Suite 1300
Salt Lake City, UT 84111
Block-1 3rd Floor, Perungudi Bypass Rd, Perungudi,
Chennai - 600096
MGR Main Rd,
Perungudi, Chennai - 600096
Villupuram,
Tamil Nadu – 605602
Contract & Chargeback Management
Facility Contract Billing and Wholesaler Chargeback Recovery as One Discipline
Facility contract billing across capitated, per-diem, and per-script models — combined with wholesaler chargeback reconciliation and recovery on contract-specific inventory and pricing arrangements. Two workflows that share data; managed as one operation.
98%+
Contract Rate Accuracy
85%+
Chargeback Recovery Rate
INTEGRATED CONTRACT +
Wholesaler Visibility
The Reality
Why contract billing and chargeback recovery belong on the same team?
Most pharmacy operations run facility contract billing and wholesaler chargeback recovery as separate workstreams — different teams, different systems, different reporting cadences. The problem: they share the same underlying data. A facility contract that defines special pricing on a drug class also defines the wholesaler chargeback arrangement on that same inventory. Run them separately and you create reconciliation gaps that quietly drain revenue from both sides of the equation.
Contract Pricing and Wholesaler Chargebacks Are Linked
Facility contracts often specify drug-class pricing tied to wholesaler chargeback arrangements — the facility gets the contract price, and the wholesaler chargebacks the manufacturer for the spread. When the contract billing system and the wholesaler chargeback reconciliation are separate operations, reconciliation gaps appear at every contract-chargeback intersection.
Per-Diem and Per-Script Reconciliation Complexity
Per-diem facility contracts pay a daily rate regardless of actual dispensing volume. Per-script contracts pay per fill. Hybrid arrangements layer both. Reconciling actual dispensing against contracted payment requires accounting infrastructure most pharmacy billing systems don't have.
Wholesaler Chargeback Disputes
Wholesaler chargebacks fail at high rates — manufacturer rejections, contract eligibility disputes, expired contract claims, NDC mismatches. Without active dispute workflow, rejected chargebacks accumulate into substantial cumulative loss that pharmacies absorb as cost-of-doing-business.
Manufacturer Contract Eligibility Changes
Manufacturer chargeback contracts have eligibility rules that change quarterly — covered NDCs shift, eligible customer classes change, contract pricing tiers update. Pharmacies running on stale contract data submit chargebacks that get rejected at high rates.
Cross-System Data Reconciliation
Facility contract billing data lives in one system. Wholesaler chargeback data lives in another. Manufacturer eligibility data lives in a third. Reconciling across three systems manually is operationally impossible at scale — so reconciliation gaps stay invisible until quarterly audits surface them.
340B and Mixed-Use Layering
For closed-door pharmacies serving 340B-eligible covered entities, contract and chargeback workflows must additionally layer 340B vs. non-340B inventory routing. Adding 340B to the contract-chargeback equation increases reconciliation complexity by an order of magnitude.
Our approach
We run contract billing and wholesaler chargeback recovery as one integrated discipline
AnnexMed runs facility contract billing and wholesaler chargeback management as a single integrated operation — with shared contract data infrastructure, unified reconciliation workflow, active chargeback dispute pursuit, and continuous manufacturer eligibility tracking. We don’t manage contract billing in one workstream and chargebacks in another. We manage them as the connected revenue and cost-recovery equation they actually are.
We serve closed-door pharmacies operating across SNFs, ALFs, correctional facilities, hospice agencies, and behavioral health centers — wherever facility contract billing intersects with wholesaler chargeback economics. Our team manages contract billing under capitated, per-diem, per-script, and hybrid models, alongside wholesaler chargeback reconciliation across the major distributors (Cardinal Health, McKesson, AmerisourceBergen) and manufacturer contract eligibility libraries.
Recent client results
A multi-state closed-door pharmacy operating 48 facility contracts and managing $14M in annual wholesaler chargeback volume improved chargeback recovery rate from 58% to 87% within 120 days of go-live, capturing approximately $1.2M in previously-rejected chargebacks. A regional closed-door pharmacy serving SNFs and hospice agencies identified $390,000 in annual contract-chargeback reconciliation gaps where contract billing rate and wholesaler chargeback arrangement had drifted out of alignment. A correctional pharmacy serving 14 county jail contracts reduced manufacturer chargeback rejection rate from 34% to 6% through continuous eligibility tracking and dispute workflow.
85%+
Wholesaler Chargeback Recovery Rate
98%+
Contract Rate Billing
Accuracy
Integrated
Contract + Chargeback
Operation
How we support you
End-to-End integrated contract & chargeback operation
AnnexMed runs contract and chargeback management as a three-stage integrated operation — facility contract billing under multiple reimbursement models, wholesaler chargeback reconciliation and dispute recovery, and continuous manufacturer eligibility tracking — so contract revenue gets billed accurately and cost-recovery chargebacks reach manufacturers at industry-leading recovery rates.
Facility Contract Billing
Per-contract reimbursement execution
- Capitated PMPM/PIPM contract billing
- Per-diem facility rate reconciliation
- Per-script contract rate application
- Hybrid model coordination (capitated + per-script)
- Contract rate tier management
- Multi-facility contract aggregation
Wholesaler Chargebacks
Cost-recovery on contract inventory
- Cardinal Health chargeback reconciliation
- McKesson chargeback reconciliation
- AmerisourceBergen chargeback reconciliation
- Manufacturer contract eligibility verification
- Chargeback dispute workflow
- Aged chargeback historical sweep
Integrated Reconciliation
Contract + chargeback alignment
- Contract-to-chargeback reconciliation
- NDC-level reconciliation across systems
- Manufacturer eligibility quarterly updates
- 340B vs. non-340B inventory routing
- Discrepancy investigation workflow
- Aggregate contract + chargeback reporting
Financial impact
What integrated contract & chargeback operations mean in dollars?
For a closed-door pharmacy with substantial facility contract book and wholesaler chargeback volume, integrated contract and chargeback operations regularly deliver $800K–$3M+ in net annual financial benefit through chargeback recovery improvement, contract billing accuracy, manufacturer eligibility tracking, and cross-system reconciliation gap elimination. Most closed-door pharmacies achieve full ROI on integrated operations within 6–8 months.
Fast Results
Chargeback recovery rate improvement shows within the first 90 days as dispute workflow activates on rejected chargebacks. Contract-chargeback reconciliation gaps surface in the first quarter as integrated reporting reveals drift between billing systems.
Built for Three Major Distributors
Wholesaler chargeback reconciliation supports Cardinal Health, McKesson, and AmerisourceBergen — the three distributors that handle the vast majority of closed-door pharmacy inventory. Multi-distributor pharmacies don’t face vendor coverage gaps.
Improvement Area
Estimated Annual Impact
Wholesaler Chargeback Recovery (58% → 87%)
$400K – $1.5M annually in recovered chargebacks
Aged Chargeback Historical Sweep (first 6 months)
$300K – $1M in one-time historical recovery
Contract Rate Billing Accuracy
$200K – $700K annually in correctly billed contracts
Contract-Chargeback Reconciliation Gap Capture
$150K – $500K annually in drift recovery
Manufacturer Eligibility Tracking
$100K – $400K annually in reduced rejection rate
340B Layered Reconciliation
$120K – $400K annually for 340B-eligible operations
Staffing Cost Reduction / Replacement
$180K – $450K annually
Contract & chargeback performance targets
Performance Metric
Industry Benchmark
AnnexMed Target
Wholesaler Chargeback Recovery Rate
Industry avg: 52–68%
85%+
Contract Rate Billing Accuracy
Industry avg: 84–92%
98%+
Manufacturer Chargeback Rejection Rate
Industry avg: 24–34%
< 8%
Contract-Chargeback Reconciliation
Industry standard: Quarterly catch-up
Continuous
Manufacturer Eligibility Update Cadence
Industry standard: Annual or ad-hoc
Quarterly
Wholesaler Coverage
Most vendors cover 1–2 distributors
Cardinal + McKesson + ABC
Aged Chargeback Recovery
Industry: rarely pursued
70%+ historical sweep
340B Integration
Industry: separate workstream
Standard
Why AnnexMed?
Separate workstreams vs. AnnexMed integrated operation
Contract billing and wholesaler chargebacks share underlying data — but most pharmacy operations manage them separately. Here’s how AnnexMed compares to typical in-house or generalist operations:
In-House / Traditional
AnnexMed Partnership
Operational Integration
Contract billing and chargebacks in separate workstreams
One integrated team managing the connected equation
Chargeback Recovery Rate
52–68% on submitted chargebacks
85%+ with active dispute and eligibility tracking
Manufacturer Eligibility
Annual or ad-hoc update cadence
Quarterly eligibility verification across all manufacturers
Contract-Chargeback Reconciliation
Quarterly catch-up; gaps accumulate
Continuous reconciliation with NDC-level alignment
Wholesaler Coverage
Strong on one distributor; gaps on others
Cardinal Health, McKesson, AmerisourceBergen all covered
Aged Chargeback Treatment
Aged rejections written off
Six-month historical sweep with dispute workflow
340B Layering
Separate 340B reconciliation workstream
Integrated 340B vs. non-340B inventory routing
Cost to Operate
$75K–$110K per FTE for chargeback specialist
30–40% lower with integrated team capacity
Technology
Powered by proprietary AI & analytics
AnnexMed’s technology stack was built for payer-specific operational demands, not adapted from provider-side billing tools. Risk adjustment accuracy, payment integrity, and credentialing compliance each require different data models, workflow logic, and reporting architectures than provider RCM. Our platform reflects that.
AI Agents & Automation
AI Agents & Intelligent Automation deploys autonomous AI agents across the full revenue cycle, automating eligibility verification, prior authorization, claims processing, payment posting, and denial management at hospital scale and speed.
Data & Analytics Platform
Data & Analytics Platform delivers real-time Power BI dashboards built for hospital executive visibility, including system-wide KPIs, service line performance, payer analysis, productivity, financial forecasting, and national benchmarking insights.
Intelligent AR Management
Intelligent AR Management handles A/R follow-up at hospital scale with intelligent worklists prioritized by dollar value and aging, payer-specific follow-up rules, automated escalation for high-value accounts, and full accountability for every claim.
Computer Assisted Coding
Computer Assisted Coding orchestrates hospital coding operation, intelligent chart assignment by service line, TAT tracking with SLA monitoring, quality audits with accuracy scoring, and coder performance management at enterprise scale.
Together, these platforms create a fully instrumented RCM operation where nothing falls through the cracks. You don’t interact with these systems directly, but the results they enable show up directly in your financial performance.
Ready to stop running contract billing and chargebacks as separate workstreams?
Most closed-door pharmacies identify $800K–$2.5M in chargeback recovery, contract accuracy, and reconciliation gap capture in their first assessment. Schedule a no-obligation Contract & Chargeback Audit.
Trusted by 100+ Healthcare Providers | AAPC, AHIMA & AAHAM Certified | SOC 2 Type II | HIPAA Compliant
Payer client outcomes
$15M–$40M
Risk
Adjustment
$18M–$50M
Payment
Integrity
6 Weeks
Credentialing Clearance
$15M–$50M+
Revenue
Impact
Case Studies
See the impact we deliver
Discover how AnnexMed reduces denials, accelerates reimbursements, and strengthens financial performance. Backed by measurable outcomes and proven RCM expertise, we deliver operational excellence, revenue stability, and sustainable growth you can trust.
Client Voices
See how our clients succeed
Proven RCM expertise. Delivered at scale.
For over 20 years, AnnexMed has delivered RCM solutions nationwide, combining expert billing, coding, and AR support to drive measurable results and growth.
- 20+ years of proven healthcare RCM experience
- 1,500+ professionals supporting billing, coding & AR
- 500+ certified coders across multiple specialties
- 99%+ compliance with HIPAA and security standards
- All 50 states served with consistent, scalable operations
