that the status quo permits use of the rebate mechanism. See e.g., Notice Regarding Section 602 of the Veterans Healthcare Act of 1992 - Rebate Option, Health Resources and Services Administration, 63 Fed. Reg. 35239 (June 29, 2998). Under that guidance, voluntary rebate agreements with covered entities that provide at least the minimum statutory discount and do not contain requirements inconsistent with section 340B and published program guidelines are considered consistent with the section 340B rebate program. Id at 35240. Under this guidance, rebates are currently in use (with the Secretary's approval) by State AIDS Drug Assistance Programs (ADAPs).

How do you ensure the solution meets the needs of all stakeholders in the 340B ecosystem?

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Kalderos has actively engaged representatives from all facets of the 340B ecosystem. Please see the blog posts below outlining our efforts to engage all stakeholders in our platform pilots.

How do the Kalderos tools integrate with our current systems, either revenue management, managed services, or both?

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Kalderos can interface with your existing systems/partners to ensure seamless and compliant transfer of data in accordance with our security and control environment. Please see the illustrations below for additional information.

What are the contracting implications of partnering with Kalderos?

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Kalderos does not require any updated contract terms with any of your existing partners. Updates to any existing contracts remain at the discretion of you, the manufacturer.

Can Kalderos actively support 340B price restatements?

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Kalderos can provide full visibility into the 340B discount extended by a participating drug manufacturer to a covered entity. Kalderos maintains up to date, quarterly based pricing enabling all parties to have transparency for determining accurate pricing based on changes to a previously calculated 340B price.

How can we ensure compliance with security and control protocols?

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Please see Kalderos’ Information Security overview for more information on the security and controls environment in place to ensure compliance.

Read information security overview

How can we learn more about Kalderos’ offerings?

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Kalderos maintains a large library of resources related to our Drug Discount Management platform and our solutions.

Visit library

How do we get in touch with a representative from Kalderos?

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Kalderos has a team of experts available to assist all stakeholders. They can be reached at support@kalderos.com.

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Please follow the link below to take a short survey and let us know how we can improve our FAQ to better answer your questions.

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What are the Kalderos tools available to providers?

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Kalderos currently offers two tools for providers. The first, Request, is part of the 340B Pay solution, and is a secure and intuitive tool designed to enable providers to request compliant drug discounts at the point of sale. The second, Review, is an easy-to-use tool that allows manufacturers to work with 340B covered entities in “good faith” to validate suspected duplicate discounts.

Kalderos for providers

What benefits will covered entities realize by being able to decide between the upfront discount or the receipt of the rebate directly?

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Covered entities now have an option to determine which process is best for them. For those covered entities that wish to use the current model of inventory replenishment, they will need to participate in using Review for the good faith inquiry process. At their contract pharmacies, covered entities will see a decrease in resources to maintain oversight, simplification of their auditable records and no impact on cash flow. Uninsured patients will be able to receive their discounts at the contract pharmacy.

How will partnering with Kalderos impact the relationship I have with my contract pharmacies and 340B Administrators (TPAs)?

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Kalderos’ program will allow the capture and processing of all prescription transactions from the covered entity’s pharmacy network. Kalderos places no restrictions on the 340B network of contract pharmacies a covered entity has. 340B administrators will still apply the covered entity’s eligibility to the transactions. Contract pharmacies will receive a negotiated fee for their services. 340B Administrators (TPAs) will continue to apply the covered entity eligibility rules to the transactions as they have done in the past. With 340B Pay, instead of tracking the inventory and ordering through the wholesaler, they will send the eligible claims with the units dispensed to Kalderos. TPAs will be paid for their services by the covered entity based on their contractual agreement

What is the justification for permissibility of rebates?

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Will we need to change our 340B Administrator to provide Kalderos with the needed information?

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Kalderos has created a platform that can accept the minimum amount of information from the covered entity, the pharmacy or the 340B Administrator. You will not be asked to switch your vendor.

What are the contracting requirements for covered entities to ensure receipt of the appropriate discount from the manufacturer?

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Covered entities will need to enter into an agreement with the manufacturer and a third-party payment platform, allowing the rebate from the manufacturer to be electronically deposited into their bank account. The contracting process is done within the Kalderos platform.

If a mistake has been found in any of the rebate payments, how will adjustments be made?

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Kalderos’ mission is to ensure the right discount to the right party on the right transaction®. This includes ensuring that a “post-audit” mechanism is in place to validate that not only was a duplicate discount not paid, but that the appropriate rebate was paid. Kalderos will work with manufacturers and covered entities to correct any discrepancies found within the platform.

Control & security environment

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Please see Kalderos’ Information Security overview for more information on the security and controls environment in place to ensure compliance.

Read information security overview

How will Kalderos protect the patient’s private information?

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Kalderos takes the protection of sensitive information very seriously. Please see the below FAQ related to the measures that Kalderos takes to protect all health information.

Read HIPAA FAQ

Does Kalderos require a business associates agreement?

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No. Kalderos works with stakeholders throughout the pharmaceutical supply chain on behalf of drug manufacturers that provide the 340B discount. Healthcare providers that are ‘covered entities’ under HIPAA can disclose information covered by HIPAA consistent with HIPAA for their own payment purposes without a BAA as part of their payment activities, among other purposes. See 45 C.F.R sec 164.501.

How can we learn more about Kalderos’ offerings?

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Kalderos maintains a large library of resources related to our Drug Discount Management platform and our solutions

Visit library

How do we get in touch with a representative from Kalderos to learn more?

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Kalderos has a team of experts available to assist all stakeholders. They can be reached at support@kalderos.com

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Please follow the link below to take a short survey and let us know how we can improve our FAQ to better answer your questions.

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What is the 340B Pay?

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Kalderos 340B Pay is a modern, cloud-based platform solution that enables covered entities to request rebates on eligible 340B contract pharmacy dispenses and manufacturers to pay them through a third party payment partner. This reduces inventory hassles and compliance concerns for covered entities and their contract pharmacy partners, gives covered entities more control over their 340B dollars and may have a positive impact on covered entity cash flow. Through the exchange of claims level data on contract pharmacy dispenses, covered entities and manufacturers can work together to prevent 99% of duplicate discounts before they happen.

Learn more about 340B Pay

How does the Kalderos 340B rebate model work?

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In the 340B rebate model operationalized at contract pharmacies, a contract pharmacy dispenses a drug to a patient from the contract pharmacy’s own inventory, collecting both the patient’s copayment and the reimbursement from the payer. The contract pharmacy then works with the TPA and the covered entity to verify if the patient is eligible for a 340B drug. If so, the covered entity submits a rebate request for the units dispensed. This request is submitted to the manufacturer via the Kalderos platform. The manufacturer validates the eligibility of the claim and (via a third party payment partner) pays the rebate to the covered entity within 24 days on average. The covered entity then pays any contractually agreed upon fees to their contract pharmacy and TPA.

Who can enroll in 340B Pay?

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Any manufacturer can sign up for 340B Pay, which works best when integrated with Kalderos’ Discount Monitoring solution for holistic Drug Discount Management. Any covered entity can also enroll in 340B Pay at any time, but will only be able to request rebates on contract pharmacy dispenses for NDCs that are already on the platform. When a new NDC is added to the platform, covered entities that utilize this NDC will be promptly notified. For covered entities, enrolling in 340B Pay is free.

How will 340B Pay impact covered entities?

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Covered entities experience changes to their workflows on specific NDCs when dispensed at contract pharmacies. On these prescriptions, the contract pharmacy will dispense from their own inventory, and the covered entity will submit a rebate request directly to the manufacturer for that individual dispense. As the rebate model is operationalized more broadly, covered entities experience reduced inventory hassles, faster payments on contract pharmacy dispenses, increased annual cash flow and enhanced control over their 340B program and 340B dollars.

How does 340B Pay handle disputes between stakeholders?

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340B Pay is designed to enable manufacturers and covered entities to work together more effectively. However, disagreements between parties may still occur. If a provider believes that a rebate has been failed, adjusted or reversed inappropriately, the Kalderos 340B Pay Dispute Resolution Program will assist them in elevating their concerns.

How will 340B Pay impact contract pharmacies?

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For contract pharmacies, the rebate model integrates more seamlessly into their current workflow for all prescriptions. Due to simplified inventory management and financial practices, contract pharmacies see reduced workload on 340B Pay eligible dispenses. As the rebate model is operationalized more broadly, covered entities may be able to negotiate lower fees with contract pharmacies without impacting contract pharmacy profitability.

What does 340B Pay and the rebate model mean for the 340B program as a whole?

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340B Pay makes it easy to exchange complete claims level data on contract pharmacy dispenses, empowering all stakeholders with more data, more visibility and more transparency to ensure accurate payments to the correct party. As a platform solution that leverages a central data hub, 340B Pay builds trust and confidence between stakeholders, enabling everyone to work together for the good of patients.

Where can I find out more?

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For a deep dive into the operational impact and stakeholder benefits of the 340B rebate model, download our whitepaper, The Kalderos 340B rebate model in action: Ensuring a thriving and sustainable 340B program. Or, explore our website product pages to learn more about the features and benefits of the 340B Pay solution (and its associated tools, Request and Verify). Have more questions, or ready to get started? For technical assistance, contact customer support. For general covered entity support, contact our customer success team. Or, if you’re a manufacturer and want to learn more about how 340B Pay can work for you, reach out to our sales team.

Download the whitepaper

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