RxParadigm is a pharmacy technology solutions company founded by experts in drug-pricing transparency, rebate administration, and 340B compliance. Powered by the Tungsten+PLUS™ platform and a centralized 340B Clearinghouse data management system, RxParadigm delivers transparency, compliance, and operational efficiency across the drug supply chain. The platform is purpose-built to support Medicare Maximum Fair Price (MFP) effectuation and the implementation of rebate-based models, while ensuring the integrity, transparency, and sustainability of the 340B program in an equitable manner for all stakeholders. Tungsten+PLUS™ eliminates duplicate payments, enables efficient and auditable dispute resolution, preserves patient access, and safeguards overall program integrity.
Products and Services Offered:
- Identify and classify 340B-eligible and MFP-impacted transactions using validated, CMS-aligned claims logic
- Serve as a single source of record for receiving and reconciling claims transmitted by CMS at the point of MFP processing
- Provide a “single pane of glass” dashboard to monitor eligibility determinations, reimbursement status, and drug-level restrictions in a centralized, auditable view
- Deliver comprehensive purchasing analytics, including accumulation of eligible purchases across all accounts and validation of accurate billing
- Automate good-faith dispute initiation and management, supported by complete documentation, version control, and end-to-end auditability
- Integrate wholesaler, pharmacy, and Covered Entity data to reconcile utilization and purchasing, improving operational efficiency and reducing administrative burden
- Integrate and automate claims submission to manufacturer-designated third-party service vendors (e.g., ESP, Truzo), with real-time reporting and visibility into submission status and outcomes
- Offer optional forward-inventory purchase management, to mitigate WAC-based purchasing challenges while preserving access and compliance
RxParadigm guarantees:
- A compliance-ready, CMS-aligned operational framework
- Reduced administrative burden and manual reconciliation
- Improved financial accuracy and protection against duplicate discounts
- Full transparency and audit defensibility across MFP and 340B transactions
- Continued patient access and long-term program sustainability
- Enhanced purchasing flexibility and preparedness in the event of 340B rebate program implementation, including improved ability to manage purchasing strategies and cash-flow impacts