When are claims loaded to my Review account?
Claims are loaded into your Review account on a monthly basis. Currently, Kalderos only reaches out to covered entities on a quarterly basis. However, we recommend covered entities log into their Review account regularly and include the review of claims as part of their internal, self-audit process.
How does Kalderos identify claims to be loaded?
Kalderos collects charge-back data from multiple manufacturers and claims level data from all fifty states. This data includes all Fee-for-Service (FFS) and Managed Medicaid (MCO) claims that have had or will have a Medicaid rebate paid on them. Our proprietary algorithm identifies only those claims which we need your assistance in reviewing.
How long do I have to complete my review?
You have 30 days from when Kalderos initially reaches out to notify you of claims within your Review account.