Negotiated-Price Refund Reconciliation (Pharmacy, 835 Files)
Negotiated-Price Refund Reconciliation (Pharmacy, 835 Files) - a deterministic tool in Sophie Well's Medication Access & Pharmacy group.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Inputs and output
- What you enter
- What you get
- Example: each claim matched to its refund in the 835 files: refunded, short, late, missing or paid twice.
How this is calculated
Citation
Medicare Transaction Facilitator 835 companion guide (CMS): CLP01 prescription and fill, CLP03 standard default refund, CLP04 manufacturer payment, CARC 307 with RARCs N907-N911; expected timing from the CMS MTF fact sheet for dispensing entities (April 2026). Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.